Minerva medica最新文献

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Borderline hyperlipidemia: preventive supplementation with berberine phospholipids to prevent early atherosclerosis evolution. 边缘性高脂血症:预防补充小檗碱磷脂以防止早期动脉粥样硬化演变。
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-04-24 DOI: 10.23736/S0026-4806.25.09637-5
Maria R Cesarone, Shu Hu, Gianni Belcaro, Umberto Cornelli, Beatrice Feragalli, Marcello Corsi, Valeria Scipione, Claudia Scipione, Roberto Cotellese, Morio Hosoi, David Cox, Francesca Coppa Zuccari
{"title":"Borderline hyperlipidemia: preventive supplementation with berberine phospholipids to prevent early atherosclerosis evolution.","authors":"Maria R Cesarone, Shu Hu, Gianni Belcaro, Umberto Cornelli, Beatrice Feragalli, Marcello Corsi, Valeria Scipione, Claudia Scipione, Roberto Cotellese, Morio Hosoi, David Cox, Francesca Coppa Zuccari","doi":"10.23736/S0026-4806.25.09637-5","DOIUrl":"10.23736/S0026-4806.25.09637-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this pilot, efficacy supplement registry was to use a supplementary management with berberine to control hyperlipidemia. Berberine (Berbevis<sup>™</sup> as Sophy<sup>®</sup> tablets) was used to control lipids and to evaluate the early evolution of subclinical atherosclerosis in subjects (otherwise healthy, not using drugs) with borderline hyperlipidemia.</p><p><strong>Methods: </strong>One group used berberine supplementation and a standard management (SM), while a second comparative group used only SM.</p><p><strong>Results: </strong>No side effects were observed during the 6 months of berberine supplementation. No tolerability problems were reported. All subjects completed the registry. The groups resulted comparable. At 3 and 6 months the average total cholesterol was decreased more with berberine (P<0.05) and HDL was significantly improved (P<0.5). Triglycerides decreased in the berberine groups (P<0.05), more than in controls. Oxidative stress was significantly more decreased with berberine supplementation (P<0.05). Homocysteine (within normal values) were significantly decreased at 3 and 6 months (P<0.05). Fasting glucose was decreased in the berberine group - at 3 and 6 months - in comparison with controls (P<0.05). Also, glycosylated hemoglobin was reduced with berberine (P<0.05) more than in the SM group. Body weight was also significantly more decreased (P<0.05) with berberine supplementation. The fat proportion also decreased significantly more (P<0.05) with the supplement (P<0.05) than in controls only using the SM. Technical athero-specific measurements: the intima-media thickness (IMT) at the carotids (high-resolution ultrasound) in all subjects was stable with berberine and did not significantly change in 6 months. In SM controls the IMT increase was significant superior at 6 months (P<0.05); more time is needed in this type of observations in subjects with minimal initial alterations at the carotid bifurcations. Endothelial function: after occlusion in normal subjects, with normal arteries, reactive hyperemia (RH) - generally - increases section/flow of more than 30% (up to 50%). The included subjects at the first observation, had a minimal increase in RH after occlusion, as an expression of endothelial dysfunction associated to the hyperlipidemia. RH was significantly increased (P<0.05) with berberine, in comparison with controls, at 3 and 6 months.</p><p><strong>Conclusions: </strong>This pilot, concept registry indicates that oral berberine administration is effective in reducing lipids (also decreasing weight, fat percentage and fasting glucose) in otherwise healthy subjects not using other drugs. A longer study, with more advanced hyperlipidemic subjects is suggested. Predictive analytics suggests that a 12-month study with 100 patients, in more advanced hyperlipidemics, also evaluating the carotid intima-media thickness for the analysis of vascular benefits, may produce a stronger ","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"285-291"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gut microbiota and iron homeostasis: implications for glycemic control. 肠道菌群和铁稳态:对血糖控制的影响。
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-05-15 DOI: 10.23736/S0026-4806.25.09706-X
Isa G Rodrigues, Jose Moreno-Navarrete, José M Fernández-Real
{"title":"Gut microbiota and iron homeostasis: implications for glycemic control.","authors":"Isa G Rodrigues, Jose Moreno-Navarrete, José M Fernández-Real","doi":"10.23736/S0026-4806.25.09706-X","DOIUrl":"10.23736/S0026-4806.25.09706-X","url":null,"abstract":"<p><p>The gut microbiome, comprised of diverse microorganisms, plays a critical role in maintaining metabolic, immune, and digestive health. This dynamic ecosystem is highly influenced by external factors such as diet, genetics, environmental factors, and even medication use, including antibiotics. Iron, already bioavailable in the Archean Ocean, is one of the most abundant elements on Earth. All organisms compete or collaborate to obtain iron, demonstrating its relevance in the biological and physiological processes essential to the maintenance of metabolic homeostasis. The bidirectional relationship between the intestinal microbiota, and the host organism in obtaining iron influences both the metabolism of the host, and that of the microbiota. Bacteria in microbiota affects the absorption of iron by the organism, while factors such as iron deficiency or excess in the host modify bacterial biodiversity, its taxonomic composition and its functions. These changes impact bacterial virulence, influencing systemic iron levels, tissue storage and glucose metabolism in the host organism. Patients with changes in glucose metabolism and insulin resistance often present imbalances in iron regulation and alterations in the profile of their intestinal microbiota. The interaction between microbiota, iron and glycemia represents an emerging field of research, standing out as a promising area for nutritional and therapeutic interventions to promote metabolic health. This review explores the relationship between iron metabolism and gut microbiota, highlighting its impact on glucose metabolism.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"329-349"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frozen embryo-transfer: a review on the optimal endometrial preparation. 冷冻胚胎移植:子宫内膜最佳制备方法综述。
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-04-15 DOI: 10.23736/S0026-4806.25.09631-4
Aikaterini Selntigia, Francesco Gebbia, Ana Del Arco, Antonio Pellicer, Daniela Galliano
{"title":"Frozen embryo-transfer: a review on the optimal endometrial preparation.","authors":"Aikaterini Selntigia, Francesco Gebbia, Ana Del Arco, Antonio Pellicer, Daniela Galliano","doi":"10.23736/S0026-4806.25.09631-4","DOIUrl":"10.23736/S0026-4806.25.09631-4","url":null,"abstract":"<p><strong>Introduction: </strong>Frozen-thawed embryo transfer (FET) has become a widely adopted method in assisted reproductive technology (ART), thanks to the advancements in vitrification techniques. FET now accounts for a significant proportion of ART cycles, but there is still no clear consensus on the optimal protocol for endometrial preparation. This review aims to evaluate the reproductive outcomes of three commonly used FET protocols: natural cycle (NC), modified natural cycle (mNC), and artificial cycle (AC), with a focus on implantation rates, clinical pregnancy rates (CPR), live birth rates (LBR), and obstetric complications such as hypertensive disorders of pregnancy (HDP) and preeclampsia (PE).</p><p><strong>Evidence acquisition: </strong>Studies published between 2014 and 2024 were reviewed and compared across these protocols.</p><p><strong>Evidence synthesis: </strong>The results show that NC and mNC protocols are associated with higher CPR and LBR compared to AC. AC, on the other hand, is linked to an increased risk of HDP and PE, likely due to the absence of a functional corpus luteum (CL), which plays a vital role in early pregnancy support.</p><p><strong>Conclusions: </strong>The presence of a CL appears to be crucial for minimizing obstetric complications, making NC and mNC preferable options. Future research is needed to refine FET protocols, focusing on personalized approaches to endometrial preparation that optimize both pregnancy outcomes and maternal health.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"300-308"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The experimental promise and clinical reality of myocardial conditioning for prevention of myocardial ischemia and reperfusion injury: an umbrella review of systematic reviews. 心肌调节预防心肌缺血再灌注损伤的实验前景和临床现实:系统综述。
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-05-15 DOI: 10.23736/S0026-4806.25.09660-0
L Maximilian Buja, Sonya E Fogg
{"title":"The experimental promise and clinical reality of myocardial conditioning for prevention of myocardial ischemia and reperfusion injury: an umbrella review of systematic reviews.","authors":"L Maximilian Buja, Sonya E Fogg","doi":"10.23736/S0026-4806.25.09660-0","DOIUrl":"10.23736/S0026-4806.25.09660-0","url":null,"abstract":"<p><strong>Introduction: </strong>Experimental research sequentially identified reperfusion (in 1972) and conditioning (in 1986) as the two most powerful interventions for reducing acute myocardial infarct (AMI) size following acute coronary occlusion. These discoveries led to further experimental studies on optimal myocardial salvage and intensive clinical efforts to translate these interventions into the management of patients. This umbrella review of systematic reviews addresses the state of research on the effectiveness of pharmacological and interventional conditioning protocols to modulate the impact of ischemia and reperfusion in experimental animals and patients and the comparability of results in experimental animals and humans. This umbrella review documents the paradox of the experimental success of conditioning strategies in the experimental arena and equivocal clinical results of the application of the same conditioning strategies in patients.</p><p><strong>Evidence acquisition: </strong>The review was conducted using the reporting guideline for overviews of reviews of healthcare interventions codified in the PRIOR statement (https://www.equator-network.org/reporting-guidelines/reporting-guideline-for-overviews-of-reviews-of-healthcare-interventions-development-of-the-prior-statement/).</p><p><strong>Evidence synthesis: </strong>The results are summarized in the PRISMA format. A discussion is provided of known and unknown factors responsible for the lack of progress in identifying and implementing interventions to further reduce morbidity and mortality from ischemic heart disease, as well as a practical strategy to achieve timely reperfusion in a larger number of patients experiencing acute coronary syndrome.</p><p><strong>Conclusions: </strong>While awaiting further research to develop a third window of cardioprotection, the most practical approach today is to reduce the morbidity and mortality from IHD is to mount a public education campaign to get the 50% of acute coronary syndrome (ACS) patients with prodromal AMI to the hospital to institute timely reperfusion therapy which has a proven to be the most effective therapy to limit the extend of myocardial damage in patients with IHD. However, the possibility has been raised that the human myocardium may have a genetically determined, primordial non-responsiveness to cardioprotective interventions that exists beyond the established recognized confounding factors. Primordial genetic factors may be particularly difficult to overcome.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"292-299"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Constructing a needs-based collaborative care model for preterm infants and their families. 为早产儿及其家庭构建基于需求的合作护理模式。
Minerva medica Pub Date : 2025-08-01 Epub Date: 2024-07-04 DOI: 10.23736/S0026-4806.24.09353-4
Xuehua Xu, Hanqi Yu
{"title":"Constructing a needs-based collaborative care model for preterm infants and their families.","authors":"Xuehua Xu, Hanqi Yu","doi":"10.23736/S0026-4806.24.09353-4","DOIUrl":"10.23736/S0026-4806.24.09353-4","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"360-361"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insomnia disorder. 失眠障碍。
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-02-11 DOI: 10.23736/S0026-4806.25.09690-9
Luigi Ferini-Strambi
{"title":"Insomnia disorder.","authors":"Luigi Ferini-Strambi","doi":"10.23736/S0026-4806.25.09690-9","DOIUrl":"10.23736/S0026-4806.25.09690-9","url":null,"abstract":"<p><p>Insomnia is a prevalent public health issue, characterized by dissatisfaction with the duration, continuity, and quality of sleep. It is closely associated with daytime symptoms, which are essential for diagnosing insomnia disorder. The condition is more common among women, middle-aged and older adults, and individuals with coexisting mental or physical health conditions. Evidence suggests that insomnia increases the risk of various health problems. Addressing insomnia is therefore crucial not only to enhance patients' quality of life but also to mitigate its significant health, social, and economic impacts. However, further studies are needed to evaluate the cost-effectiveness of insomnia treatments. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment for chronic insomnia in adults. When CBT-I proves ineffective or is unavailable, pharmacological treatments may be considered. Benzodiazepines (BZs) and benzodiazepine receptor agonists (BZRAs) are suitable for short-term treatment (up to 4 weeks). Among BZs, triazolam is notable for its short half-life and demonstrated efficacy in treating sleep-onset and middle-of-the-night (MOTN) insomnia, supported by robust clinical evidence. Additionally, triazolam does not impair psychomotor performance. In certain cases, longer-term use of BZs or BZRAs may be appropriate; however, this approach requires careful individual assessment of the benefits and risks. Non-nightly use of hypnotic medications may also be a viable option for patients who do not require nightly treatment. Low-dose sedating antidepressants may be considered for short-term insomnia management (off-label), while antipsychotics and antihistamines are not recommended for this purpose. Orexin receptor antagonists are an option for treating insomnia for up to three months. It is important to note that although insomnia guidelines are based on daily use as evaluated in randomized controlled trials, clinical practice may vary.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"309-322"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decoding uterine leiomyosarcoma: is ultrasound diagnosis still a daunting challenge? 解码子宫平滑肌肉瘤:超声诊断仍然是一个艰巨的挑战吗?
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-05-12 DOI: 10.23736/S0026-4806.25.09669-7
Camilla DI Dio, Stefania Pipitone, Rossella Del Vecchio, Elisa Noce, Marika Denotti, Mauro Ceccanti, Luigi Tarani, Ludovico Muzii, Giampiero Ferraguti, Marco Fiore, Maria G Piccioni
{"title":"Decoding uterine leiomyosarcoma: is ultrasound diagnosis still a daunting challenge?","authors":"Camilla DI Dio, Stefania Pipitone, Rossella Del Vecchio, Elisa Noce, Marika Denotti, Mauro Ceccanti, Luigi Tarani, Ludovico Muzii, Giampiero Ferraguti, Marco Fiore, Maria G Piccioni","doi":"10.23736/S0026-4806.25.09669-7","DOIUrl":"10.23736/S0026-4806.25.09669-7","url":null,"abstract":"<p><strong>Introduction: </strong>This narrative review, based on the current literature, aims to evaluate whether or not preoperative ultrasound can effectively distinguish between uterine leiomyosarcomas (ULMS) and leiomyomas (ULM).</p><p><strong>Evidence acquisition: </strong>By using PubMed, Scopus and WOS, an extensive literature search was conducted to identify ultrasound characteristics that specifically differentiate uterine ULMS from ULM.</p><p><strong>Evidence synthesis: </strong>This review analyzed several ultrasound features to distinguish ULMS from ULM, including the maximum diameter of myometrial growth, the number of lesions (solitary/multiple), tissue echogenicity (homogeneous/heterogeneous), growth borders (regular/irregular), the presence of cystic regions, shadow presence, subjective color grading, and the vascular pattern of the myometrial lesion (circumferential/intralesional). Our findings suggest that in postmenopausal patients with abnormal uterine bleeding and a new or enlarging mesenchymal mass, ULMS should be suspected. Features such as irregular tumor margins, moderate-to-abundant intralesional blood flow, cystic regions, and lack of calcifications indicate a higher risk of ULMS.</p><p><strong>Conclusions: </strong>Benign and malignant myometrial lesions should be disclosed by algorithms including ultrasound combined with clinical presentations and, if necessary, magnetic resonance imaging. This means that further prospective studies should be conducted to consolidate our findings.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"350-358"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between dapagliflozin and risk of dementia and Parkinson's disease: a subgroup analysis of a meta-analysis of randomized controlled trials. 达格列净与痴呆和帕金森病风险之间的关联:随机对照试验荟萃分析的亚组分析
Minerva medica Pub Date : 2025-08-01 Epub Date: 2025-03-27 DOI: 10.23736/S0026-4806.25.09695-8
João V Fernandes, João V Ramos, Maurus M Holanda
{"title":"Association between dapagliflozin and risk of dementia and Parkinson's disease: a subgroup analysis of a meta-analysis of randomized controlled trials.","authors":"João V Fernandes, João V Ramos, Maurus M Holanda","doi":"10.23736/S0026-4806.25.09695-8","DOIUrl":"10.23736/S0026-4806.25.09695-8","url":null,"abstract":"<p><strong>Introduction: </strong>Dementia and Parkinson's disease (PD) are prevalent neurodegenerative disorders with substantial global health impacts. Emerging evidence suggests that SGLT2 inhibitors, such as dapagliflozin, may offer neuroprotective benefits. This study aims to evaluate dapagliflozin's association with risks of dementia and PD through a sub-analysis of a meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Evidence acquisition: </strong>This sub-analysis adhered to PRISMA 2020 guidelines and included RCTs from a prior meta-analysis focusing on dapagliflozin. Studies comparing dapagliflozin to placebo with reported dementia or PD outcomes were selected. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using the I<sup>2</sup> statistic, and bias was evaluated with the Cochrane Risk of Bias 2 tool.</p><p><strong>Evidence synthesis: </strong>Four RCTs met the inclusion criteria. For dementia, the pooled OR was 2.826 (95% CI: 0.264-30.229; I<sup>2</sup>=0%). For Alzheimer's-type dementia, the OR was 2.308 (95% CI: 0.232-22.928; I<sup>2</sup>=0%), while for PD, the OR was 0.533 (95% CI: 0.072-3.944; I<sup>2</sup>=0%). None of the results were statistically significant, and heterogeneity across studies was negligible.</p><p><strong>Conclusions: </strong>This sub-analysis found no significant association between dapagliflozin and reduced risks of dementia or PD. While these results align with previous meta-analyses, further long-term RCTs are necessary to clarify dapagliflozin's neuroprotective potential and broader therapeutic applications.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"323-328"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unveiling the mechanistic synergy of palmitoylethanolamide and acetyl-L-carnitine in lumbosciatalgia. 揭示棕榈酰乙醇酰胺和乙酰左旋肉碱在腰痛中的机制协同作用。
Minerva medica Pub Date : 2025-07-08 DOI: 10.23736/S0026-4806.25.09763-0
Simone Parisi
{"title":"Unveiling the mechanistic synergy of palmitoylethanolamide and acetyl-L-carnitine in lumbosciatalgia.","authors":"Simone Parisi","doi":"10.23736/S0026-4806.25.09763-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09763-0","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pitfalls in contrast enhanced ultrasound: lack of washout in malignant liver lesions. A scoping review. 超声造影缺陷:肝恶性病变缺乏冲洗。范围审查。
Minerva medica Pub Date : 2025-07-03 DOI: 10.23736/S0026-4806.25.09658-2
Kathleen Möller, Mikael Sawatzki, Christian Jenssen, Carla Serra, Sofia Bakken, Christian Görg, Yi Dong, Christoph F Dietrich
{"title":"Pitfalls in contrast enhanced ultrasound: lack of washout in malignant liver lesions. A scoping review.","authors":"Kathleen Möller, Mikael Sawatzki, Christian Jenssen, Carla Serra, Sofia Bakken, Christian Görg, Yi Dong, Christoph F Dietrich","doi":"10.23736/S0026-4806.25.09658-2","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09658-2","url":null,"abstract":"<p><p>Contrast-enhanced ultrasound (CEUS) is a reliable examination procedure to differentiate benign and malignant liver lesions, which is superior to contrast enhanced computed tomography (CECT) and equally to contrast enhanced magnetic resonance imaging (CEMRI) in large comparative studies. In this review, the data on the enhancement of malignant liver lesions in the late phase in CEUS are analyzed in detail. Hypoenhancement in the late phase on CEUS with SonoVue<sup>®</sup> is a typical feature of metastases and other malignant tumors. However, this is not guaranteed in every case. It is explicitly analyzed in the present studies which malignant lesions did not demonstrate washout in the late phase with SonoVue<sup>®</sup>. Lack of washout is known for some hepatocellular carcinomas. However, there are also a few rare exceptions described for metastases of neuroendocrine tumors. The possible causes are analyzed. While metastases and cholangiocellular carcinoma demonstrate an early marked washout, this can start very late in neuroendocrine metastases. Some predominantly well differentiated hepatocellular carcinomas in the cirrhotic liver may also show no or only very delayed and faintly washout in the late phase. Isoenhancement at the beginning of the late phase does not rule out metastases or HCC (in the cirrhotic liver). This contrast behavior is known for some HCC in the cirrhotic liver, but it is atypical, poorly reported and understood, especially in liver metastases. The present review analyzes the data on isoenhancement in the late phase of malignant liver lesions. The novel aspect is the focus on liver metastases.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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