Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Ultra-sonografia"

Navegando por Palavras-chave "Ultra-sonografia"

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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.
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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.
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Aspectos ultra-sonográficos das alterações não-neoplásicas do testículo
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2007-02-01) Vital, Ricardo Jorge; Mattos, Leandro Accardo De; Souza, Luís Ronan Marquez Ferreira De; Figueirêdo, Sizenildo Da Silva; Szejnfeld, Jacob [UNIFESP]; Colégio Brasileiro de Radiologia e Diagnóstico por imagem; Universidade Federal do Triângulo; Universidade Federal de Rondônia Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP)
Pathological processes of the testis are very frequently found, and include non-tumoral and tumoral lesions. Ultra-sonography performed with a high-frequency transducer has become the imaging modality of choice for examination of these organs. This method is of help to improve intratesticular lesions characterization, and in many instances the findings suggest a more specific diagnosis, especially in the presence of similar clinical manifestations such as pain, swelling and local increase in volume. Color Doppler is an invaluable tool for demonstrating anomalous patterns of testicular perfusion and aids in the diagnosis of acute clinical conditions. In the present iconographic essay, the authors summarize the most frequent clinical, pathological findings as well as the main diagnostic features of benign intratesticular lesions such as microlithiasis, simple cysts, spermatocele, varicocele, tubular ectasia of the rete testis, orchitis, hematomas and more rare conditions. Familiarity with clinical and sonographic features is essential for the correct diagnosis and starting of the most effective therapy, as necessary.
Acesso aberto (Open Access)
Avaliação crítica dos benefícios e limitações da ressonância magnética como método complementar no diagnóstico das malformações fetais
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-10-01) Ximenes, Renato Luis Da Silveira [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Ximenes, Andréa Regina Da Silveira; Zanderigo, Valdir; Universidade Federal de São Paulo (UNIFESP); Centro de Ultra-Sonografia e Medicina Fetal de Campinas; Cura
OBJECTIVE: The present study was aimed at evaluating by means of magnetic resonance imaging a series of fetuses with sonographic diagnosis of malformation, establishing the diagnostic benefits and limitations of fetal magnetic resonance imaging as compared with ultrasonography. MATERIALS AND METHODS: Forty women between 15-35 gestational weeks and previously diagnosed with fetal abnormality by ultrasonography were referred to undergo complementary fetal magnetic resonance imaging, particularly for evaluating abnormalities in the fetal central nervous system, thorax, abdomen, renal system, skeletal system, and tumors. The whole evaluation process included a review of the fetal ultrasonography and magnetic resonance images, postnatal follow-up, laboratory tests, imaging studies and necropsy. RESULTS: The present study has demonstrated that complementary magnetic resonance imaging did provide further information in 60% of cases, with the following benefits: improved information on the fetus as a whole, with a large field of view, higher anatomic resolution provided by fast sequences, superior soft tissue contrast resolution, besides the fact that the visualization of the fetus is not significantly affected by maternal obesity or oligohydramnios. Limitations of the method include contraindication in the first gestational trimester and in cases of maternal claustrophobia, sensitivity to fetal motion, low sensitivity for detecting cardiovascular and skeletal malformations. CONCLUSION: Fetal magnetic resonance imaging plays a significant role as a complementary method for the diagnosis of fetal anomalies.
Acesso aberto (Open Access)
Avaliação da concordância entre ressonância magnética de ultra-sonografia na classificação de fibrose periportal em esquitossomóticos, segundo a classificação de Niamey
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2007-10-01) Scortegagna Junior, Eduardo [UNIFESP]; Leão, Alberto Ribeiro de Souza [UNIFESP]; Santos, José Eduardo Mourão [UNIFESP]; Sales, Danilo Moulin [UNIFESP]; Shigueoka, David Carlos [UNIFESP]; Aguiar, Luciane Aparecida Kopke de [UNIFESP]; Brant, Paulo Eugênio [UNIFESP]; Colleoni Neto, Ramiro [UNIFESP]; Borges, Durval Rosa [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To evaluate the reproducibility of magnetic resonance imaging and the agreement between ultrasound and magnetic resonance imaging in the classification of periportal fibrosis in patients with schistosomiasis based on Niamey's qualitative criteria. MATERIALS AND METHODS: A prospective, double-blinded study was conducted between February 2005 and June 2006 with 20 patients (10 men and 10 women, with ages ranging between 24 and 60 years, mean age 42.7 years) diagnosed with schistosomiasis mansoni. Both ultrasound and magnetic resonance images were independently evaluated by two experienced observers. Interobserver agreement was evaluated for findings of periportal fibrosis on magnetic resonance images and in a comparison between magnetic resonance and ultrasound images. RESULTS: The analysis of magnetic resonance images showed total interobserver agreement in 14 patients (70%). The comparison between ultrasound and magnetic resonance imaging showed agreement between images in only six cases (30%) by observer 1, and in eight cases (40%) by observer 2. CONCLUSION: Magnetic resonance imaging presents a good reproducibility in the evaluation of periportal fibrosis in later stages of schistosomiasis, however, the correlation between magnetic resonance imaging and ultrasound is poor.
Acesso aberto (Open Access)
Avaliação ultra-sonográfica de nódulos sideróticos esplênicos em pacientes esquistossomóticos com hipertensão portal
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-04-01) Gonzalez, Thais Dias [UNIFESP]; Santos, José Eduardo Mourão [UNIFESP]; Sales, Danilo Moulin [UNIFESP]; Takemoto, Kenji [UNIFESP]; Capobianco, Júlia [UNIFESP]; Brant, Paulo Eugênio [UNIFESP]; Colleoni Neto, Ramiro [UNIFESP]; Ahmed, Munneb; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Harvard Medical School Beth Israel Deaconess Medical Center Department of Radiology
OBJECTIVE: To evaluate ultrasound sensitivity and reproducibility as compared with magnetic resonance imaging as the gold standard in the detection of splenic siderotic nodules in schistosomal patients. MATERIALS AND METHODS: Initially, 21 patients with hepatosplenic schistosomiasis and diagnosed with splenic siderotic nodules by magnetic resonance imaging were ultrasonographically evaluated for determining the method sensitivity. In a second phase, the method reproducibility in the detection and quantification of siderotic nodules (A: 1-5 nodules; B: 6-20 nodules; C: > 20 nodules) was evaluated in 30 patients who were submitted to ultrasonography blindly and independently assessed by two observers. Interobserver agreement was measured by kappa statistics. RESULTS: Ultrasound sensitivity was 95.2% (95% confidence interval [77.3%; 99.2%]). Intermethod agreement in the detection of siderotic nodules was 96.7% (95% confidence interval [82.8%; 99.9%]). For classification of nodules according to their quantification, the kappa test demonstrated a statistically significant interobserver agreement (kappa = 0.67). CONCLUSION: Ultrasonography is highly sensitive and accurate in the assessment of splenic siderotic nodules in schistosomal patients.
Acesso aberto (Open Access)
Avaliação Ultra-Sonográfica do Crescimento Fetal com uso do Diâmetro Transverso do Cerebelo
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2000-06-01) Nery, Luiz; Moron, Antonio Fernandes [UNIFESP]; Kulay Junior, Luiz [UNIFESP]; Universidade Estadual de Maringá Hospital Universitário; Universidade Federal de São Paulo (UNIFESP)
Purpose: to evaluate the effectiveness of the transverse cerebellar diameter (TCD), by ultrasonography, in the evolution of the fetal growth, and to relate it to gestational age, biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). Method: a prospective and longitudinal study was performed on 254 pregnant women considered of low risk, with a gestational age from 20 to 40 weeks. Only 55 pregnant women were included in the study, according to inclusion and exclusion criteria. All the examinations, 217 ultrasonographic evaluations, were done by the author (LN), at least three and at most six examinations for each pregnant woman being accomplished at an interval of one to five weeks. Normality patterns were established between the 10 and 90 percentiles for each gestational age and confirmed postnatally. Results: the transverse cerebellar diameter presented a good correlation with the gestational age either as a dependent variable (R² = 0.90) or as an independent variable (R² = 0.92). A significant relationship was found in the evaluation of the fetal growth between the TCD and the several fetal parameters: BPD and HC (R² = 0.92), FL (R² = 0.90) and AC (R² = 0.89). Conclusions: the transverse cerebellar diameter is a parameter that should be used in the follow-up of development and of fetal growth because of the ascending pattern of its growth curve. Any up- or downward alteration in the growth curve can be useful for the detection of deviations of fetal growth.
Acesso aberto (Open Access)
Biomicroscopia ultra-sônica em esclerectomia profunda: relato de caso
(Conselho Brasileiro de Oftalmologia, 2008-06-01) Villas-bôas, Flávia; Allemann, Norma [UNIFESP]; Morales, Maira Saad Avila; Omi, Carlos Akira [UNIFESP]; Instituto Brasileiro de Oftalmologia e Prevenção à Cegueira; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
Case report of a woman with the diagnosis of primary open-angle glaucoma who was submitted to a successful surgical procedure of deep sclerectomy in the right eye. In the postoperative period, at month 3, the surgical procedure was evaluated with ultrasound biomicroscopy (UBM) utilizing two distinct equipments (UBM 840-Zeiss; UBM-VUMAX-Sonomed), with 50-MHz transducers. The diagnostic method of ultrasound biomicroscopy can be utilized as a non invasive method to evaluate the internal architecture of the eye at the topography of deep sclerectomy. It allows to identify the anterior segment structures, their anatomical relationship, and also the intact trabecular-Descemet membrane and the intrascleral space. Ultrasound biomicroscopy showed to be useful in evaluating postoperative status of the surgical procedure.
Acesso aberto (Open Access)
Capacitação de enfermeiros para uso da ultrassonografia na punção intravascular periférica
(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2010-06-01) Avelar, Ariane Ferreira Machado [UNIFESP]; Peterlini, Maria Angélica Sorgini [UNIFESP]; Onofre, Priscilla Sete de Carvalho [UNIFESP]; Pettengill, Myriam Aparecida Mandetta [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The objective was to explain, to the nurses training, procedures using vascular ultrasound for obtaining peripheral vascular access. The program consisted of theoretical and practical educational interventions developed over a period of six months. The strategies were developed and implemented by two nurses specialized in intravascular therapy, one doctor specialized in vascular ultrasound and, one biomedical engineer. Eight nurses participated in the training. The knowledge, skills and abilities acquired in the identification of arteries, veins, blood flow and catheter position, were evaluated. The strategy will enable that the pediatrician nurses acquiring skills to promote innovative interventions in peripheral intravascular puncture.
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)
Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting
(Associação Paulista de Medicina - APM, 2007-03-01) Souza, Luís Ronan Marquez Ferreira de [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Faintuch, Salomão [UNIFESP]; Faria, Juliano Ferreira [UNIFESP]; Bekhor, Daniel [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Choyke, Peter [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
CONTEXT AND OBJECTIVE: Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING: Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS: US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS: Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS: US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.
Acesso aberto (Open Access)
Comprimento do colo uterino e dilatação do orifício interno avaliados pela ultra-sonografia bidimensional e tridimensional
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-07-01) Brandão, Rosieny Souza [UNIFESP]; Murta, Carlos Geraldo Viana; Moron, Antonio Fernandes [UNIFESP]; Mattar, Rosiane [UNIFESP]; Pires, Claudio Rodrigues [UNIFESP]; Guerzet, Eduardo Almeida; Universidade Federal de São Paulo (UNIFESP); Centro de Diagnóstico por Imagem; Universidade Federal do Espírito Santo Departamento de Ginecologia e Obstetrícia; Centro de Treinamento de Ultra-sonografia; Santa Casa de Misericórdia de Vitória Escola de Medicina Departamento de Tocoginecologia
PURPOSE: to compare the uterine cervix measurements and funneling obtained by two- and three-dimensional transvaginal sonography during pregnancy. METHODS: a prospective, descriptive study, with group comparison, was carried out between April 2004 and February 2005 in 74 pregnant women, who were between the 19th and 24th week of pregnancy, regardless of risk factors for premature delivery. The ultrasound examination of the cervix was carried out only once in the same patient and by only one observer. The measurements of the cervix by two-dimensional ultrasound were made at the time of the test and by three-dimensional ultrasound at intervals of 7 to 15 days after the two-dimensional ultrasound. The measurements of cervical length, funnel width and length were taken by two-dimensional ultrasound in the sagittal plane and by three-dimensional in the sagittal plane as well as in coronal plane. RESULTS: there was no significant difference between the averages of the measurements of the cervix obtained by two- and three-dimensional ultrasound in the sagittal plane (p=0.23); however, there was a difference in the averages of the measurements of the cervix obtained by two-dimensional ultrasound in sagittal plane and three-dimensional ultrasound in the coronal plane (p=0.009) and between three-dimensional ultrasound in the sagittal and coronal planes (p=0.001). The kappa test (0.86) showed no superiority of either the two-dimensional and three-dimensional ultrasound in the visualization of the cervical funnel. No statistically significant difference was observed between the methods when the average of the measurements of funneling was compared (p>0.05). CONCLUSION: there were differences between two-dimensional and three-dimensional ultrasound of cervical length, only using the coronal plane of the three-dimensional ultrasound.
Acesso 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 Católica
PURPOSES: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.
Acesso aberto (Open Access)
Contribuição da mamografia e da ultra-sonografia na avaliação da mama reconstruída com retalho miocutâneo
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-02-01) Louveira, Maria Helena; Kemp, Claudio [UNIFESP]; Vilar, Vanessa Sales [UNIFESP]; Elias, Simone [UNIFESP]; Spadoni, Cristiane Grein Basso; Gracino, Alencar; Szejnfeld, Jacob [UNIFESP]; Colégio Brasileiro de Radiologia e Diagnóstico por Imagem; Universidade Federal de São Paulo (UNIFESP); CBR
Breast reconstruction using myocutaneous flaps has been widely used in patients undergoing modified radical mastectomy for the treatment of breast cancer with significant improvement in esthetical results, which also helps to improve self-esteem of the patients as it minimizes the feeling of mutilation, without changing disease prognosis. Previously, it was believed that there was no risk of recurrence in the reconstructed breast due to the complete removal of breast tissue. However, histological studies have shown that a small amount of glandular tissue may remain after mastectomy, with a high potential for malignancy. Clinical follow-up of mastectomy patients is recommended as most recurring lesions occur at the flap margins and can be detected by palpation. In addition, the inclusion of mammographic and ultrasound monitoring has been proposed for the follow-up of patients as these methods may contribute to the diagnosis of recurrent lesions before they become palpable.
Acesso aberto (Open Access)
Diagnóstico de metástases de carcinoma papilífero de tiróide através da dosagem de tiroglobulina no líquido obtido da lavagem da agulha utilizada na punção aspirativa
(Sociedade Brasileira de Endocrinologia e Metabologia, 2007-04-01) Biscolla, Rosa Paula M. [UNIFESP]; Ikejiri, Elza S. [UNIFESP]; Mamone, Maria Conceição [UNIFESP]; Nakabashi, Cláudia C.d. [UNIFESP]; Andrade, Victor P.; Kasamatsu, Teresa S. [UNIFESP]; Crispim, Felipe [UNIFESP]; Chiamolera, Maria Izabel [UNIFESP]; Andreoni, Danielle M. [UNIFESP]; Camacho, Cleber P. [UNIFESP]; Hojaij, Flávio C. [UNIFESP]; Vieira, José Gilberto H. [UNIFESP]; Furlanetto, Reinaldo P. [UNIFESP]; Maciel, Rui Monteiro de Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Laboratório Fleury
The widespread use of neck ultrasonography (US) during the follow-up of patients with papillary thyroid carcinoma (PTC) has led to the discovery of small cervical lymph nodes (LN). Although US has a high sensitivity for diagnosing LN, fine needle aspiration biopsy (FNA) and measurement of thyroglobulin in fine needle aspirates (FNA-Tg) have proven to be invaluable tools. The aim of this study is to determine the sensitivity of the combined use of neck US, FNA biopsy and FNA-Tg for diagnosis of cervical lymph nodes. We have studied 32 patients with 44 LN detected by US, 19 classified as inflammatory and 25 as suspicious. 15 of those 25 suspicious LN had high FNA-Tg (13 of the 15 had positive cytology and 2 indeterminate). All of these 15 LN (11 patients) were proven to be PTC metastasis by histopathology. All 19 inflammatory LN and those 10/25 suspicious LN, had cytology negative for malignancy and undetectable FNA-Tg. We conclude that fine needle aspiration biopsy and FNA-Tg combined with neck US are essential for detecting positive cervical lymph nodes due to its high sensitivity and specificity and it should be considered the standard for investigating locally recurrent disease in patients with PTC.
Acesso aberto (Open Access)
O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF): relato de caso
(Conselho Brasileiro de Oftalmologia, 2003-01-01) Corrêa, Zélia Maria da Silva [UNIFESP]; Irion, Luciane Cristina Dreher; Marcon, Ítalo Mundialino; Goldhardt, Raquel; Travi, Giovanni Marcos; Universidade Federal de São Paulo (UNIFESP); Fundação Faculdade Federal de Ciências Médicas de Porto Alegre; Serviço de Oftalmologia da Santa Casa de Porto Alegre; Santa Casa de Porto Alegre
PURPOSE: To report a case of a patient with lung carcinoma in which the first detected metastasis was to the choroid, how it was diagnosed and confirmed. METHODS: A 35 year-old white male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye) for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB) was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3) positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.
Acesso aberto (Open Access)
Effect of mydriatic and cycloplegic drugs in glaucomatous and nonglaucomatous eyes using ultrasound biomicroscopy
(Conselho Brasileiro de Oftalmologia, 2000-08-01) Miranda, Danielle [UNIFESP]; Allemann, Norma [UNIFESP]; Mello, Paulo Augusto de Arruda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Purpose: To study the anatomical relationships of the anterior segment of the eye, using ultrasound biomicroscopy in patients with chronic simple glaucoma and nonglaucomatous eyes, after mydriatic and cycloplegic instillation. Patients and Methods: Thirty eyes with chronic simple glaucoma and 30 nonglaucomatous eyes were studied. Anterior chamber depth, iris-lens contact and iris-zonule distance were measured, in both groups, using ultrasound biomicroscopy, in the three following conditions: without mydriatic and cycloplegic instillation, with 1% tropicamide alone and with 1% tropicamide plus 10% phenylephrine chlorhydrate. Results: Ultrasound biomicroscopy examinations of glaucomatous and nonglaucomatous eyes, without mydriatic and cycloplegic instillation, showed no statistically significant difference in the central anterior chamber depth, iris-lens contact and iris-zonule distance. The difference between examinations without mydriatic and cycloplegic instillation, with 1% tropicamide and with 1% tropicamide plus 10% phenylephrine chlorhydrate was statistically significant regarding the variables measured in both groups. Conclusions: No anatomical difference was observed between the anterior segment of glaucomatous and nonglaucomatous eyes after mydriatic and cycloplegic instillation. The results of this clinical investigation, using ultrasound biomicroscopy were innovative, allowing a dynamic and quantitative evaluation of the anatomical relationships between intraocular structures when submitted to mydriasis and cycloplegy, which up to now were only qualitative.
Acesso aberto (Open Access)
O emprego da biomicroscopia ultra-sônica no diagnóstico e evolução clínica dos diferentes tipos de esclerite anterior
(Conselho Brasileiro de Oftalmologia, 2001-06-01) Sternlicht, Telma [UNIFESP]; Allemann, Norma [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Purpose: To correlate findings on ultrasound biomicroscopy with types of anterior scleritis. Methods: Six patients with clinical findings of anterior scleritis were examined by ultrasound biomicroscopy (50 MHz transducer), performed at the Ocular Ultrasound Section of Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina for elucidation of histopathological alterations in anterior scleritis. Results: Patients with nodular scleritis had well-limited lesions, with homogeneously low reflectivity and localized increased thickness with lower reflectivity of adjacent tissues. Patients with diffuse scleritis had an heterogeneous increased thickness with heterogeneous reflectivity (a mottled appearance). Patients with necrotizing scleritis presented loss of tissue with scleral thinning and inflammatory adjacent vitreous changes. Conclusions: Ultrasound biomicroscopy is an excellent noninvasive method in identifying involved ocular tissues in anterior scleritis, helping the ophthalmologist in his/her diagnosis and treatment.
Acesso aberto (Open Access)
Emprego da ultra-sonografia cervical no seguimento de pacientes com carcinoma diferenciado de tireóide
(Sociedade Brasileira de Endocrinologia e Metabologia, 2007-06-01) Rosário, Pedro W.; Tavares Júnior, Wilson C.; Biscolla, Rosa Paula M. [UNIFESP]; Purisch, Saulo; Maciel, Rui Monteiro de Barros [UNIFESP]; Santa Casa de Belo Horizonte Serviço de Endocrinologia; Instituto Alpha de Gastroenterologia; Universidade Federal de São Paulo (UNIFESP)
Neck ultrasonography (US) is recommended for the assessment of all patients with thyroid carcinoma after initial therapy, since even low-risk patients with undetectable stimulated thyroglobulin (Tg) may present cervical metastases. In the case of these metastases, US is the most sensitive method and is superior to whole-body 131I scanning. Cervical lymph nodes with a diameter > 5 mm presenting thin calcifications and/or cystic degeneration have almost always a malignant etiology. In the absence of these characteristics, a round shape and the absence of an echogenic hilum are suspicious findings, whereas elongated lymph nodes with a visible echogenic hilum are considered benign. Doppler flow analysis helps with the differential diagnosis, usually revealing peripheral or mixed hypervascularization in malignant cases. In the presence of suspicious lymph nodes upon US, fine-needle aspiration cytology and measurement of Tg in the needle lavage fluid are useful and complementary exams for the definition of the etiology, with the combination of the two methods showing elevated sensitivity and 100% specificity. US is also useful before thyroidectomy, even contributing in some cases to modify the surgical planning, and before ablation for the measurement of thyroid remnants and detection of persistent lymph node metastases. Another application of this imaging method is to guide the injection of ethanol (sclerotherapy) or the introduction of electrodes for radiofrequency ablation in selected cases of isolated lymph node metastases as an alternative to traditional therapies.
Acesso aberto (Open Access)
Importância da ultra-sonografia anorretal tridimensional na decisão terapêutica da endometriose profunda
(Cidade Editora Científica Ltda, 2009-12-01) Sagae, Univaldo Etsuo; Lima, Doryane Maria Dos Reis; Cavalli, Namir; Sagae, Lucia Matiko Takamatsu; Tanaka, Tomaz Massayuki [UNIFESP]; Bonatto, Mauro Willemann; Tsuchiya, Ricardo Shigeo; Carvalho, Carlos Alberto De [UNIFESP]; Shiratori, Andrea Ishikawa; Universidade Estadual do Oeste do Paraná; UFC/CE Universidade Estadual do Oeste do Paraná; Universidade Estadual do Oeste do Paraná Departamento de Ginecologia e Obstetrícia SOBENGE; Universidade Federal de São Paulo (UNIFESP); UFPR Universidade Estadual do Oeste do Paraná
OBJECTIVE: This study aims to demonstrate the importance of three-dimensional anorectal ultrasonography (US 3D) in the diagnosis of deep endometriosis and level of intestinal involvement in the decision of the therapy of endometriosis of rectovaginal septum. METHODS: A prospective study between March 2007 and July 2009. Sixty-five women with pelvic endometriosis and gastrointestinal complaints were evaluated and submitted to 3D U.S.. Twenty patients, mean age 33.7 years, with suspected of intestinal endometriosis were submitted to laparoscopic procedure and surgical treatment. RESULTS: In nineteen women (95%), the laparoscopic findings confirmed endometriosis in the rectum. The procedure was performed to laparoscopy: the focus peritoneal excision (n = 1), partial resection of rectosigmoid (n = 9), excision of a nodule of rectum (n = 10). The average operative time per procedure was 120 minutes. The average time to stay in hospital was 1.7 days. Two patients had the appearance as complication of rectovaginal fistula. CONCLUSION: We conclude that three-dimensional anorectal ultrasonography is specific in the assessment of anorectal segment, crucial for detecting endometriosis focus of the rectovaginal septum and evaluates possible associated diseases in this segment, determining the appropriate therapeutic strategy and surgical.