Navegando por Palavras-chave "Imaging, three-dimensional"

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    Assessment of pelvic floor by three-dimensional-ultrasound in primiparous women according to delivery mode: initial experience from a single reference service in Brazil
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2013-03-01) Araujo Júnior, Edward [UNIFESP]; Freitas, Rogério Caixeta Moraes De [UNIFESP]; Di Bella, Zsuzsanna Ilona Katalin De Jármy [UNIFESP]; Alexandre, Sandra Maria [UNIFESP]; Nakamura, Mary Uchiyama [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. METHODS: A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. RESULTS: The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm², respectively, versus 12.4 cm² in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). CONCLUSION: Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.
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    Avaliação da evolução da área das valvas mitral e tricúspide fetal com ultrassonografia tridimensional
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2010-09-01) Rolo, Liliam Cristine [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Simioni, Christiane [UNIFESP]; Zamith, Marina Maccagnano [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to evaluate the areas of the atrioventricular valves (tricuspid and mitral) of normal fetuses by the use of three-dimensional ultrasound (3DUS) and the spatiotemporal image correlation (STIC) method. METHODS: a cross-sectional study was conducted on 141 women between the 18th and the 33rd week of pregnancy. Cardiac volumes were measured with a volumetric transabdominal transducer attached to the Voluson 730 Expert equipment. The four chamber plane was used as reference, with the region of interest (ROI) positioned from the ventricles, and the area of the valves was obtained manually. To determine the correlation of the areas with gestational age, scatter plots were constructed and the Pearson correlation coefficient (r) was calculated. Means, medians, standard deviations (SD) and maximum and minimum values were calculated. The simple linear regression model was used to determine reference ranges of valve areas according to the gestational age by the Altman method, with the level of significance set at p<0.05. To calculate the intraobserver reproducibility, we used the intraclass correlation coefficient (ICC) and the Bland-Altman graph. RESULTS: the mitral and tricuspid valve areas were correlated to the gestational age (r=0.80 for the tricuspid and r=0.79 for the mitral valve) and the mean value of the tricuspid and mitral valves increased from 0.22±0.10 cm² and 0.23±0.10 cm² on the 18th week to 0.92±0.29 cm² and 1.08±0.41 cm² on the 33rd of pregnancy, respectively. The intraobserver reproducibility resulted in an ICC=0.993 (95%CI 0.987; 0.996) and the mean difference was 0.01 cm² (SD±0.2 cm² and CI95%±0.4 cm²). CONCLUSION: reference intervals for the areas of the mitral and tricuspid valve between the 18th and the 33rd week of gestation were determined and proved to be highly reproducible.
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    Efetividade da expansão rápida da maxila assistida cirurgicamente utilizando técnica de osteotomias em dois e três segmentos: ensaio clinico randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-01) Prado, Gabriela Pereira Ribeiro [UNIFESP]; Pereira, Max Domingues [UNIFESP]; Furtado, Fabianne Magalhães Girardin Pimentel [UNIFESP]; http://lattes.cnpq.br/5809529650066993; http://lattes.cnpq.br/9679136417299816; http://lattes.cnpq.br/9612434112678451; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The treatment of choice for adult transversal maxillary deficiency (TMD) ≥ 5mm is surgically assisted rapid maxillary expansion (SARME). There is no consensus in the literature on the best operatory technique, type and location of the osteotomies. Objective: Comparing 2- and 3-segment SARME effectiveness concerning quality of life (QL), maxillary expansion symmetry, stability of changes in palate area and volume, changes in nose width and topology of the paranasal area. Methods: 32 adult patients with TMD ≥ 5mm were randomly assigned to groups 2S (n=16) and 3S (n=16). Physical and psychological assessments were carried out before SARME (PREVIOUS) and in one of the following points in time: expansion accomplishment (EA), and four, six and ten months after EA (4M, 6M and 10M, respectively). QL was assessed according to Oral Health Impact Profile (OHIP-49) and Brazilian Orthognatic Quality of Life Questionaire (B-OQLQ). Symmetry of maxillary expansion was determined by superposing PRE and FE tomographs; stability of palate volume changes was assessed on 3D digital images produced from scanning PRE, 4M and 10M plaster casts; changes in nose width was established by superimposing PRE and 6M digital images obtained from scanning of patients faces; and clinical complications. Results: Results: There was statistical differences in the domains of Deficiency and Social Inability of OHIP-49 between 2S and 3S techniques. None of the tools assessing QL showed any statistically significant difference in total scoring when comparing groups 2S and 3S. There was an asymmetry of the expansion between the two techniques, however no differences were detected between the groups. The 2S and 3S techniques showed a significant increase in the area and volume of the A b s t r a c t | 161 palate at 4M, and at 10M the area measurement was stable while the volume showed a significant increase. The mean increase in nose width was greater (p=0.17) in group 2S (2.73mm) as compared with group 3S (1.92mm). There were no differences between the techniques regarding total, anteroposterior (Z axis) and vertical (Y axis) displacements, excepting for changes along X-axis (transversal) which were greater for 3S technique (p=0.014). The clinical postoperative complications were low and did not differ statistically between groups. Conclusion: Both SARME techniques produced the same positive quality-of-life impact on groups 2S and 3S as assessed 6 months after intervention; in the parameters used, the maxillary expansion asymmetry is similar in the 2S and 3S techniques; stable increase in palate area and volume as assessed in 10-month followup; similar forward changes in the topology of paranasal areas and 2S technique produced a larger nose width as compared with 3S intervention; postoperative complications were similar in 2S and 3S techniques .
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    Predição de peso ao nascimento pela medida do volume de membros fetais por meio da ultrassonografia tridimensional
    (Universidade Federal de São Paulo (UNIFESP), 2009-03-25) Vieira, Márcio Fragoso [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: to determine a formula for birth weight prediction with use of the fetal upper-arm and thigh volumetry obtained by three-dimensional ultrasonography (3DUS); to compare this formula with the Hadlock’s and Shepard’s; to assess the reliability of the method. Patients and methods: a cross seccional study was carried out involving 81 singleton pregnant women without fetal structural anomaly or aneuploidy, within 48 hours before delivery. After measured the BPD, HC, AC and F, the upper-arm (ArmVol) and thigh volume (ThVol) were assessed by 3DUS, slice by slice at 5 mm intervals. From linear and polinomial regression, we generate the best formula for predicting birth weight on the basis of ArmVol and ThVol. The errors of these formulas were compared with the Shepard’s and Hadlock’s formulas erros, with one-way ANOVA. To assess the reliability of ArmVol and ThVol, the intraclass correlation coefficients had been calculated. Level of significance of 5% was adopted. Results: The ArmVol formula is linear (Birthweight = 803,91 + 39,89 ArmVol) and the ThVol, polynomial of second degree (Birthweight = 32,37 ThVol - 0,06 ThVol²). Another formula was determined using the two parameters (Birthweight = 792,87 + 22,81 ArmVol + 7,54 ThVol). The error, absolute error, percentile error and absolute percentile error of the ArmVol formula was 0 g, 0.5%, 163,4 g and 5.4%; the ThVol, -0,99 g, 0.3%, 155,5 g and 5.2%; and the ArmVol and ThVol, 0 g, -0.4%, 138.4 g and 4.6%. When compared with the Hadlock’s and Shepard’s formulas, the ArmVol and ThVol showed lower errors, but only the absolute error and percentile absolute erros were significant lower than Shepard’s. The formula with the two parameters also showed lower errors, but only the error, percentile error and absolute percentile error had been significant, also in relation to the Shepard’s formula. The measure of the ArmVol and the ThVol are reliables with intraclass correlation coefficients of intraobserver 0,98 and 0,99; interobserver e 0.96 and 0.97, respectively. Conclusions: it was generated three formulas for predicting birth weight by ArmVol and ThVol; these formulas showed lower errors than Shepard’s and Hadlock’s formulas, despite only in relation to the first one, some types of errors had been significants; the measure of the ArmVol and the ThVol was well reproductible.
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    Predição de peso ao nascimento pela ultra-sonografia tridimensional usando o volume do braço fetal: resultados preliminares
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2008-04-01) Vieira, Márcio Fragoso [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Guimarães Filho, Hélio Antonio [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to evaluate the accuracy of fetal upper arm volume, using three-dimensional ultrasound (3DUS), in the prediction of birth weight. METHODS: this prospective cross-sectional study involved 25 pregnancies without structural or chromosomal anomalies. Bidimensional parameters (biparietal diameter, abdominal circumference and femur length) and the 3DUS fetal upper arm volume were obtained in the last 48 hours before delivery. The multiplanar method, using multiple sequential planes with 5.0-mm intervals, was used to calculate fetal upper arm volume. Polynomial regressions were used to determine the best equation in the prediction of fetal weight. The accuracy of this new formula was compared with Shepard's and Hadlock's formulas. RESULTS: fetal upper arm volume was strongly correlated to birth weight (r=0.83; p<0.005). Linear regression was the best equation [birth weight=681.59 + 43.23 x fetal upper arm volume]. The fetal upper arm volume mean error (0 g), mean absolute error (196.6 g) and mean percent absolute error (6.5%) were lower than using Shepard's formula; however, the difference did not reach significance (p>0.05). Birth weight predicted by fetal upper arm volume had a mean error lower than Hadlock's formula, but this difference was not statistically significant (p>0.05). CONCLUSIONS: the accuracy of fetal upper arm volume obtained through 3DUS is similar to the accuracy of bidimensional ultrasound in the prediction of birth weight. These findings need to be confirmed by larger studies.