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Shahriyari H, Ramezani M, Nilipour Y, Okhovat AA, Kariminejad A, Aghaghazvini L, Fatehi F, Nafissi S. Neutral lipid storage disease with myopathy: clinicopathological and genetic features of nine Iranian patients. Neuromuscul Disord 2024; 35:19-24. [PMID: 38194732 DOI: 10.1016/j.nmd.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/12/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
The rare disorder known as Neutral Lipid Storage Disease with Myopathy presents with a variety of clinical manifestations, including myopathy, cardiac dysfunction, and other organ complications. Early diagnosis is crucial due to the increased risk of cardiomyopathy. We describe the clinical, histopathological, muscle imaging, and genetic findings of nine neutral lipid storage myopathy patients. Proximal weakness and asymmetric involvement may suggest lipid storage myopathy. While skeletal muscle weakness was the main manifestation in our patients, one case presented only with hyperCKemia. Additionally, three patients had fertility issues, two suffered from diabetes mellitus, two had cardiomyopathy, and one had a history of hypothyroidism. Muscle histopathology revealed lipid depositions and rimmed vacuoles, prompting peripheral blood smears to detect Jordan Anomalies. All muscle biopsies and peripheral blood smear showed lipid droplets, rimmed vacuoles, and Jordan anomaly. Identifying PNPLA2 gene mutations is important for diagnosing neutral lipid storage myopathy; our cases showed some novel mutations. This study highlights the importance of early diagnosis and comprehensive evaluation in managing neutral lipid storage myopathy cases.
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Affiliation(s)
- Hamed Shahriyari
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Ramezani
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yalda Nilipour
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Pathology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | - Ali Asghar Okhovat
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Leila Aghaghazvini
- Radiology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Nafissi
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Hadighi P, Faezi ST, Mortazavi SMJ, Rokni M, Aghaghazvini L, Kasaeian A, Nejadhosseinian M, Haerian H, Fateh HR. Evaluation of core decompression outcome in systemic lupus erythematosus with hip osteonecrosis: a retrospective cohort study. Adv Rheumatol 2024; 64:4. [PMID: 38167574 DOI: 10.1186/s42358-023-00345-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. METHODS In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. RESULTS In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphosphonate use (P < 0.02). Of the 23 studied cases, the mean cumulative dose of prednisolone before and after core decompression surgery was 46.41 mg and 14.74 mg respectively. Besides, one case (2.6%) that had a high anti-phospholipid antibodies level during follow-up did not have any radiographic deterioration, and 9 cases (23.1%) had some degrees of radiographic deterioration. CONCLUSIONS The patients group that used bis-phosphonate, had a higher level of satisfaction with joint function after core decompression. Patients with high-level anti-phospholipid antibodies are related to a poor prognosis after core decompression.
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Affiliation(s)
- Pouya Hadighi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Mohammad Javad Mortazavi
- Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rokni
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Immunology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Nejadhosseinian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Haerian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Fateh
- Department of Physical Medicine and Rehabilitation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Nejadhosseinian M, Haerian H, Tabatabaie Nejad M, Sadeghi K, Aghaghazvini L, Alikhani M, Loghman M, Faezi ST. Who is the convict; COVID-19 or corticosteroid? Late onset avascular necrosis of hips after COVID-19. A case report with literature review. Int J Rheum Dis 2023; 26:2069-2072. [PMID: 37088889 DOI: 10.1111/1756-185x.14703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/23/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
AIM Avascular necrosis (AVN) or osteonecrosis is characterized by death of bone tissue due to endothelial damage and vascular abnormality. Coronavirus can induce endothelial damage and abnormal blood clotting, so that COVID-19 is known as a vascular disease. We aim to evaluate the relationship between AVN and COVID-19. CASE Here we present a 39-year old man with severe COVID-19 and corticosteroid consumption who developed late onset AVN of both hips 20 month after COVID-19. CONCLUSION An awareness of the possible osteonecrosis for all physicians dealing with patients with musculoskeletal problems following COVID-19 is necessary.
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Affiliation(s)
- Mohammad Nejadhosseinian
- Joint Reconstruction Research Center, Tehran University of Medical Science, Tehran, Iran
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Haerian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kourosh Sadeghi
- Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Alikhani
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Loghman
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Akbari-Papkiadehi F, Saboor-Yaraghi AA, Farhadi E, Tahmasebi MN, Sharafat Vaziri A, Aghaghazvini L, Asgari M, Poursani S, Mansouri F, Jamshidi A, Mahmoudi M. Effect of curcumin on the expression of NOD2 receptor and pro-inflammatory cytokines in fibroblast-like synoviocytes (FLSs) of rheumatoid arthritis (RA) patients. Adv Rheumatol 2023; 63:27. [PMID: 37370181 DOI: 10.1186/s42358-023-00308-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Previous studies has shown that nucleotide-binding and oligomerization domain-containing protein 2 (NOD2) is expressed in Fibroblast-like synoviocytes (FLSs) of rheumatoid arthritis (RA) patients which is stimulated by muramyl dipeptide (MDP) present in the joint environment and induces inflammation via the NF-κB pathway. Also, other studies have shown that curcumin inhibits proliferation, migration, invasion, and Inflammation and on the other hand increases the apoptosis of RA FLSs. In this study, we aim to evaluate the effect of curcumin, a natural anti-inflammatory micronutrient, on the expression of NOD2 and inflammatory cytokines. METHODS Synovial membranes were collected from ten patients diagnosed with RA and ten individuals with traumatic injuries scheduled for knee surgery. The FLSs were isolated and treated with 40 μM curcumin alone or in combination with 20.3 μM MDP for 24 h. mRNA was extracted, and real-time PCR was performed to quantitatively measure gene expression levels of NOD2, p65, IL-6, TNF-α, and IL-1β. RESULTS The study findings indicate that administering MDP alone can significantly increase the mRNA expression levels of IL-6 and IL-1β in the trauma group and TNF-α in the RA group. Conversely, administering curcumin alone or in combination whit MDP can significantly reduce mRNA expression levels of P65 and IL-6 in FLSs of both groups. Moreover, in FLSs of RA patients, a single curcumin treatment leads to a significant reduction in NOD2 gene expression. CONCLUSION This study provides preliminary in vitro evidence of the potential benefits of curcumin as a nutritional supplement for RA patients. Despite the limitations of the study being an investigation of the FLSs of RA patients, the results demonstrate that curcumin has an anti-inflammatory effect on NOD2 and NF-κB genes. These findings suggest that curcumin could be a promising approach to relieve symptoms of RA.
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Affiliation(s)
- Fereshteh Akbari-Papkiadehi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, P.O. Box: 6446-14155, Tehran, Iran
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Ave., P.O. Box: 1411713137, Tehran, Iran
| | - Ali Akbar Saboor-Yaraghi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, P.O. Box: 6446-14155, Tehran, Iran.
| | - Elham Farhadi
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Ave., P.O. Box: 1411713137, Tehran, Iran
- Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naghi Tahmasebi
- Division of Knee Surgery, Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Sharafat Vaziri
- Division of Knee Surgery, Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Marzieh Asgari
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Ave., P.O. Box: 1411713137, Tehran, Iran
| | - Shiva Poursani
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Ave., P.O. Box: 1411713137, Tehran, Iran
| | - Fatemeh Mansouri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, P.O. Box: 6446-14155, Tehran, Iran
| | - Ahmadreza Jamshidi
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Ave., P.O. Box: 1411713137, Tehran, Iran
| | - Mahdi Mahmoudi
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Ave., P.O. Box: 1411713137, Tehran, Iran.
- Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Lashkari R, Loghman M, Aghaghazvini L, Saffar H, Ziaadini B, Shahriarirad R, Nekooeian M, Nejadhosseinian M, Alikhani M. Atypical Presentation of Amyloidosis in a Female Patient with Muscle Weakness. Case Rep Med 2023; 2023:1553163. [PMID: 37090743 PMCID: PMC10118899 DOI: 10.1155/2023/1553163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 02/26/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Muscle involvement represents a well-recognized but rare manifestation of amyloidosis. Here, we report a 40-year-old female who presented with muscle weakness, musculoskeletal pain, and proteinuria, which was eventually diagnosed as myopathic amyloidosis based on muscle biopsy results. A multidisciplinary approach appears to be the cornerstone of the diagnostic work up for recognizing the unusual amyloid myopathy.
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Affiliation(s)
| | - Maryam Loghman
- Department of Internal Medicine, School of Medicine, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hiva Saffar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bentolhoda Ziaadini
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Shahriarirad
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nekooeian
- Health and System Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nejadhosseinian
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Alikhani
- Department of Internal Medicine, School of Medicine, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Fathi Kazerooni A, Nabil M, Alviri M, Koopaei S, Salahshour F, Assili S, Saligheh Rad H, Aghaghazvini L. Radiomic Analysis of Multi-parametric MR Images (MRI) for Classification of Parotid Tumors. J Biomed Phys Eng 2022; 12:599-610. [PMID: 36569565 PMCID: PMC9759641 DOI: 10.31661/jbpe.v0i0.2007-1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/13/2020] [Indexed: 12/05/2022]
Abstract
Background Characterization of parotid tumors before surgery using multi-parametric magnetic resonance imaging (MRI) scans can support clinical decision making about the best-suited therapeutic strategy for each patient. Objective This study aims to differentiate benign from malignant parotid tumors through radiomics analysis of multi-parametric MR images, incorporating T2-w images with ADC-map and parametric maps generated from Dynamic Contrast Enhanced MRI (DCE-MRI). Material and Methods MRI scans of 31 patients with histopathologically-confirmed parotid gland tumors (23 benign, 8 malignant) were included in this retrospective study. For DCE-MRI, semi-quantitative analysis, Tofts pharmacokinetic (PK) modeling, and five-parameter sigmoid modeling were performed and parametric maps were generated. For each patient, borders of the tumors were delineated on whole tumor slices of T2-w image, ADC-map, and the late-enhancement dynamic series of DCE-MRI, creating regions-of-interest (ROIs). Radiomic analysis was performed for the specified ROIs. Results Among the DCE-MRI-derived parametric maps, wash-in rate (WIR) and PK-derived Ktrans parameters surpassed the accuracy of other parameters based on support vector machine (SVM) classifier. Radiomics analysis of ADC-map outperformed the T2-w and DCE-MRI techniques using the simpler classifier, suggestive of its inherently high sensitivity and specificity. Radiomics analysis of the combination of T2-w image, ADC-map, and DCE-MRI parametric maps resulted in accuracy of 100% with both classifiers with fewer numbers of selected texture features than individual images. Conclusion In conclusion, radiomics analysis is a reliable quantitative approach for discrimination of parotid tumors and can be employed as a computer-aided approach for pre-operative diagnosis and treatment planning of the patients.
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Affiliation(s)
- Anahita Fathi Kazerooni
- PhD, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Mahnaz Nabil
- PhD, Department of Mathematics, Islamic Azad University, Qazvin Branch, Qazvin, Iran
| | - Mohammadreza Alviri
- MSc, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Soheila Koopaei
- MSc, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Faeze Salahshour
- MD, Department of Radiology, Advanced Diagnostic and Invasive Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Assili
- MSc, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Hamidreza Saligheh Rad
- PhD, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
- PhD, Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Iran
| | - Leila Aghaghazvini
- MD, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sharafat Vaziri A, Aghaghazvini L, Jahangiri S, Tahami M, Borazjani R, Tahmasebi MN, Rabie H, Mamaghani HJ, Vosoughi F, Salimi M. Determination of Normal Reference Values for Meniscal Extrusion Using Ultrasonography During the Different Range of Motion: A Pilot, Feasibility Study. J Ultrasound Med 2022; 41:2715-2723. [PMID: 35137975 DOI: 10.1002/jum.15955] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES It is essential to know the normal extrusion measures in order to detect pathological ones. In this study, we aimed to define some normal reference values for meniscal extrusion in the normal knees during different ranges of motion. METHODS The amount of anterior and posterior portion of meniscal extrusion among 21 asymptomatic volunteers (42 knees) were tracked in 0, 45, and 90° of knee flexion using an ultrasound machine. The repeated measures analysis of variance (ANOVA) was used to show the interaction between the amounts of meniscal extrusion and the different degrees of knee flexion. RESULTS The anterior portion of the lateral menisci at full knee extension (0.59 ± 1.40) and the posterior portion of the medial menisci during 90° flexion (3.06 ± 2.36) showed the smallest and the highest mean amount of extrusion, respectively. The normal average amounts of anterior extrusion were 1.12 ± 1.17 and 0.99 ± 1.34 mm for medial and lateral menisci, respectively. The posterior meniscal normal extrusions were significantly increasing in both medial and lateral menisci during the survey (F = 20.250 and 11.298; both P values <.001) as they were measured 2.37 ± 2.16 and 1.53 ± 2.18 mm in order. CONCLUSIONS The medial meniscus can extrude 1.74 ± 1.84 mm normally while this amount was 1.26 ± 1.82 mm for the lateral meniscus. These measures commonly increased with the rising of knee flexion motion. Likewise, the posterior portion showed more extrusion than the anterior portion on both sides. These measures commonly increased with higher knee flexion.
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Affiliation(s)
- Arash Sharafat Vaziri
- Fellowship of Knee, Sport and Reconstruction Surgery, Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Soodeh Jahangiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Tahami
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roham Borazjani
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Naghi Tahmasebi
- Knee, Sport and Reconstruction Surgery, Knee Surgery Fellowship Program, Orthopaedic Surgery Department, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Rabie
- Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fardis Vosoughi
- Fellowship of Knee, Sport and Reconstruction Surgery, Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Salimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Saleh M, Vaezi AA, Sohrabpour AA, Barkhordar M, Aghaghazvini L, Alijani N, Verdi J. Wharton's jelly-mesenchymal stem cells treatment for severe COVID 19 patients: 1-year follow-up. Gene Reports 2022; 29:101691. [PMID: 36373143 PMCID: PMC9635897 DOI: 10.1016/j.genrep.2022.101691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 12/04/2022]
Abstract
Background Recently, attention has been focused on mesenchymal stem cells (MSC) because of their unique ability to suppress inflammation induced by cytokine storms caused by COVID-19. Several patients have been successfully treated in this manner. After one year of treatment with Wharton's jelly-derived MSC injections, this study evaluated the safety and efficacy of injecting MSCs intravenously in patients with COVID-19. Methods This study treated four patients with severe COVID-19 with Wharton's jelly-derived mesenchymal stem cells. In this study, patients were followed up for routine tests, tumor markers, and whole-body imaging (spiral neck CT scan (with contrast), spiral chest CT scan (with & without contrast), and spiral abdominopelvic CT scan (with IV & Oral contrast)) one year after cell therapy. Results The results indicated that lymphocyte; lymph count significantly increased, and neutrophil, ESR, ferritin, and CRP significantly decreased. LDH showed a non-significant decrease (P-value<0.05). One year after the WJ-MSC injection, the tumor markers were normal, and no tumors were observed in patients after one year. Also, the CT scan result was normal. Conclusions In patients, no serious complications were observed after a one-year follow-up. After monitoring the patient via laboratory tests, tumor markers, and whole-body imaging, we concluded that the Wharton jelly-derived mesenchymal stem cells did not cause severe complications, including tumor formation, in severe COVID19 patients within a year. More clinical trials with higher sample sizes need to be performed on cell therapy with Wharton jelly-derived mesenchymal stem cells in the future.
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Affiliation(s)
- Mahshid Saleh
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Vaezi
- Department of internal medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir Ali Sohrabpour
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Barkhordar
- Hematology, Oncology and Stem Cell Transplantation Research Center (HORCSCT), Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Alijani
- Department of lnfectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Verdi
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Kavosi H, Nayebi Rad S, Atef Yekta R, Tamartash Z, Dini M, Javadi Nejad Z, Aghaghazvini L, Javinani A, Mohammadzadegan AM, Fotook Kiaei SZ. Cardiopulmonary predictors of mortality in patients with COVID-19: What are the findings? Arch Cardiovasc Dis 2022; 115:388-396. [PMID: 35752584 PMCID: PMC9174274 DOI: 10.1016/j.acvd.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Since 2019, coronavirus disease 2019 (COVID-19) has been the leading cause of mortality worldwide. AIMS To determine independent predictors of mortality in COVID-19, and identify any associations between pulmonary disease severity and cardiac involvement. METHODS Clinical, laboratory, electrocardiography and computed tomography (CT) imaging data were collected from 389 consecutive patients with COVID-19. Patients were divided into alive and deceased groups. Independent predictors of mortality were identified. Kaplan-Meier analysis was performed, based on patients having a troponin concentration>99th percentile (cardiac injury) and a CT severity score ≥18. RESULTS The mortality rate was 29.3%. Cardiac injury (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.14-4.18; P=0.018), CT score ≥18 (OR 2.24, 95% CI 1.15-4.34; P=0.017), localized ST depression (OR 3.77, 95% CI 1.33-10.67; P=0.012), hemiblocks (OR 3.09, 95% CI 1.47-6.48; P=0.003) and history of leukaemia/lymphoma (OR 3.76, 95% CI 1.37-10.29; P=0.010) were identified as independent predictors of mortality. Additionally, patients with cardiac injury and CT score ≥ 18 were identified to have a significantly shorter survival time (mean 14.21 days, 95% CI 10.45-17.98 days) than all other subgroups. There were no associations between CT severity score and electrocardiogram or cardiac injury in our results. CONCLUSIONS Our findings suggest that using CT imaging and electrocardiogram characteristics together can provide a better means of predicting mortality in patients with COVID-19. We identified cardiac injury, CT score ≥18, presence of left or right hemiblocks on initial electrocardiogram, localized ST depression and history of haematological malignancies as independent predictors of mortality in patients with COVID-19.
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Affiliation(s)
- Hoda Kavosi
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Nayebi Rad
- Students' Scientific Research Centre (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Atef Yekta
- Department of Anaesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Tamartash
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Dini
- Non-Communicable Disease Centre, Ministry of Health and Medical Education, Tehran, Iran
| | - Zahra Javadi Nejad
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Javinani
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
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10
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Ashraf MA, Shokouhi N, Shirali E, Davari-Tanha F, Shirani K, Memar O, Kamalipour A, Azarnoush A, Mabadi A, Ossareh A, Sanginabadi M, Azad TM, Aghaghazvini L, Ghaderkhani S, Poordast T, Pourdast A, Nazemi P. COVID-19, An early investigation from exposure to treatment outcomes in Tehran, Iran. J Res Med Sci 2022; 26:114. [PMID: 35126577 PMCID: PMC8765513 DOI: 10.4103/jrms.jrms_1088_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/30/2020] [Accepted: 05/31/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is a growing need for information regarding the recent coronavirus disease of 2019 (COVID-19). We present a comprehensive report of COVID-19 patients in Iran. MATERIALS AND METHODS One hundred hospitalized patients with COVID-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and postdischarge follow-up were analyzed. RESULTS The median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), and lymphocytopenia (74.2%) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in computed tomography scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom aggravation, 8.6% were readmitted to the hospital, and three patients (4.3%) died. CONCLUSION This report demonstrates a heterogeneous nature of clinical manifestations in patients affected with COVID19. The most common presenting symptoms are nonspecific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom aggravation.
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Affiliation(s)
- Mohammad Ali Ashraf
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasim Shokouhi
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shirali
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Davari-Tanha
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiana Shirani
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omeed Memar
- Academic Dermatology and Skin Cancer Institute, Chicago, IL, USA
| | - Alireza Kamalipour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA, USA.,MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ayein Azarnoush
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Avin Mabadi
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Adele Ossareh
- Department of Statistics, Shahid Beheshti University, Tehran, Iran
| | - Milad Sanginabadi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari Azad
- The National Influenza Centre, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghaderkhani
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alieh Pourdast
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Research Center for HIV/AIDS (IRCHA), Tehran, Iran
| | - Pershang Nazemi
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
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11
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Honarkar Shafie E, Taheri F, Alijani N, Okhovvat AR, Goudarzi R, Borumandnia N, Aghaghazvini L, Rezayat SM, Jamalimoghadamsiahkali S, Hosseinzadeh-Attar MJ. Effect of nanocurcumin supplementation on the severity of symptoms and length of hospital stay in patients with COVID-19: A randomized double-blind placebo-controlled trial. Phytother Res 2022; 36:1013-1022. [PMID: 35023260 DOI: 10.1002/ptr.7374] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/02/2021] [Accepted: 12/27/2021] [Indexed: 12/14/2022]
Abstract
It has been more than a year since the outbreak of COVID-19, and it is still the most critical issue of the healthcare system. Discovering effective strategies to treat infected patients is necessary to decrease the mortality rate. This study aimed to determine the effects of nanocurcumin on the severity of symptoms and length of hospital stay (LOS) in COVID-19 patients. Forty-eight COVID-19 patients were randomly assigned into nanocurcumin (n = 24) and placebo (n = 24) groups receiving 160 mg/day nanocurcumin or placebo capsules for 6 days. Mean differences of O2 saturation were significantly higher in patients who received nanocurcumin supplements (p = 0.02). Also, nanocurcumin treatment significantly reduced the scores of domains 3 and 4 and the total score of Wisconsin Upper Respiratory System Survey (WURSS-24), indicating milder symptoms in the treatment group (p = 0.01, 0.03, and 0.01 respectively). Besides, the LOS in curcumin groups was lower than in the placebo group, although the difference was not statistically significant (6.31 ± 5.26 vs. 8.87 ± 8.12 days; p = 0.416). CBC/differentiate, hs-CRP level and the pulmonary involvement in CT scan were not different between the two groups. As nanocurcumin can be effective in increasing O2 saturation and reducing the severity of symptoms in COVID-19 patients, it could probably be used as a complementary agent to accelerate the recovery of patients.
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Affiliation(s)
- Elaheh Honarkar Shafie
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Taheri
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Alijani
- Department of Infectious Disease, Shariati Hospital, Tehran university of medical sciences, Tehran, Iran
| | | | - Razieh Goudarzi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Borumandnia
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mahdi Rezayat
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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12
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Imani Z, Milan N, Nematian H, Aghaghazvini L, Sedaghat M, Ahadpour Sefidan MB, Mirbagheri A, Nabian MH. Evaluation of Intra-Articular Injection of Bevacizumab on the Prevention of Physeal Bar Formation in Type 4 Salter Harris Model in Rats: A Pilot Study. jost 2021. [DOI: 10.18502/jost.v7i3.8103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: This study was designed to achieve a new method as a preventive treatment for complications of growth plate fractures. In this study, we investigate the effect of intra-articular injection of anti-vascular endothelial growth factor (anti-VEGF) antibody bevacizumab on the repair process of articular cartilage in a type 4 Salter Harris injury model.
Methods: A Salter Harris injury was created on the proximal tibial growth plate of 14 rats by a 1.8 mm drill. The rats were randomly classified into two groups: group LD, administration of high-dose intra-articular injection of bevacizumab (250 μg), and group HD, administration of low-dose intra-articular injection of bevacizumab (50 μg) after injury. The rats were killed 2 months postoperatively and their tibia underwent micro-computed tomography (CT) analysis, histological assessment, and measurement of tibial bone length.
Results: Bony bar formation was observed in 71% of the samples in the high-dose group and in 100% of the low-dose group. Relative increase in physeal cartilage thickness (P = 0.007) and decrease in bony bar formation (P = 0.029) were observed significantly in the high dose group. There was no significant difference in tibia length between the two groups (P = 0.150).
Conclusion: Intra-articular administration of bevacizumab demonstrated positive restorative effects. We suggest this method of treatment due to its potential of improving cartilage repair and capability to be used as a main or adjacent treatment in osteochondral defects.
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13
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Saleh M, Vaezi AA, Aliannejad R, Sohrabpour AA, Kiaei SZF, Shadnoush M, Siavashi V, Aghaghazvini L, Khoundabi B, Abdoli S, Chahardouli B, Seyhoun I, Alijani N, Verdi J. Cell therapy in patients with COVID-19 using Wharton's jelly mesenchymal stem cells: a phase 1 clinical trial. Stem Cell Res Ther 2021; 12:410. [PMID: 34271988 PMCID: PMC8283394 DOI: 10.1186/s13287-021-02483-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/26/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Mesenchymal stem cells (MSCs) have received particular attention because of their ability to modulate the immune system and inhibit inflammation caused by cytokine storms due to SARS-CoV-2. New alternative therapies may reduce mortality rates in patients with COVID19. This study aimed to assess the safety and efficacy of injecting intravenous Wharton's jelly-derived MSCs in patients with COVID-19 as a treatment. METHODS In this study, five patients with severe COVID-19 were treated with Wharton's jelly-derived mesenchymal stem cells (150 × 106 cells per injection). These patients were subject to three intravenous injections 3 days apart, and monitoring was done on days 0, 3, 6, and 14 in routine tests, inflammatory cytokines, and flow cytometry of CD4 and CD8 markers. A lung CT scan was performed on base and days 14 and 28. In addition, IgM and IgG antibodies against SARS-CoV-2 were measured before and after treatment. RESULTS The results showed that IL-10 and SDF-1 increased after cell therapy, but VEGF, TGF-β, IFN-γ, IL-6, and TNFα decreased. Routine hematology tests, myocardial enzyme tests, biochemical tests, and inflammation tests were performed for all patients before and after cell therapy on base and days 3, 6, and 14, which indicated the improvement of test results over time. COVID-19 antibody tests rose in 14 days after WJ-MSC injection. The total score of zonal involvement in both lungs was improved. CONCLUSIONS In patients, the trend of tests was generally improving, and we experienced a reduction in inflammation. No serious complications were observed in patients except the headache in one of them, which was resolved without medication. In this study, we found that patients with severe COVID-19 in the inflammatory phase respond better to cell therapy. More extensive clinical trials should be performed in this regard. TRIAL REGISTRATION IRCT, IRCT20190717044241N2 . Registered April 22, 2020.
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Affiliation(s)
- Mahshid Saleh
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Vaezi
- Department of Internal Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Rasoul Aliannejad
- Department of Pulmonary and Critical Care, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Sohrabpour
- Associate Professor of Gastroenterology and Hepatology, Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahdi Shadnoush
- Department of Clinical Nutrition, Faculty of Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Siavashi
- Department of Clinical Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Leila Aghaghazvini
- Associate Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Batoul Khoundabi
- Iran Helal Institute of Applied-Science and Technology, Research Center for Health Management in Mass Gathering, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
| | - Shahriyar Abdoli
- Pasteur Institute of Iran, National Cell Bank of Iran, Tehran, Iran
| | - Bahram Chahardouli
- Hematology, Oncology, and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Iman Seyhoun
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Neda Alijani
- Department of Infectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Javad Verdi
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Zanjani LO, Shafiee Nia B, Vosoughi F, Mirzaian E, Aghaghazvini L, Arabzadeh A. An unusual case of chest wall glomus tumor presenting with axillary pain: a case report and literature review. Eur J Med Res 2021; 26:49. [PMID: 34034818 PMCID: PMC8146208 DOI: 10.1186/s40001-021-00518-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Glomus tumor is an uncommon soft tissue tumor. However, as the tumor causes significant disability, its early diagnosis is essential. It involves subungual areas of fingers and toes in most cases, and its extra-digital involvement is rarely seen. To the best of the authors' knowledge, only a few chest wall involvement cases have been reported in the literature. CASE PRESENTATION In this paper, we describe a 63-year-old patient with a chest wall glomus tumor presenting with axillary paroxysmal pain and limitation in his shoulder range of motion that had been missed for nearly 15 years. His symptoms were relieved immediately following surgical excision. CONCLUSION Glomus tumors may involve any part of the human body. It is curable with surgical excision in most cases. Therefore, a correct early diagnosis has paramount importance. A high index of suspicion is needed for early diagnosis, especially when the tumor involves uncommon anatomic areas.
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Affiliation(s)
- Leila Oryadi Zanjani
- Orthopedic Surgery Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Shafiee Nia
- Orthopedic Surgery Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Vosoughi
- Joint Reconstruction Research Center, Orthopedic Surgery Department, End of Keshavarz Blvd, Imam Khomeini Hospital, Tehran University of Medical Sciences, 1419733141 Tehran, Iran
| | - Elham Mirzaian
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Aidin Arabzadeh
- Joint Reconstruction Research Center, Orthopedic Surgery Department, End of Keshavarz Blvd, Imam Khomeini Hospital, Tehran University of Medical Sciences, 1419733141 Tehran, Iran
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15
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Shiri I, Sorouri M, Geramifar P, Nazari M, Abdollahi M, Salimi Y, Khosravi B, Askari D, Aghaghazvini L, Hajianfar G, Kasaeian A, Abdollahi H, Arabi H, Rahmim A, Radmard AR, Zaidi H. Machine learning-based prognostic modeling using clinical data and quantitative radiomic features from chest CT images in COVID-19 patients. Comput Biol Med 2021; 132:104304. [PMID: 33691201 PMCID: PMC7925235 DOI: 10.1016/j.compbiomed.2021.104304] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To develop prognostic models for survival (alive or deceased status) prediction of COVID-19 patients using clinical data (demographics and history, laboratory tests, visual scoring by radiologists) and lung/lesion radiomic features extracted from chest CT images. METHODS Overall, 152 patients were enrolled in this study protocol. These were divided into 106 training/validation and 46 test datasets (untouched during training), respectively. Radiomic features were extracted from the segmented lungs and infectious lesions separately from chest CT images. Clinical data, including patients' history and demographics, laboratory tests and radiological scores were also collected. Univariate analysis was first performed (q-value reported after false discovery rate (FDR) correction) to determine the most predictive features among all imaging and clinical data. Prognostic modeling of survival was performed using radiomic features and clinical data, separately or in combination. Maximum relevance minimum redundancy (MRMR) and XGBoost were used for feature selection and classification. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC), sensitivity, specificity, and accuracy were used to assess the prognostic performance of the models on the test datasets. RESULTS For clinical data, cancer comorbidity (q-value < 0.01), consciousness level (q-value < 0.05) and radiological score involved zone (q-value < 0.02) were found to have high correlated features with outcome. Oxygen saturation (AUC = 0.73, q-value < 0.01) and Blood Urea Nitrogen (AUC = 0.72, q-value = 0.72) were identified as high clinical features. For lung radiomic features, SAHGLE (AUC = 0.70) and HGLZE (AUC = 0.67) from GLSZM were identified as most prognostic features. Amongst lesion radiomic features, RLNU from GLRLM (AUC = 0.73), HGLZE from GLSZM (AUC = 0.73) had the highest performance. In multivariate analysis, combining lung, lesion and clinical features was determined to provide the most accurate prognostic model (AUC = 0.95 ± 0.029 (95%CI: 0.95-0.96), accuracy = 0.88 ± 0.046 (95% CI: 0.88-0.89), sensitivity = 0.88 ± 0.066 (95% CI = 0.87-0.9) and specificity = 0.89 ± 0.07 (95% CI = 0.87-0.9)). CONCLUSION Combination of radiomic features and clinical data can effectively predict outcome in COVID-19 patients. The developed model has significant potential for improved management of COVID-19 patients.
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Affiliation(s)
- Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Majid Sorouri
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parham Geramifar
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Nazari
- Department of Biomedical Engineering and Medical Physics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yazdan Salimi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Bardia Khosravi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Dariush Askari
- Department of Radiology Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Hajianfar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran,Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Abdollahi
- Department of Radiologic Sciences and Medical Physics, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Arabi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Arman Rahmim
- Departments of Radiology and Physics, University of British Columbia, Vancouver, BC, Canada,Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland,Geneva University Neurocenter, Geneva University, Geneva, Switzerland,Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands,Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark,Corresponding author. Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, CH-1211, Geneva, Switzerland
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16
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Khosravi B, Aghaghazvini L, Sorouri M, Naybandi Atashi S, Abdollahi M, Mojtabavi H, Khodabakhshi M, Motamedi F, Azizi F, Rajabi Z, Kasaeian A, Sima AR, Davarpanah AH, Radmard AR. Predictive value of initial CT scan for various adverse outcomes in patients with COVID-19 pneumonia. Heart Lung 2021; 50:13-20. [PMID: 33097297 PMCID: PMC7556824 DOI: 10.1016/j.hrtlng.2020.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Chest computed tomography (CT) scan is frequently used in the diagnosis of COVID-19 pneumonia. OBJECTIVES This study investigates the predictive value of CT severity score (CSS) for length-of-stay (LOS) in hospital, initial disease severity, ICU admission, intubation, and mortality. METHODS In this retrospective study, initial CT scans of consecutively admitted patients with COVID-19 pneumonia were reviewed in a tertiary hospital. The association of CSS with the severity of disease upon admission and the final adverse outcomes was assessed using Pearson's correlation test and logistic regression, respectively. RESULTS Total of 121 patients (60±16 years), including 54 women and 67 men, with positive RT-PCR tests were enrolled. We found a significant but weak correlation between CSS and qSOFA, as a measure of disease severity (r: 0.261, p = 0.003). No significant association was demonstrated between CSS and LOS. Patients with CSS>8 had at least three-fold higher risk of ICU admission, intubation, and mortality. CONCLUSIONS CSS in baseline CT scan of patients with COVID-19 pneumonia can predict adverse outcomes and is weakly correlated with initial disease severity.
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Affiliation(s)
- Bardia Khosravi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, North Kargar St., Tehran 14117, Iran
| | - Majid Sorouri
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Naybandi Atashi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, North Kargar St., Tehran 14117, Iran
| | - Mohammad Abdollahi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Helia Mojtabavi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Khodabakhshi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Motamedi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Azizi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeynab Rajabi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir H Davarpanah
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, USA
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, North Kargar St., Tehran 14117, Iran.
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17
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Katal S, Aghaghazvini L, Gholamrezanezhad A. Chest-CT findings of COVID-19 in patients with pre-existing malignancies; a pictorial review. Clin Imaging 2020; 67:121-129. [PMID: 32619773 PMCID: PMC7282750 DOI: 10.1016/j.clinimag.2020.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/13/2020] [Accepted: 06/01/2020] [Indexed: 12/20/2022]
Abstract
As of April 17th, 2020, more than 2,190,010 COVID-19 cases with 147,010 deaths have been recorded worldwide. It has been suggested that a high mortality rate occurs in patients with severe disease and is associated with advanced age and underlying comorbidities, such as malignancies. To the best of our knowledge, no study has been conducted to evaluate chest CT features in patients with malignancy and concomitant COVID-19 infection. In fact, the imaging findings can be challenging and have not yet been fully understood in this setting. In this manuscript, we go over imaging findings in chest CT of patients with COVID-19 and known cancer. With the ongoing COVID-19 pandemic and exponentially increasing incidence throughout the world, in at-risk and vulnerable populations such as patients with known malignancies, infection with SARS-CoV-2 should be included in the differential considerations even with atypical image pictures. Detection of superimposed infection in patients with cancers who present with pulmonary infiltrations warrant correlation with clinical picture, contact history, and RT-PCR confirmatory testing.
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Affiliation(s)
- Sanaz Katal
- Nuclear Medicine PET/CT of Shiraz Kowsar Hospital
| | - Leila Aghaghazvini
- Shariati General hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Gholamrezanezhad
- Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
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18
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Behzad S, Aghaghazvini L, Radmard AR, Gholamrezanezhad A. Extrapulmonary manifestations of COVID-19: Radiologic and clinical overview. Clin Imaging 2020; 66:35-41. [PMID: 32425338 PMCID: PMC7233216 DOI: 10.1016/j.clinimag.2020.05.013] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/04/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
COVID-19 is principally a respiratory illness and pulmonary manifestations constitute main presentations of the disease. According to the reported studies, SARS-CoV-2 infection is not limited to the respiratory system and other organs can be also affected. Renal dysfunction, gastrointestinal complications, liver dysfunction, cardiac manifestations, mediastinal findings, neurological abnormalities, and hematological manifestations are among the reported extrapulmonary features. Considering the broad spectrum of clinical manifestations and the increasing worldwide burden of the disease, there is an urgent need to rapidly scale up the diagnostic capacity to detect COVID-19 and its complications. This paper focuses on the most common extrapulmonary manifestations in patients with COVID-19 pneumonia. Further studies are needed to elaborate and confirm the causative relationship between SARS-CoV-2 and the reported extrapulmonary manifestations of COVID-19.
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Affiliation(s)
- Shima Behzad
- School of Medicine, Azad University, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
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19
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Eslambolchi A, Aghaghazvini L, Gholamrezanezhad A, Kavosi H, Radmard AR. Coronavirus disease 2019 (COVID-19) in patients with systemic autoimmune diseases or vasculitis: radiologic presentation. J Thromb Thrombolysis 2020; 51:339-348. [PMID: 32981005 PMCID: PMC7519703 DOI: 10.1007/s11239-020-02289-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has transformed into a worldwide challenge, since its outbreak in December 2019. Generally, patients with underlying medical conditions are at a higher risk of complications and fatality of pneumonias. Whether patients with systemic autoimmune diseases or vasculitides, are at increased risk for serious complications associated with COVID-19, is not established yet. Computed tomography (CT) has been employed as a diagnostic tool in the evaluation of patients with clinical suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection with a reported sensitivity of higher than reverse transcription polymerase chain reaction (RT-PCR) test. Multifocal bilateral ground-glass opacities (GGOs) with peripheral and posterior distribution and subsequent superimposition of consolidations are considered the main imaging features of the disease in chest CT. However, chest CT images of underlying rheumatologic or autoimmune diseases or vasculitides, such as systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, Behçet disease, and granulomatosis with polyangiitis, especially those with extensive lung involvement can overshadow or obliterate features of COVID-19. In addition, CT findings of such diseases may resemble manifestations of COVID-19 (such as ground glass opacities with or without superimposed consolidation), making the diagnosis of viral infections, more challenging on imaging. Comparing the imaging findings with prior studies (if available) for any interval change is the most helpful approach. Otherwise, the diagnosis of COVID-19 in such patients must be cautiously made according to the clinical context and laboratory results, considering a very high clinical index of suspicion on imaging.
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Affiliation(s)
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences (TUMS), Jalal-e-Al-e-Ahmad Hwy, Tehran, Iran.
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Hoda Kavosi
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences (TUMS), Jalal-e-Al-e-Ahmad Hwy, Tehran, Iran
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20
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Rajabkhah S, Moradi K, Okhovat AA, Van Alfen N, Fathi D, Aghaghazvini L, Ashraf-Ganjouei A, Attarian S, Nafissi S, Fatehi F. Application of muscle ultrasound for the evaluation of patients with amyotrophic lateral sclerosis: An observational cross-sectional study. Muscle Nerve 2020; 62:516-521. [PMID: 32710682 DOI: 10.1002/mus.27036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION We evaluated the association between muscle ultrasound, number of motor units, and clinical parameters, and assessed their utility for distinguishing amyotrophic lateral scleorisis (ALS) patients from healthy individuals. METHODS Three muscle pairs (abductor pollicis brevis, abductor digiti minimi, and tibialis anterior) of 18 ALS patients and 18 controls underwent muscle ultrasound (echointensity and thickness) and assessment of motor unit number index (MUNIX). The clinical and functional status of participants were also assessed. RESULTS Mean age of the patients was 53.8 ± 12.1 years, and score on the ALS Functional Rating Scale-Revised was 38.9 ± 4.1. Echointensity of all tested muscles of ALS participants was significantly higher than that of controls, but there was no significant difference in muscle thickness. Muscle echointensity correlated significantly with clinical and electrophysiological parameters. CONCLUSION Echointensity of muscles was highly associated with clinical scales and MUNIX, confirming its relevance as an ancillary diagnostic test in ALS patients.
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Affiliation(s)
- Sahebeh Rajabkhah
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran
| | - Kamyar Moradi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran
| | - Ali A Okhovat
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nens Van Alfen
- Department of Neurology and Clinical Neurophysiology, Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
| | - Davood Fathi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran.,Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ashraf-Ganjouei
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran
| | - Shahram Attarian
- Neuromuscular Disease and ALS Reference Center, Timone University Hospital Aix-Marseille University, Marseille, France
| | - Shahriar Nafissi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Jalal al Ahmad, Tehran, 1411713135, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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21
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Aghaghazvini L, Tahmasebi MN, Gerami R, Vaziri AS, Rasuli B, Tahami M, Vosoughi F. Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies. J Ultrasound 2020; 23:259-263. [PMID: 32524280 DOI: 10.1007/s40477-020-00488-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/29/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE MRI is now the modality of choice for evaluating articular cartilage. Nevertheless, it has some general drawbacks. Some patients cannot undergo MRI, and in others US scan could be the first examination and cartilage should be evaluated. Ultrasound could be a useful method for detecting trochlear cartilage low-grade lesions. In this study, our goal was to evaluate the efficacy of ultrasonography in detecting these lesions. METHODS All patients referred to our hospital, from July 2018 to July 2019, who were arthroscopic candidates due to sport-related pathologies, underwent ultrasound scan 1 day prior to surgery. Ultrasound assessment was performed by an expert radiologist, with a 13-MHz probe, located transversely proximal to the patella in different degrees of knee flexion to assess trochlear lesion grade and thickness. Arthroscopic examination of all patients was performed by an experienced orthopedic knee surgeon (second author). Sensitivity and specificity of ultrasound were calculated. RESULTS A total of 48 patients were involved in the study with a mean age of 33.2 years (SD: 9.7), between 19 and 51 years of age. Patients were 81% male (39 patients). The sensitivity of ultrasound in grading of trochlear cartilage lesion was 100%, meanwhile its specificity was 88.2% (30 cases had normal cartilage while this figure was 34 in arthroscopy). CONCLUSION Sonography is a low-cost, accessible diagnostic tool with high sensitivity and specificity for early detection of trochlear cartilage pathologies. It can play an important role as an outpatient diagnostic workup in patients with anterior knee pain.
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Affiliation(s)
- Leila Aghaghazvini
- Musculoskeletal Radiology, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naghi Tahmasebi
- Knee, Sport and Reconstruction Surgery, Chairman of Orthopaedic Surgery Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Gerami
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Sharafat Vaziri
- Knee, Sport and Reconstruction Surgery, Department of Orthopaedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Rasuli
- Department of Radiology, Jame-jam Imaging Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Tahami
- Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Jalal Street, Tehran, Iran.
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22
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Aghaghazvini L, Maheronnaghsh R, Soltani A, Rouzrokh P, Chavoshi M. Diagnostic value of shear wave sonoelastography in differentiation of benign from malignant thyroid nodules. Eur J Radiol 2020; 126:108926. [PMID: 32171916 DOI: 10.1016/j.ejrad.2020.108926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To study the efficacy of shear wave elastography (SWE), using both qualitative and quantitative methods, alone and in conjunction with other B-mode features. METHOD 117 patients with 123 nodules were studied both by conventional ultrasonography and SWE. Size, echogenicity, margins, internal calcification (micro- or macro-calcification), composition, shape and color Doppler were assessed for each nodule. The elasticity was assessed both qualitatively and quantitatively. Velocity in the ROI (Region of Interest) was calculated in the stiffest portions for 3 times, and maximum and mean velocity were obtained. ROC curve was analyzed to calculate the best cut-off value of the SWV (Shear Wave Velocity). Univariate logistic regression was used to examine the maximum and mean SWV as discrete variables and the results were compared to key variables of conventional US (Ultrasound) features. RESULT 123 nodules in 117 patients were evaluated. Poor margins, hypoechogenicity, micro-calcification, color Doppler grades III and IV, color map grades IV and V, maximum and minimum velocity had significant correlation with malignancy. The highest Nagelkerke R2 belonged to maximum and mean velocity (R2 = 41.2 and 39 respectively) which propose them as the strongest predictors of malignancy. The best cut-off point for differentiation of benign from malignant nodules was 3.63 m/s for maximum velocity (sensitivity of 90 %, specificity of 78.2 %,) and 3.44 m/s for mean velocity (sensitivity of 90 %, specificity of 76.4 %). CONCLUSION The Real-time SWE is a promising test for the preoperative malignancy risk stratification of patients and maximum velocity has the strongest predictive value for both conventional and elastography variables.
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Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Aleahmed Highway, Tehran, Iran.
| | - Radin Maheronnaghsh
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Aleahmed Highway, Tehran, Iran.
| | - Akbar Soltani
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Shariati Hospital, Aleahmed Highway, Tehran, Iran.
| | - Pouria Rouzrokh
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Shariati Hospital, Aleahmed Highway, Tehran, Iran.
| | - Mohammadreza Chavoshi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Aleahmed Highway, Tehran, Iran.
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23
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Aghaghazvini L, Sharifian H, Yazdani N, Hosseiny M, Kooraki S, Pirouzi P, Ghadiri A, Shakiba M, Kooraki S. Differentiation between benign and malignant thyroid nodules using diffusion-weighted imaging, a 3-T MRI study. Indian J Radiol Imaging 2019; 28:460-464. [PMID: 30662211 PMCID: PMC6319093 DOI: 10.4103/ijri.ijri_488_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Preoperative differentiation of benign from malignant thyroid nodules remains a challenge. Aims: This study assessed the accuracy of diffusion-weighted imaging (DWI) for differentiation between benign and malignant thyroid nodules. Materials and Methods: Preoperative DWI was performed in patients with thyroid nodule by means of a 3-T scanner magnetic resonance imaging (MRI). Images were obtained at b value of 50, 500, and 1000 mm2/s to draw an ADC (apparent diffusion coefficient) map. Findings were compared with postoperative histopathologic results. Receiver operating characteristic curve was used to assess the accuracy of different cutoff points. Results: Forty-one thyroid nodules (26 benign and 15 malignant) were included in this study. None of static MRI parameters such as signal intensity, heterogeneity, and nodule border was useful to discriminate between benign and malignant lesions. Mean ADC value was (1.94 ± 0.54) × 10-3 mm2/s and (0.89 ± 0.29) × 10-3 mm2/s in benign and malignant nodules, respectively (P-value < 0.005). ADC value cutoff of 1 × 10-3 mm2/s yielded an accuracy, sensitivity, and specificity of 93%, 87%, and 96% to discriminate benign and malignant nodules. Conclusion: DWI is highly accurate for discrimination between benign and malignant thyroid nodules.
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Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Yazdani
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Melina Hosseiny
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saina Kooraki
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pirouz Pirouzi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsoon Ghadiri
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiologic Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Kooraki
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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24
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Tahmasebi MN, Aghaghazvini L, Mirkarimi SS, Zehtab MJ, Sheidaie H, Sharafatvaziri A. The Influence of Tibial Tuberosity-trochlear Groove Distance on Development of Patellofemoral Pain Syndrome. Arch Bone Jt Surg 2019; 7:46-51. [PMID: 30805415 PMCID: PMC6372266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/20/2018] [Indexed: 04/05/2023]
Abstract
Background Tibial tuberosity-trochlear groove distance (TT-TGD) measurements play a decisive role in evaluating patellofemoral joint disorders. However, the prevalence of pathological TT-TGD among patients with patellofemoral pain remains unclear. The purpose of this study was to compare the size of TT-TGD among patients with patellofemoral pain syndrome (PFPS) and those with no history of patellofemoral pain. Methods A total of 100 cases participated in this case-control study, among whom 53 individuals were in the case group and 47 individuals were in the control group. TT-TGD was measured by magnetic resonance imaging. Results The mean TT-TGD was 12.3±3.3 in patients and 9.3±2.4 in controls (P<0.001). Among patients, we had totally 34 patients with TT-TG equal or lower than 13 (64.2%) and in 18 patients, it was higher than 13 (34%). Conclusion The mean TT-TGD in patients with PFPS was greater than that in the control group (P=0.001). An increase in TT-TGD can be considered one of the factors behind the development of PFPS.
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Affiliation(s)
- Mohamad N Tahmasebi
- Department of Orthopedic Surgery, Division of Knee Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences,Tehran, iran
- Department of Orthopedic Surgery, Division of Knee Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Research performed at department of radiology and orthopaedics, shariati hospital, tehran university of medical sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Orthopedic Surgery, Division of Knee Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences,Tehran, iran
- Department of Orthopedic Surgery, Division of Knee Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Research performed at department of radiology and orthopaedics, shariati hospital, tehran university of medical sciences, Tehran, Iran
| | - Seyed Shahin Mirkarimi
- Department of Orthopedic Surgery, Division of Knee Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences,Tehran, iran
- Department of Orthopedic Surgery, Division of Knee Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Research performed at department of radiology and orthopaedics, shariati hospital, tehran university of medical sciences, Tehran, Iran
| | - Mohamad J Zehtab
- Department of Orthopedic Surgery, Division of Knee Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences,Tehran, iran
- Department of Orthopedic Surgery, Division of Knee Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Research performed at department of radiology and orthopaedics, shariati hospital, tehran university of medical sciences, Tehran, Iran
| | - Hossein Sheidaie
- Department of Orthopedic Surgery, Division of Knee Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences,Tehran, iran
- Department of Orthopedic Surgery, Division of Knee Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Research performed at department of radiology and orthopaedics, shariati hospital, tehran university of medical sciences, Tehran, Iran
| | - Arash Sharafatvaziri
- Department of Orthopedic Surgery, Division of Knee Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences,Tehran, iran
- Department of Orthopedic Surgery, Division of Knee Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Research performed at department of radiology and orthopaedics, shariati hospital, tehran university of medical sciences, Tehran, Iran
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Aghaghazvini L, Pirouzi P, Sharifian H, Yazdani N, Kooraki S, Ghadiri A, Assadi M. 3T magnetic resonance spectroscopy as a powerful diagnostic modality for assessment of thyroid nodules. Arch Endocrinol Metab 2018; 62:501-505. [PMID: 30462802 PMCID: PMC10118653 DOI: 10.20945/2359-3997000000069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 08/03/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Magnetic resonance spectroscopy (MRS) is a powerful tool for structural studies of chemical compounds and biomolecules and also documented promising findings as a potential imaging technology in thyroid oncology. This prospective study was to ascertain the clinical significance of 3 Tesla MRS in the evaluation of patients with thyroid nodules (TNs) as an ancillary diagnostic technique for thyroid carcinoma. MATERIALS AND METHODS Magnetic resonance spectroscopy at 3T at echo- times (TEs) 136 and 270 ms was carried out on 15 patients with total number of 32 TNs larger than 1 cm3, which all were surgically resected. Choline (Chol) to creatine (Cr) ratio was assessed at 136 and 270 TEs on each nodule and a receiver operating characteristic (ROC) curve was used to determine optimal cut-off point. The findings were compared with histopathology of thyroid specimens. RESULTS There were 23 benign and 9 malignant lesions (7 papillary and 2 follicular thyroid carcinomas). The mean values of Chol/Cr at 136 and 270 TEs was 2.28 ± 3.65 and 1.52 ± 1.67 respectively and the difference between benign and malignant nodules was only significant at 136 TEs. The study revealed that Chol/ Cr ratio cut-off point of 2.5 best correlates with histopathology results (sensitivity = 75%; specificity = 100%; PPV = 100%; NPV= 92%). CONCLUSION This preliminary study showed that 3T magnetic resonance spectroscopy might be a specific modality for the evaluation of thyroid nodules in differentiation of benign from malignant thyroid tissue. However, a larger series would give much greater confidence that this state-of-the-art technology will worth pursuing in clinical practice.
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Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati General Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pirouz Pirouzi
- Advanced Diagnostic and Interventional Radiology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amir Alam General Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Yazdani
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Kooraki
- Advanced Diagnostic and Interventional Radiology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsoon Ghadiri
- Advanced Diagnostic and Interventional Radiology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Assadi
- The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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Abstract
We report a case of a 12-year-old boy with previously shunted congenital hydrocephalus, presenting with a progressive headache, nausea, vomiting, and lethargy. In the brain magnetic resonance imaging, a large cyst was seen in the superior recess of the fourth ventricle extending through the cerebral aqueduct toward the third ventricle. Endoscopic dual fenestration of the cyst was performed successfully using the posterior suboccipital approach through the foramen of Magendie, which resulted in the relief of symptoms without any complications, and the patient was symptom-free in the subsequent follow-up visits for 4 years.
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Affiliation(s)
- Saba Jafarpour
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA.,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Research Centre for Neural Repair, University of Tehran, Tehran, Iran
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27
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Alipour Z, Khatib F, Tabib SM, Javadi H, Jafari E, Aghaghazvini L, Mahmoud-Pashazadeh A, Nabipour I, Assadi M. Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis. Mol Imaging Radionucl Ther 2017; 26:17-23. [PMID: 28291006 PMCID: PMC5350501 DOI: 10.4274/mirt.61587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia. Methods: Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of 99mTc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired. Results: The prevalence of gastroparesis in this study population was determined as 64%. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups. Conclusion: According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Majid Assadi
- Bushehr University of Medical Sciences, The Persian Gulf Nuclear Medicine Research Center, Bushehr, Iran Phone: +098-771-2580169 E-mail:
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Radmard AR, Haghighi S, Hashemi Taheri AP, Mohammadinejad P, Eftekhar Vaghefi R, Naybandi Atashi S, Pak N, Aghaghazvini L, Malekzadeh R. Magnetic Resonance Enterography in 300 Known Cases of Crohn's Disease: An Initial Report from a Referral Center in Iran. Middle East J Dig Dis 2016; 8:273-281. [PMID: 27957290 PMCID: PMC5145294 DOI: 10.15171/mejdd.2016.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Magnetic resonance enterography (MRE) has become the modality of choice in assessment of patients with Crohn’s disease (CD). We aimed to present our experience on 300 patients with CD who underwent MRE during the first 30 months after setting up MRE for the first time in a referral center in Iran. METHODS Patients with a definite diagnosis of CD based on either ileocolonoscopy or histopathological studies were included in the final report and categorized into four phenotypes of inactive, active, stricturing, and penetrating disease. RESULTS This was a case series study on 300 patients with known CD out of 594 referred subjects. The most prevalent phenotype was inactive observed in 162 (54.0%) patients followed by stricturing in 44 (14.7%), active in 40 (13.3%), penetrating in 27(9%), and active on chronic in 27 (9%) cases. The number of referred patients increased from 51 cases in the first 6 months to 165 in the last 6 months. CONCLUSION This study presents the first report on the application of MRE in Iran as superb modality for management of CD. The growing number of referred patients indicates that MRE has been successful in addressing the most critical concerns of clinicians on determining the dominant disease phenotype.
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Affiliation(s)
- Amir Reza Radmard
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Haghighi
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Payam Mohammadinejad
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rana Eftekhar Vaghefi
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Naybandi Atashi
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Autoimmune and Motility Disorders of the Gastro-Intestinal Tract Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Sharifian H, Rasuli B. Primary Hyperparathyroidism Misdiagnosed as Giant Cell Bone Tumor of Maxillary Sinus: A Case Report. Iran J Radiol 2016; 13:e13260. [PMID: 27127572 PMCID: PMC4841893 DOI: 10.5812/iranjradiol.13260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 03/17/2014] [Indexed: 11/25/2022]
Abstract
Primary hyperparathyroidism is an endocrine disorder recognized by hyperfunction of parathyroid gland, which can result in persistent bone absorption and brown tumor. Facial involvement of brown tumor is rare and usually involves the mandible. Giant cell tumor ( GCT) is an expansile osteolytic bone tumor which is very similar in clinical, radiological and histological features to brown tumor. Herein, we present a 35-year-old woman with an 11-month history of gradually swelling of the right maxilla and buccal spaces began during pregnancy two years ago. No other clinical or laboratory problems were detected. Postpartum CT scan demonstrated a lytic expansile multi-septated mass lesion containing enhancing areas, which initially described as GCT of the right maxillary sinus following surgery. Four months later, gradual progressive swelling of the bed of tumor was recurred and revised pathological slices were compatible with GCT. Regarding patient recent paresthesia, repeated laboratory tests were performed. Finally, according to laboratory results (elevation of serum calcium and parathyroid hormone), ultrasonographic findings and radioisotope scan (Sestamibi), probable parathyroid mass and brown tumor of maxilla was diagnosed. Pathology confirmed hyperplasia of right inferior parathyroid gland. Our case was thought-provoking due to its interesting clinical presentation and unusual presentation of brown tumor in parathyroid hyperplasia.
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Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Leila Aghaghazvini, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9123389318, Fax: +98-2166581577, E-mail:
| | - Hashem Sharifian
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Rasuli
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
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Assili S, Fathi Kazerooni A, Aghaghazvini L, Saligheh Rad H, Pirayesh Islamian J. Dynamic Contrast Magnetic Resonance Imaging (DCE-MRI) and Diffusion Weighted MR Imaging (DWI) for Differentiation between Benign and Malignant Salivary Gland Tumors. J Biomed Phys Eng 2015; 5:157-168. [PMID: 26688794 PMCID: PMC4681460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/12/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Salivary gland tumors form nearly 3% of head and neck tumors. Due to their large histological variety and vicinity to facial nerves, pre-operative diagnosis and differentiation of benign and malignant parotid tumors are a major challenge for radiologists. OBJECTIVE The majority of these tumors are benign; however, sometimes they tend to transform into a malignant form. Functional MRI techniques, namely dynamic contrast enhanced (DCE-) MRI and diffusion-weighted MRI (DWI) can indicate the characteristics of tumor tissue. METHODS DCE-MRI analysis is based on the parameters of time intensity curve (TIC) before and after contrast agent injection. This method has the potential to identify the angiogenesis of tumors. DWI analysis is performed according to diffusion of water molecules in a tissue for determination of the cellularity of tumors. CONCLUSION According to the literature, these methods cannot be used individually to differentiate benign from malignant salivary gland tumors. An effective approach could be to combine the aforementioned methods to increase the accuracy of discrimination between different tumor types. The main objective of this study is to explore the application of DCE-MRI and DWI for assessment of salivary gland tumor types.
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Affiliation(s)
- S. Assili
- Medical Physics Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Fathi Kazerooni
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - L. Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - H.R. Saligheh Rad
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - J. Pirayesh Islamian
- Medical Physics Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Aghaghazvini L, Aghaghazvini S. Intraosseous pleomorphic adenoma of the mandible. Iran J Radiol 2015; 12:e6921. [PMID: 25785181 PMCID: PMC4347725 DOI: 10.5812/iranjradiol.6921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/04/2013] [Accepted: 08/07/2013] [Indexed: 11/16/2022]
Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Aghaghazvini
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Salahshour F, Yazdani N, Sharifian H, Kooraki S, Pakravan M, Shakiba M. Dynamic contrast-enhanced MRI for differentiation of major salivary glands neoplasms, a 3-T MRI study. Dentomaxillofac Radiol 2014; 44:20140166. [PMID: 25299931 DOI: 10.1259/dmfr.20140166] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Pre-operative differentiation of salivary gland neoplasms is of great importance. This study was designed to evaluate the use of dynamic contrast-enhanced MRI (DCE-MRI) for differentiation between malignant, Warthin and benign non-Warthin (BNW) neoplasms of major salivary glands. METHODS 46 major salivary gland tumours (SGTs) underwent pre-operative DCE-MRI. Post-surgical histopathological evaluation showed 30 BNW, 6 Warthin and 10 malignant tumours. Time-signal intensity curves (TICs) were categorized as (a) Tpeak >43 s and washout ratio at 180 s (WR180) <4.6%; (b) Tpeak <43 s and WR >22%; (c) Tpeak >43 s and WR180 = 4.6-22.0% RESULTS Accuracy of Tpeak was 98.9% for differentiation between BNW and Warthin tumours, 83.7% between BNW and malignant and 80% between malignant and Warthin tumours. All Warthin tumours showed Tpeak ≤43 s, while one BNW had Tpeak <43 s. A Tpeak <63.5 s differentiated 8/10 (80%) malignant tumours from BNW tumours, whereas 4/30 of BNW tumours had a Tpeak <63.5 s. Two malignant tumours had Tpeak <43 s. WR180 had an accuracy of 100% for differentiation between Warthin and BNW tumours, 87.3% between BNW and malignant, and 93.3% between Warthin and malignant tumours. 29 (96.7%) BNW tumours had a washout <4.60%, while 8 (80%) malignant tumours had a washout >4.60%. All Warthin tumours had a WR180 >22%, while two malignant tumours had a WR180 >22%. 29/30 of BNW tumours demonstrated TIC curve Type A and 1 tumour demonstrated Type C. 6/10 of malignant tumours had TIC Type C, 2 had TIC Type A and 2 Type B. All Warthin tumours were categorized as Type B. CONCLUSIONS This study showed that DCE-MRI could be helpful in pre-operative differentiation of SGTs; especially for discrimination between Warthin and BNW tumours.
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Affiliation(s)
- L Aghaghazvini
- 1 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Sadeghi A, Navabakhsh B, Aghaghazvini L. Thinking outside the cranium. Iran J Neurol 2014; 13:188-90. [PMID: 25422742 PMCID: PMC4240940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 04/29/2014] [Indexed: 12/02/2022]
Affiliation(s)
- Anahita Sadeghi
- Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Behrouz Navabakhsh
- Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Sadeghi A, Rasuli B, Aghaghazvini S. Baló's concentric sclerosis in a girl with interesting presentation. Iran J Neurol 2013; 12:166-8. [PMID: 24250927 PMCID: PMC3829302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 06/09/2013] [Indexed: 11/16/2022]
Abstract
Balo's concentric multiple scleroses (MS) is a rare demyelinating disease and a variant of multiple sclerosis. We report a case with interesting misleading clinical history and typical RI findings of Balo disease. A 19-year-old girl presented with fever and left hemiparesis following dental procedure 15 days ago. On physical examination fever and left limbs forces loss were noted. On CT scan a hypodense mass like area, and in MRI a low T1 and high T2, and flair concentric onion-like partial enhancement of mass in parieto-frontal periventricular white matter was detected. Regarding the findings tumefactive MS, Low grade glioma, lymphoma, and abscess and regarding the history of abscess formation were in differential diagnosis. After therapy and no improvement in clinical condition and MRI findings during 2 months, the patient underwent stereotactic biopsy and tumefactive balo MS was revealed. After 4 months of intensive therapy, the patient was discharged with normal condition.
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Affiliation(s)
- Leila Aghaghazvini
- Assistant Professor, Department of Radiology, School of Medicine AND Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Assistant Professor, Department of Internal Medicine, School of Medicine AND Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Rasuli
- Resident, Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Aghaghazvini
- General Physician, Advanced Diagnostic and Interventional Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Sedighi N, Karami P, Yeganeh O. Skull base aneurysmal bone cyst presented with foramen jugular syndrome and multi-osseous involvement. Iran J Radiol 2012; 9:157-60. [PMID: 23329983 PMCID: PMC3522374 DOI: 10.5812/iranjradiol.7952] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 06/27/2012] [Accepted: 07/16/2012] [Indexed: 11/17/2022]
Abstract
Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.
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Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran, Iran
- Corresponding author: Leila Aghaghazvini, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-2184902387, Fax: +98-2188220029, E-mail:
| | - Nahid Sedighi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran, Iran
- Department of Radiology, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Karami
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Yeganeh
- Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Sharifian H, Mazaher H, Aghaghazvini S. What is your Diagnosis? Iran J Radiol 2011; 8:190-1. [PMID: 23329940 PMCID: PMC3522333 DOI: 10.5812/kmp.iranjradiol.17351065.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Revised: 09/15/2011] [Accepted: 09/19/2011] [Indexed: 11/16/2022]
Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Leila Aghaghazvini, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-2184902387, Fax: +98-2188220029, E-mail:
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Mazaher
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Aghaghazvini
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Karami P, Yeganeh O, Aghaghazvini S. What is your diagnosis? Iran J Radiol 2011; 8:126-8. [PMID: 23329929 PMCID: PMC3522314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- L. Aghaghazvini
- Assistant Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Leila Aghaghazvini, MD, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +9821 8490 2387, Fax: +9821 8822 0029, E-mail:
| | - P. Karami
- Resident of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - O. Yeganeh
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sh. Aghaghazvini
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Aghaghazvini L, Shirani S. Photoclinic. Tumoral calcinosis. Arch Iran Med 2008; 11:227-8. [PMID: 18298307 DOI: 08112/aim.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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