Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Computed tomography"

Navegando por Palavras-chave "Computed tomography"

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Acesso aberto (Open Access)
Análise por tomografia computadorizada do teto etmoidal: importante área de risco em cirurgia endoscópica nasal
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-06-01) Souza, Soraia Ale [UNIFESP]; Souza, Marcia Maria Ale de [UNIFESP]; Idagawa, Marcos [UNIFESP]; Wolosker, Ângela Maria Borri [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To evaluate the olfactory fossae depth according to the Keros' classification and determine the incidence and degree of asymmetry in the height and contour of the ethmoid roof. MATERIALS AND METHODS: Retrospective analysis of 200 coronal computed tomography studies of paranasal sinuses performed in the period between August and December, 2006. RESULTS: According to the Keros' classification, olfactory fossae type II was most frequently found in 73.3% of cases followed by type I in 26.3% and type III in 0.5% of cases. Asymmetry in the ethmoid roof height was found in 12% of cases (24 computed tomography studies), and contour asymmetry was found in 48.5% (97 computed tomography studies), with flattening of the ethmoid roof on one of the sides. CONCLUSION: As regards the olfactory fossae depth, the Keros' type II was most frequently found. In most of cases, the ethmoid roof asymmetry was related to angulation of the lateral lamella of the cribriform plate.
Acesso aberto (Open Access)
Aneurisma de artéria hepática simulando lesão em cabeça de pâncreas: relato de caso
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2005-12-01) Pinto, Oswaldo Luiz; Tornin, Olger De Souza; Botelho, Renato Assayag; Menezes, Marcelo Carneiro; Chagas, José Francisco de Sales [UNIFESP]; Camargo, José Gonzaga; Souza, Ricardo Pires De; Pontifícia Universidade Católica de Campinas Departamento de Cirurgia; Complexo Hospitalar Heliópolis; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
The aim of this study is to report a rare case of hepatic artery aneurysm simulating a lesion in the head of the pancreas. A precise evaluation using computed tomography and magnetic resonance imaging is important in the treatment planning, which will influence the prognosis.
Somente Metadadados
Application of computed tomography images in the evaluation of magnetic nanoparticles biodistribution
(Elsevier B.V., 2010-08-01) Dias, Argleydson Leao; Kunzel, Roseli; Levenhagen, Ronaldo Savarino [UNIFESP]; Okuno, Emico; Universidade de São Paulo (USP); Ctr Univ Franciscano; Universidade Federal de São Paulo (UNIFESP)
In this work we evaluate the effectiveness of computed tomography images as a tool to determine magnetic nanoparticle biodistribution over biological tissues. for this purpose, tomography images for magnetic nanoparticles, composed of Fe(3)O(4), coated with 2,3-dimercaptosuccinic acid (DMSA), were generated at several material concentrations. the comparison of CT numbers, calculated from these images generated at clinical conditions, with typical CT numbers for biological tissues, shows that the detection of nanoparticle in most tissues is only possible for high material concentrations. (C) 2010 Elsevier B.V. All rights reserved.
Acesso aberto (Open Access)
Apresentações incomuns do hemangioma hepático: ensaio iconográfico
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-06-01) D'Ippolito, Giuseppe [UNIFESP]; Appezzato, Luis Fernando; Ribeiro, Alessandra Caivano R.; Abreu Junior, Luiz de; Borri, Maria Lucia [UNIFESP]; Galvão Filho, Mário de Melo; Hartmann, Luiz Guilherme C.; Wolosker, Angela Maria Borri; Universidade Federal de São Paulo (UNIFESP); Hospital São Luiz Serviço de US/TC/RM; Setor de Diagnóstico por Imagem Hospital São Luiz
In order to evaluate atypical aspects of hepatic hemangiomas at ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI), we have retrospectively analyzed 300 cases of patients diagnosed with hepatic hemangiomas by means of combined imaging studies, clinical follow-up and/or biopsy results. Based on this analysis we have selected those cases with atypical findings at one or more imaging methods or those presenting an unusual evolution such as: hypoechoic nodules at US; giant, heterogeneous hemangiomas; rapidly filling hemangiomas; calcified hemangiomas; pedunculated hemangiomas; hypointense hemangiomas at T2-weighted images; causing perfusion defect; with central scar simulating focal nodular hyperplasia; hemangiomas with adjacent abnormalities such as arterial-portal venous shunt and capsular retraction as well as hemangiomas enlarging over time. The hepatic hemangioma is the most common benign tumor affecting the liver and usually presents typical aspect. However, atypical findings should be known aiming at supporting diagnosis guidance and clinical decisions.
Acesso aberto (Open Access)
Apresentações incomuns do hepatocarcinoma: ensaio iconográfico
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-04-01) D'Ippolito, Giuseppe [UNIFESP]; Abreu Junior, Luiz de; Borri, Maria Lucia [UNIFESP]; Galvão Filho, Mário de Melo; Hartmann, Luiz Guilherme C.; Wolosker, Angela Maria Borri; Ribeiro, Marcelo [UNIFESP]; Salem, Marcelo Zindel; Misiara, Adriano; Universidade Federal de São Paulo (UNIFESP); Hospital São Luiz - Itaim Serviço de US/TC/RM; Hospital São Luiz Setor de Diagnóstico por Imagem; Universidade de São Paulo (USP)
In order to evaluate atypical aspects of hepatocellular carcinoma at computed tomography and magnetic resonance imaging, we have retrospectively evaluated 100 patients with diagnosed hepatocellular carcinoma, based on combined imaging studies, laboratory results, biopsy and surgery. We have selected those cases with atypical findings at computed tomography or magnetic resonance imaging, including cystic lesions, bleeding tumors, with calcifications, with spontaneous regression, pedunculated tumors, hypovascular lesions, giant hepatocellular carcinomas, and those with unusual local invasiveness. The hepatocellular carcinoma is the most usual primary malignant lesion of the liver and usually it has a typical aspect and is associated with hepatic cirrhosis. However, in a significant number of cases, some uncommon findings can be responsible for a delayed diagnosis.
Acesso aberto (Open Access)
Aspectos comuns e pseudolesões na colonografia por tomografia computadorizada: ensaio iconográfico
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2012-06-01) Atzingen, Augusto Castelli von [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Matsumoto, Carlos Alberto [UNIFESP]; Nunes, Thiago Franchi; Maia, Marcos Vinicius Alvim Soares [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Computed tomography colonography is a minimally invasive method for screening for polyps and colorectal cancer, with extremely unusual complications, increasingly used in the clinical practice. In the last decade, developments in bowel preparation, imaging, and in the training of investigators have determined a significant increase in the method sensitivity. Images interpretation is accomplished through a combined analysis of two-dimensional source images and several types of three-dimensional renderings, with sensitivity around 96% in the detection of lesions with dimensions equal or greater than 10 mm in size, when analyzed by experienced radiologists. The present pictorial essay includes examples of diseases and pseudolesions most frequently observed in this type of imaging study. The authors present examples of flat and polypoid lesions, benign and malignant lesions, diverticular disease of the colon, among other conditions, as well as pseudolesions, including those related to inappropriate bowel preparation and misinterpretation.
Acesso aberto (Open Access)
Avaliação da concordância interobservador na análise da tomografia computadorizada sem contraste no diagnóstico da urolitíase em pacientes com cólica renal aguda
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-10-01) Souza, Luís Ronan Marquez Ferreira De [UNIFESP]; Faintuch, Salomão [UNIFESP]; Bekhor, Daniel [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
OBJECTIVE: To evaluate the interobserver agreement on non-contrast computed tomography interpretation by a group of experienced abdominal radiologists, for the study of urolithiasis in patients presenting acute flank pain. MATERIALS AND METHODS: Prospective study of 52 patients submitted to non-contrast enhanced helical computed tomography. The images were subsequently analyzed by three independent observers, with the interobserver agreement assessed by means of the kappa (kappa) statistical method. The following parameters were analyzed: a) presence, localization and measurement of ureteral calculi; b) intrarenal calyceal system dilatation; c) perirenal fat heterogeneity; d) ureteral dilatation; e) ureteral wall edema (halo sign). RESULTS: Ureteral calculi were found in 40 of 52 patients (77%). The interobserver agreement was almost perfect as regards identification of ureteral calculi (kappa = 0.89) and ureteral dilatation (kappa = 0.87), substantial for calyceal system dilatation (kappa = 0.77), and moderate for perirenal fat heterogeneity (kappa = 0.55) and ureteral wall edema (kappa = 0.56). CONCLUSION: Non-contrast-enhanced abdominal computed tomography presents high reproducibility in the evaluation of urolithiasis and secondary signs of the calyceal system obstruction.
Acesso aberto (Open Access)
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica
(Universidade Federal de São Paulo (UNIFESP), 2019-05-30) Bichels, Andre Valente [UNIFESP]; Kaneko, Maria Ayako Kamimura [UNIFESP]; Silva Júnior, Antonio Carlos Cordeiro; http://lattes.cnpq.br/5874601346158886; http://lattes.cnpq.br/3356377676492451; http://lattes.cnpq.br/7254976533483796; Universidade Federal de São Paulo (UNIFESP)
Background: In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the loss of skeletal muscle mass. Muscle mass is a key element for evaluation of nutritional disturbances, and low muscle mass is associated with increased morbidity and mortality. An accurate method for muscle mass evaluation that is not subject to errors caused by perturbations in the uremic milieu remains a challenge for the nephrology community. Methods: This is a prospective observational cohort study. We evaluated 223 non-dialyzed CKD patients [60.3±10.6 years; 64% men; 50% diabetics; glomerular filtration rate (GFR) 27.3±16.3 ml/min/1.73m2]. Muscle mass was measured by computed tomography at the third lumbar vertebra region (CTMM-L3) using the Slice-O-Matic software and analyzed according to percentile adjusted by gender. Nutritional parameters, laboratory data and comorbidities were evaluated, and mortality was followed-up for 4 years. Results: During the study period 63 patients died, and the main cause of death was cardiovascular disease. Patients who died were older, had lower GFR, hemoglobin and albumin, as well as lower muscle markers. CTMM-L3 below the 25th percentile was associated with higher mortality according to the Kaplan-Meier curve (P=0.017), and in Cox-regression analysis [crude hazard ratio, HR, 1.87 (95% confidence interval, CI, 1.11-3.16)], also when adjusting for potential confounders [HR 1.83 (CI 1.02-3.30)]. Conclusions: Low muscle mass measured by computed tomography at the third lumbar vertebra region is an independent predictor of increased mortality in non-dialyzed CKD patients.
Acesso aberto (Open Access)
Avaliação por imagem das lesões da placa de crescimento
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-06-01) Yanaguizawa, Matiko [UNIFESP]; Taberner, Gustavo Sobreira [UNIFESP]; Aihara, André Yui [UNIFESP]; Yamaguchi, Cláudia Kazue; Guimarães, Maria Carolina; Rosenfeld, André [UNIFESP]; Fernandes, João Luiz; Fernandes, Artur da Rocha Correa [UNIFESP]; Diagnósticos da América; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Casa de Misericórdia Serviço de Diagnóstico por Imagem Setor de Músculo-Esquelético; Image Memorial
The structures responsible for the growth of bones include the physis (also called growth plate) and the epiphysis. Affections involving patients with immature skeletons, i.e., with a still open growth plate, may affect the bone growth, resulting in complications such as growth arrest, limb shortening and angular deformities. Traumatic conditions, many times resulting in epiphyseal fractures, are the most frequent cause of growth plate injuries. A careful evaluation of these patients by means of currently available imaging methods, especially radiography, computed tomography and magnetic resonance imaging, allows an early diagnosis of the involvement of structures related to the bone growth, besides an appropriate management, reducing the probability of secondary complications.
Acesso aberto (Open Access)
Avaliação tomográfica das alterações dimensionais do espaço orofaríngeo pré e pós expansão rápida da maxila
(Universidade Federal de São Paulo (UNIFESP), 2017-06-29) Yuki, Aparecida Keiko Akutsu [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Cappellette Júnior, Mário [UNIFESP]; http://lattes.cnpq.br/3772804052798387; http://lattes.cnpq.br/4416616059943202; http://lattes.cnpq.br/0364119997044968; Universidade Federal de São Paulo (UNIFESP)
Este estudo tem por objetivo avaliar, em curto prazo, as possíveis alterações dimensionais do espaço orofaríngeo pré e pós-expansão rápida da maxila (ERM) por meio de tomografia computadorizada (TC) em pacientes respiradores orais. Material e método: Neste estudo retrospectivo selecionados 35 pacientes respiradores orais com atresia maxilar sendo 20 do gênero masculino e 15 do gênero feminino, com média de idade 9,6 anos, desvio padrão de 1,8 anos variando de 5 a 12 anos. Os exames de tomografia computadorizada (TC) foram realizados em dois momentos: pré-ERM (T1) e 6 meses após a finalização da fase ativa da ERM (T2). Após a seleção dos pacientes do banco de dados, as imagens tomográficas foram obtidas por meio do programa de manipulação de imagens e as comparações entre as TC iniciais (T1) e finais (T2) foram executadas com o auxilio do programa Dolphin Imaging Version 11.7 Preminun, de acordo com as estruturas e avaliações a serem realizadas. Os dados foram submetidos a análises do erro intra e inter-observador e testes estatísticos para comprovar a significância dos resultados obtidos. Resultados: Houve aumento significativo nas mensurações de área e volume da orofaringe. A área aumentou em 12,6% e o volume em 16,3% pós ERM. Em relação as medidas lineares de deslocamento da maxila houve aumento da distância ENACli em 1,45mm e da distância ENA-Ba em 1,31mm. Conclusões: Os resultados obtidos neste trabalho permitem concluir que a ERM promove, em curto prazo, deslocamento anterior da maxila com aumentos significativos da área e volume da orofaringe.
Acesso aberto (Open Access)
Avaliação tomográfica do espaço nasofaríngeo pré e pós expansão rápida da maxila
(Universidade Federal de São Paulo (UNIFESP), 2017-06-29) Gonçalves, Raquel Mori [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Cappellette Júnior, Mário [UNIFESP]; http://lattes.cnpq.br/3772804052798387; http://lattes.cnpq.br/4416616059943202; http://lattes.cnpq.br/1583943809543796; Universidade Federal de São Paulo (UNIFESP)
O objetivo desse estudo foi avaliar, em curto prazo, o impacto da expansão rápida da maxila (ERM) no espaço nasofaríngeo por meio de tomografia computadorizada (TC) em pacientes respiradores orais. Material e método: Este estudo retrospectivo incluiu 70 imagens tomográficas correspondente a 35 pacientes respiradores orais com atresia maxilar, com ou sem mordida cruzada posterior, de ambos os gêneros, com média de idade de 9,6 anos variação entre 5 e 12 anos com desvio padrão de 1,8 anos, predominando os participantes com 8 (22,9%) e 9 anos (22,9%), sendo 42,9 (%) do sexo feminino e 57,1 (%) do sexo masculino que foram submetidos à ERM sequencialmente. Foram excluídas as imagens de pacientes portadores de síndromes genéticas craniofaciais. Os exames tomográficos foram realizados em dois momentos: pré-ERM (T1) e 180 dias após a finalização da ERM (T2). Neste estudo, a fase de contenção foi de 180 dias, minimizando a influência do crescimento, idade ou dimorfismo sexual nos resultados. Após a seleção dos pacientes do banco de dados, as imagens tomográficas foram obtidas por meio do programa de imagens e as comparações entre as TC iniciais (T1) e finais (T2) foram executadas com auxílio do programa Dolphin ImagingR versão 11.7 Premium, de acordo com as estruturas e avaliações a serem realizadas. Os dados foram submetidos a análises do erro intra e inter-observador e testes estatísticos para comprovar a significância dos resultados obtidos. Resultados: Houve um aumento significativo na área e no volume da nasofaringe (p<0,001) e nas variáveis lineares entre as médias das distâncias ENA-Cli (p < 0,001) e ENA-Ba (p < 0,001). Em relação as variáveis angulares não existiram diferenças significativas ENP.Ho.Ba (p= 0,143) e Cli.ENA.Ba (p= 0,636). Conclusões: A ERM promoveu a curto prazo um aumento nas medidas lineares, angulares da maxila como também na área e volume da nasofaringe.
Acesso aberto (Open Access)
Biópsia pulmonar percutânea guiada por tomografia computadorizada: dados de um hospital
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-08-01) Carazzai, Emílio Humberto; Andreosi, Maristela; Gonzalez, Fábio Mota; Uzêda, Sandra de Quadros [UNIFESP]; Tornin, Olger de Souza; Rossi, Marcelo D'andrea; Hospital São Luís; Hospital Santa Cecília; Hospital Beneficência Portuguesa de São Paulo Setor de Ultra-sonografia da Medimagem; Hospital Heliópolis; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
OBJECTIVE: To present the experience of Santa Cecília Hospital (São Paulo, SP, Brazil) radiology service in the handling of computed tomography-guided fine-needle aspiration biopsy and percutaneous core biopsy of pulmonary lesions, analyzing their importance and associated complications. MATERIALS AND METHODS: One hundred and sixty-eight computed tomography-guided biopsies were performed in 84 men and 84 women. Sixty-four patients underwent fine-needle aspiration biopsy, 68 underwent percutaneous core biopsy and 36 patients underwent both techniques. RESULTS: Pneumothorax occurred in 38 patients, and pulmonary hemorrhage in then cases. The biopsied lesions ranged in size from 0.5 to 15 cm. The diagnosis was achieved at the first attempt in 132 cases and at the second attempt in ten cases. CONCLUSION: The accuracy of fine-needle aspiration and percutaneous core biopsies depends both on the size of the lesion and the patient's cooperation. These techniques are relatively safe and present a high diagnostic accuracy when performed by an experienced professional.
Acesso aberto (Open Access)
Calcificações hepáticas: freqüência e significado
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2003-08-01) Bezerra, Alexandre Sérgio de Araújo [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Martelli, Pierpaolo [UNIFESP]; Pinto, Gustavo Alfredo Duarte Henrique [UNIFESP]; Galvão Filho, Mário Melo; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital São Luiz Serviço de Tomografia Computadorizada
PURPOSE: To determine the frequency and etiology of intrahepatic calcifications diagnosed on abdominal computed tomography (CT) studies. MATERIALS AND METHODS: A retrospective study of 1,362 consecutive CT scans of the abdomen was carried out to determine the presence of intrahepatic calcifications. The clinical and laboratorial data of all patients with liver calcifications were reviewed in order to establish the etiology of the lesions. RESULTS: Intrahepatic calcifications were found in 3.6% (49/1,362) of the patients, and were predominantly seen in women (57.2%) than in men (42.8%). The population age ranged from 18 to 92 years (mean 59.4 years; median 63.5 years). Calcifications were considered residual and without clinical repercussion in most cases (39/49; 79.5%) whereas in 14.4% (7/49) of the patients calcifications were associated with metastatic disease and in 6.1% (3/49) with cystic lesions. The primary tumors in the seven patients with calcified liver metastases were colon carcinoma (five patients), sarcoma (one patient) and malignant ovarian teratoma (one patient). Two of these patients presented calcifications only after chemotherapy. CONCLUSION: Intrahepatic calcifications are infrequent findings on routine abdominal CT scans (< 5%) and are mostly related to previous inflammatory and/or infectious diseases.
Acesso aberto (Open Access)
Calcificações orbitárias incidentais na tomografia computadorizada
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2001-02-01) Fugita, Dalton Yukio A. [UNIFESP]; Cruz, Daniela Nogueira [UNIFESP]; Cappucci, Alessandro [UNIFESP]; Arakava, Márcia Mayumi [UNIFESP]; Guimarães, Maria Carolina [UNIFESP]; Manso, Paulo Góes [UNIFESP]; Wolosker, Ângela Maria B. [UNIFESP]; Yamashita, Helio Kiitiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
We retrospectively studied the computed tomography scans of the orbit in 75 patients in order to identify the presence of incidental calcifications (scleral and trochlear apparatus calcifications). These imaging findings should integrate the vast list of differential diagnosis of orbital calcifications, as they may help radiologists to distinguish these calcifications from orbital foreign bodies.
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Can diffusion-weighted whole-body MRI replace contrast-enhanced CT for initial staging of Hodgkin lymphoma in children and adolescents?
(Springer, 2018) Regacini, Rodrigo [UNIFESP]; Puchnick, Andrea [UNIFESP]; Luisi, Flavio Augusto Vercillo [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]
Although positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET/CT) has been recommended as the method of choice for lymphoma staging, it has limited availability in several countries, therefore, studies comparing whole-body magnetic resonance imaging (MRI) to conventional staging methods or to FDG-PET/CT are an important tool to establish whole-body MRI as an alternative to these methods. To compare whole-body MRI versus conventional imaging methods for staging of Hodgkin lymphoma in children and adolescents. The study included 22 patients ages 5 to 21 years. Staging was performed using conventional imaging methods and whole-body MRI. Conventional imaging methods were defined as computed tomography (CT) of the neck, chest, abdomen and pelvis and ultrasonography of the neck and/or abdomen. We calculated the sensitivity of these methods for Hodgkin lymphoma staging and their sensitivity and specificity for detecting sites of nodal and extranodal involvement. The sensitivity of whole-body MRI for Hodgkin lymphoma staging was superior to that of conventional imaging methods (95.5% vs. 86.4%, respectively), but both methods had similar sensitivity and specificity for detecting involvement of nodal sites (99.1% and 100% vs. 97.3% and 100%, respectively) and extranodal sites (90.5% and 98.7% vs. 90.5% and 99.4%, respectively). Whole-body MRI has excellent sensitivity for staging of Hodgkin lymphoma in children and adolescents. It can thus be considered an alternative for this purpose, particularly because it does not expose patients to ionizing radiation.
Acesso aberto (Open Access)
Carcinoma renal sarcomatóide: achados de imagem e anatomopatológicos. A propósito de um caso
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2003-08-01) Figueirêdo, Sizenildo Da Silva [UNIFESP]; Argollo, Renato Santos; Costa, Marlos Augusto Bittencourt; Ribeiro, Flávia Aparecida De Souza; Nóbrega, Bruno Barcelos Da [UNIFESP]; Pinto, Sebastião Alves; Lôbo, Leonardo Valadares Barbosa; Rebolças, Marise Amaral Moreira; Teixeira, Kim-ir-sen Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Goiás Faculdade de Medicina Hospital das Clínicas; Universidade Federal de Goiás Faculdade de Medicina Serviço de Anatomia Patológica
Sarcomatoid renal carcinoma is an aggressive neoplasm with clinical and radiological features similar to those of clear cell renal sarcomas. The tumor is formed by layers of malignant spindle cells that show immunohistochemical and ultrastructural characteristics of both stromal and epithelial cells, and may also contain mixoid areas of osteoclast-like giant cells, rhabdomyoblast-like pleomorphic cells as well as other rare sarcomatoid components. The authors report a case of sarcomatoid renal carcinoma in a 54-year-old male patient presenting with the classic clinical triad seen on patients with renal cell carcinomas. The typical macroscopic and microscopic features, imaging findings and differential diagnosis with true renal sarcomas are discussed.
Acesso aberto (Open Access)
Colonografia por tomografia computadorizada na visão do médico encaminhador: qual o seu valor segundo a visão de especialistas?
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2014-06-01) Kierszenbaum, Marcelo Longo; Atzingen, Augusto Castelli von [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Alvim, Marcos Vinicius; Lopes Filho, Gaspar de Jesus [UNIFESP]; Matos, Delcio [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Laboratório Fleury
Objective: To map the view of surgeons on the role played by computed tomography colonography (CTC). Materials and Methods: An electronic questionnaire was sent to members of the Brazilian College of Surgeons. The questionnaire consisted of 16 multiple-choice questions about demographics and general knowledge about CTC. Results: The authors obtained 144 responses; 90.3% of the specialists were men, 60% with less than 30 years from graduation, 77.1% were gastrointestinal surgeons, 22.9% were general surgeons, 53.5% were involved in academic activity, and 59.7% had their professional activity in cities with more than 500,000 inhabitants. As regards the knowledge about CTC, 84.7% of the respondents knew the method, 70.8% knew how it is performed, 56.9% reported knowing the bowel preparation used for the procedure, 31.3% used the method, and 53.5% knew some CTC service in their city. About half of the respondents did not know the precise indication of the method. The method is most frequently known and used by professionals working in cities with more than 500,000 inhabitants (p < 0.005). There was a tendency of a more frequent use of the method by the professionals pursuing an academic career. Conclusion: Despite its infrequent use in Brazil, CTC is a well known method, particularly in large urban centers and in the academic environment.
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Comparative study of clinical, pathological and HRCT findings of primary alveolar proteinosis and silicoproteinosis
(Elsevier B.V., 2012-02-01) Souza, Carolina Althoff; Marchiori, Edson; Goncalves, Leticia Pereira; Meirelles, Gustavo de Souza Portes [UNIFESP]; Zanetti, Glaucia; Escuissato, Dante Luiz; Capobianco, Julia; Souza, Arthur Soares; Ottawa Gen Hosp; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP); Univ Fed Parana; Fac Med Sao Jose do Rio Preto
Objective: To compare the clinical, high-resolution computed tomography (HRCT) and pathological findings of primary alveolar proteinosis (PAP) and silicoproteinosis.Material and methods: the study included 15 patients with PAP (6 women, 9 men, mean age 31 years) and 13 with silicoproteinosis (13 men, mean age 29.5 years). PAP was diagnosed by lung biopsy in 13 and bronchoalveolar lavage in two patients and silicoproteinosis by bronchoalveolar lavage in 10 and autopsy in three cases. HRCT images were reviewed by two chest radiologists with consensus for the presence, extent and distribution of ground-glass opacities, septal thickening, consolidation and nodules. Radiological-pathological correlation was performed by one radiologist and one chest pathologist.Results: Seven (46%) patients with PAP were asymptomatic; the remainder presented slowly progressive dyspnea and dry cough. All silicoproteinosis patients had dry cough and rapidly progressive dyspnea. the most common HRCT finding on PAP was the crazy-paving pattern (93%). All cases had areas of geographic sparing in the affected lung. the most common finding in silicoproteinosis (92%) was dependent consolidation with calcification in 83%. Centrilobular nodules were common (85%). On pathology, both diseases demonstrated intra-alveolar accumulation of PAS material, thickening of interlobular septae and alveolar walls and no evidence of fibrosis. A few silica particles were seen in silicoproteinosis.Conclusion: Despite the pathological similarities, PAP and silicoproteinosis have distinct clinical and imaging features and prognosis. Bilateral crazy-paving pattern with areas of geographic sparing is characteristic for PAP. Silicoproteinosis presents with bilateral dependent consolidation often with areas of calcification. the crazy-paving pattern is not seen in silicoproteinosis. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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Concordância entre radiologistas na quantificação de bronquiectasias pela tomografia computadorizada de alta resolução
(Universidade Federal de São Paulo (UNIFESP), 2014-11-26) Brito, Milene Carneiro Barbosa de [UNIFESP]; Meirelles, Gustavo de Souza Portes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVES: To determinethe agreement on the quantification of HRCT. METHODS: HRCT scans of 43 patients with bronchiectasis were analyzed by two radiologists. Findings were graded with a score, and kappa values and overall agreement were calculated. RESULTS: Measurement and appearance of bronchiectasis showed moderate interobserver (k = 0.45 and k = 0.43, respectively) and intraobserver agreement (k = 0.54 and k = 0.47, respectively). Agreement on the presence of mucous plugging was fair(central distribution: overall interobserver agreement of 68.3%, k = 0.39 for intraobserver agreement; peripheral distribution: k = 0.34 and k = 0.35 for inter- and intraobserver agreement, respectively) and forperibronchial thickening (k = 0.21 and k = 0.30 for interand intraobserver agreement, respectively). Agreement on the detection of opacities, ground-glass areas, and cysts/bullae was fair (k = 0.39, overall agreement of 64.3%, and k = 0.47 for interobserver agreement, and overall agreement of 71.9%, k = 0.24, and k = 0.44for intraobserver agreement, respectively). After qualitative analysis of the findings of bronchiectasis on HRCT, the total score for each patient was calculated, showing excellent correlation between observers (intraclass correlation coefficient of 0.85 for interobserver agreement and of 0.81 for intraobserver agreement). CONCLUSION: HRCT findings of bronchiectasis showed fair agreement between observers. After final analysis of the findings using the proposed score, we observed an excellent inter- and intra-observer correlation.
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Crazy-paving pattern on HRCT of patients with H1N1 pneumonia
(Elsevier B.V., 2011-11-01) Marchiori, Edson; Zanetti, Glaucia; D'Ippolito, Giuseppe [UNIFESP]; Hochhegger, Bruno; Universidade Federal Fluminense (UFF); Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP)

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