Navegando por Palavras-chave "Tomography, X-ray computed"
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- ItemAcesso aberto (Open Access)Alterações tomográficas pulmonares em mulheres não fumantes com DPOC por exposição à fumaça da combustão de lenha(Sociedade Brasileira de Pneumologia e Tisiologia, 2013-04-01) Moreira, Maria Auxiliadora Carmo; Barbosa, Maria Alves; Queiroz, Maria Conceição De Castro Antonelli Monteiro De; Teixeira, Kim Ir Sen Santos; Torres, Pedro Paulo Teixeira E Silva; Santana Júnior, Pedro José De; Montadon Júnior, Marcelo Eustáquio; Jardim, José Roberto [UNIFESP]; Universidade Federal de Goiás Faculdade de Medicina; Universidade Federal de Goiás Faculdade de Enfermagem; Universidade Federal de Goiás Faculdade de Medicina Hospital das Clínicas; Universidade Federal de Goiás Faculdade de Medicina Departamento de Imagenologia e Patologia; Clínica Multimagem Diagnósticos; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To identify and characterize alterations seen on HRCT scans in nonsmoking females with COPD due to wood smoke exposure. METHODS: We evaluated 42 nonsmoking females diagnosed with wood smokerelated COPD and 31 nonsmoking controls with no history of wood smoke exposure or pulmonary disease. The participants completed a questionnaire regarding demographic data, symptoms, and environmental exposure. All of the participants underwent spirometry and HRCT of the chest. The COPD and control groups were adjusted for age (23 patients each). RESULTS: Most of the patients in the study group were diagnosed with mild to moderate COPD (83.3%). The most common findings on HRCT scans in the COPD group were bronchial wall thickening, bronchiectasis, mosaic perfusion pattern, parenchymal bands, tree-in-bud pattern, and laminar atelectasis (p < 0.001 vs. the control group for all). The alterations were generally mild and not extensive. There was a positive association between bronchial wall thickening and hour-years of wood smoke exposure. Centrilobular emphysema was uncommon, and its occurrence did not differ between the groups (p = 0.232). CONCLUSIONS: Wood smoke exposure causes predominantly bronchial changes, which can be detected by HRCT, even in patients with mild COPD.
- ItemAcesso aberto (Open Access)Avaliação da rinussinusite bacteriana aguda em pacientes asmáticos com base em parâmetros clínicos, exame otorrinolaringológico e estudo de imagem(Sociedade Brasileira de Pneumologia e Tisiologia, 2008-06-01) Faure, Alecsandra Calil Moises [UNIFESP]; Santoro, Ilka Lopes [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; Fernandes, Ana Luisa Godoy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate paranasal sinuses in patients with stable or acute asthma in order to determine the prevalence of acute bacterial rhinosinusitis. METHODS: A cross-sectional study including 30 patients with acute asthma (73% females) treated in the emergency room and 30 patients with stable asthma (80% females) regularly monitored as outpatients. All patients completed a questionnaire on respiratory signs and symptoms and were submitted to ear, nose and throat (ENT) examination, as well as to X-ray and computed tomography (CT) imaging of the sinuses. RESULTS: Based on the clinical diagnosis, the prevalence of acute bacterial rhinosinusitis was 40% in the patients with acute asthma and 3% in those with stable asthma. The ENT examination findings and the imaging findings in isolation were not useful to confirm the diagnosis. CONCLUSIONS: In themselves, ENT examination findings, X-ray findings and CT findings were not useful for the diagnosis of acute bacterial rhinosinusitis. Our results provide further evidence that a clinical diagnosis of bacterial rhinosinusitis should be made with caution.
- ItemAcesso aberto (Open Access)Considerações sobre eficiência administrativa relacionado aos exames de ultra-sonografia, tomografia computadorizada e ressonância magnética nas afecções orbitárias(Sociedade Brasileira de Oftalmologia, 2007-12-01) Watanabe, Magno [UNIFESP]; Morais, Carlos Augusto De; Couto Júnior, Abelardo De Souza; Universidade Federal de São Paulo (UNIFESP); Instituto Benjamin Constant Setor de Ultra-sonografia; Instituto Benjamin Constant; Faculdade de Medicina de Valença; Instituto Benjamin Constant Setor de Plástica Ocular e Órbita; Pontifícia Universidade CatólicaPURPOSES:This study focuses the orbital exams of ultrassononography (US), computed tomography (CT) and magnetic resonance imaging (MRI), and has the following purposes: Collecting the paid amounts by Sistema Único de Saúde (SUS), Associação Médica Brasileira (AMB) and private clinic tables. Reviewing the advantages and disadvantages of the referred diagnostic tests. Suggesting administrative efficiency measures related to these tests in the orbit. METHODS: The costs were achieved based on the amounts paid by SUS, brazilian medical insurance companies and private clinics in Rio de Janeiro City. Bibliographic research of the advantages and disadvantages of these tests. RESULTS: Amounts of these tests in reais (R$): US: 9,05 SUS / 81,77 AMB 90 / 57,01 AMB/CIEFAS 93 / 102,00 AMB/LPM 99 / 158,33 private clinics. CT 86,76 SUS / 193,70 AMB90 / 196,30 AMB/CIEFAS 93 / 204,12 AMB/LPM 99 / 255,33 private clinics MRI: 268,75 SUS / 475,80 AMB 90 and AMB/CIEFAS 93 / 472,50 AMB/LPM 99 / 563,33 private clinics. The advantages and disadvantages of these tests were described according to the literature review. CONCLUSION: Knowing the tests costs and its advantages and disadvantages are important strategies to improve efficiency in diagnostic imaging. It was also concluded the need of new clinical studies that includes economic evaluation of cost-effectiveness in US, CT and MRI exams in orbital diseases which allow the development of clinical practice guidelines or clinical protocols to be applied in medical and administrative decision making.
- ItemSomente MetadadadosCT and MRI in monitoring response: state-of-the-art and future developments(Edizioni Minerva Medica, 2011-12-01) D'Ippolito, Giuseppe [UNIFESP]; Torres, Lucas Rios [UNIFESP]; Saito Filho, Celso Fernando [UNIFESP]; Ferreira, R. M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The present review is aimed at updating the reader with the current role of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of tumor response, contextualizing the imaging methods advantages and limitations. CT has been the most frequent and widely adopted diagnostic tool. The main advantages of such method include wide availability, high reproducibility, capability to contemporarily evaluate soft tissues, bone and lung parenchyma, besides being easy to perform. Its main limitation is related to the use of ionizing radiation. MRI has emerged as a feasible alternative to CT, particularly in patients with contraindications to the use of iodinated contrast agents, with advantages related to its high soft tissues contrast. The disadvantages are based on its operational complexity and the many technical variables involved which may influence and compromise the reproducibility and broad implementation of the method. New criteria for evaluation of tumor response have recently been proposed, contemplating lately developed drugs and therapeutic strategies that demand the utilization of functional parameters. In this context, the technological developments incorporated in the CT and MRI imaging techniques, such as perfusion analysis, diffusion studies (DW-RM) and MR spectroscopy (MRS), among others, have provided relevant information regarding the tumor response to targeted therapies, anticipating dimensional alterations and guiding physicians in the course of the treatment. Despite such developments, further efforts are needed to establish reproducible protocols, functional response criteria and time intervals for response evaluation in order to allow a definitive incorporation of these new technologies in the assessment of tumor response.
- ItemAcesso aberto (Open Access)Diagnóstico auxiliado por computador na detecção de nódulos pulmonares pela tomografia computadorizada com múltiplos detectores: estudo preliminar de 24 casos(Sociedade Brasileira de Pneumologia e Tisiologia, 2008-01-01) Capobianco, Julia [UNIFESP]; Jasinowodolinski, Dany [UNIFESP]; Szarf, Gilberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Centro de Medicina Diagnóstica FleuryOBJECTIVES: To evaluate the performance of a computer program designed to facilitate the detection of pulmonary nodules using multidetector computed tomography (MDCT) scans of the chest. METHODS: We evaluated 24 consecutive MDCT scans of the chest at the Fleury Diagnostic Imaging Center during the period from October 7 to October 19 of 2006, using a 64-channel CT scanner. The study comprised 12 females and 12 males, ranging from 35 to 77 years of age (mean, 57.9 years). Double reading and a computer-aided diagnosis (CAD) system were used in order to perform two independent analyses of the data. The nodules found using both methods were recorded, and the data were compared. RESULTS: The total sensitivity of CAD for the detection of nodules was 16.5%, increasing to 55% when nodules <4 mm in diameter were excluded. Sensitivity by diameter was 6.5% for nodules <4 mm, 45% for nodules of 4-6 mm, 100% for nodules of 6 mm-10 cm, and 0% for nodules >1 cm. More than 99% of true nodules detected by CAD were registered in the image double reading process. CONCLUSIONS: In this preliminary 24-case study, the sensitivity of computer program tested was not significantly greater than that of the double-reading process that is routinely performed in this facility.
- ItemAcesso aberto (Open Access)Hematopoese extramedular: achados em tomografia computadorizada do tórax de 6 pacientes(Sociedade Brasileira de Pneumologia e Tisiologia, 2008-10-01) Marchiori, Edson; Escuissato, Dante Luiz; Irion, Klaus Loureiro; Zanetti, Gláucia; Rodrigues, Rosana Souza; Meirelles, Gustavo de Souza Portes [UNIFESP]; Hochhegger, Bruno; Universidade Federal Fluminense Departamento de Radiologia; Universidade Federal do Paraná; NHS Trust The Royal Liverpool Cardiothoracic Centre; Broadgreen University Hospitals; Faculdade de Medicina de Petrópolis; Hospital Clementino Fraga Filho; Hospital Copa D'Or; Universidade Federal de São Paulo (UNIFESP); Complexo Hospitalar Santa Casa de Porto AlegreOBJECTIVE: To present findings on computed tomography scans of the chest indicative of extramedullary hematopoiesis in six patients. METHODS: We retrospectively analyzed computed tomography scans of six adult patients - five males and one female - with a mean age of 36.5 years. Two radiologists independently reviewed the scans, and a consensus was reached in discrepant cases. RESULTS: The most common finding in the scans was lower paravertebral masses with heterogeneous content (four patients). The scans of two patients showed a solitary parietal and pleural mass. CONCLUSIONS: There are findings in computed tomography scans that are highly suggestive of extramedullary hematopoiesis, especially when those findings correlate with underlying blood diseases. Such findings, in most of the cases, allow physicians to dispense with histopathological confirmation.
- ItemAcesso aberto (Open Access)Observer agreement in the diagnosis of interstitial lung diseases based on HRCT scans(Sociedade Brasileira de Pneumologia e Tisiologia, 2010-02-01) Antunes, Viviane Baptista [UNIFESP]; Meirelles, Gustavo de Souza Portes [UNIFESP]; Jasinowodolinski, Dany [UNIFESP]; Pereira, Carlos Alberto de Castro [UNIFESP]; Verrastro, Carlos Gustavo Yuji [UNIFESP]; Torlai, Fabíola Goda [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To determine the interobserver and intraobserver agreement in the diagnosis of interstitial lung diseases (ILDs) based on HRCT scans and the impact of observer expertise, clinical data and confidence level on such agreement. METHODS: Two thoracic radiologists and two general radiologists independently reviewed the HRCT images of 58 patients with ILDs on two distinct occasions: prior to and after the clinical anamnesis. The radiologists selected up to three diagnostic hypotheses for each patient and defined the confidence level for these hypotheses. One of the thoracic and one of the general radiologists re-evaluated the same images up to three months after the first readings. In the coefficient analyses, the kappa statistic was used. RESULTS: The thoracic and general radiologists, respectively, agreed on at least one diagnosis for each patient in 91.4% and 82.8% of the patients. The thoracic radiologists agreed on the most likely diagnosis in 48.3% (κ = 0.42) and 62.1% (κ = 0.58) of the cases, respectively, prior to and after the clinical anamnesis; likewise, the general radiologists agreed on the most likely diagnosis in 37.9% (κ = 0.32) and 36.2% (κ = 0.30) of the cases. For the thoracic radiologist, the intraobserver agreement on the most likely diagnosis was 0.73 and 0.63 prior to and after the clinical anamnesis, respectively. That for the general radiologist was 0.38 and 0.42.The thoracic radiologists presented almost perfect agreement for the diagnostic hypotheses defined with the high confidence level. CONCLUSIONS: Interobserver and intraobserver agreement in the diagnosis of ILDs based on HRCT scans ranged from fair to almost perfect and was influenced by radiologist expertise, clinical history and confidence level.
- ItemAcesso aberto (Open Access)Papilomatose laringotraqueobrônquica: aspectos em tomografia computadorizada de tórax(Sociedade Brasileira de Pneumologia e Tisiologia, 2008-12-01) Marchiori, Edson; Araujo Neto, Cesar de; Meirelles, Gustavo de Souza Portes [UNIFESP]; Irion, Klaus Loureiro; Zanetti, Gláucia; Missrie, Israel [UNIFESP]; Sato, Juliana [UNIFESP]; Universidade Federal Fluminense Departamento de Radiologia; Universidade Federal da Bahia; Universidade Federal de São Paulo (UNIFESP); Broadgreen University Hospitals Royal Liverpool; Faculdade de Medicina de PetrópolisOBJECTIVE: To present the findings of computed tomography (CT) scans of the chest in patients with laryngotracheobronchial papillomatosis. METHODS: We retrospectively analyzed CT scans of eight patients, five males and three females, ranging from 5 to 18 years of age with a mean age of 10.5 years. Images were independently reviewed by two radiologists. In discrepant cases, a consensus was reached. RESULTS: The most common CT findings were intratracheal polypoid lesions and pulmonary nodules, many of which were cavitated. CONCLUSIONS: In patients with laryngotracheobronchial papillomatosis, the most common tomographic finding was the combination of intratracheal polypoid lesions and multiple pulmonary nodules, many of which were cavitated.