Navegando por Palavras-chave "tomografia computadorizada"
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- ItemAcesso aberto (Open Access)Ablação por radiofrequência percutânea no tratamento de adenomas funcionantes de adrenal: resultados clínicos e laboratoriais(Universidade Federal de São Paulo (UNIFESP), 2015-08-20) Szejnfeld, Denis [UNIFESP]; Goldman, Suzan Menasce Goldman [UNIFESP]; Aizen, Sergio [UNIFESP]; http://lattes.cnpq.br/4029665568653148; http://lattes.cnpq.br/4903816455277036; http://lattes.cnpq.br/6143040854616763; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To evaluate clinical and laboratory findings in patients undergoing radiofrequency (RF) ablation for functioning adrenal adenomas. MATERIALS AND METHODS: Eleven adult patients, nine with Conn syndrome and two with Cushing syndrome, underwent percutaneous computed tomography-guided RF ablation for benign adrenal neoplasms. Systolic, diastolic, and mean blood pressure and the number of classes of antihypertensive drugs used by each patient were analyzed before and 1, 4, and 12 weeks after the procedure. Serum hormone levels were analyzed within 30 days before and 12 weeks after the procedure. RESULTS: Of the nine patients with Conn syndrome, eight showed normal serum aldosterone levels after the procedure and one patient had a nodule located very close to the inferior vena cava, resulting in incomplete ablation. The two patients with Cushing syndrome had normal serum and salivary cortisol levels after the procedure. Mean aldosterone concentration at baseline was 63.3 ng/dL ± 28.0 and decreased to 13.3 ng/dL ± 13.5 at 12 weeks postoperatively (P = .008). Systolic, diastolic, and mean blood pressures decreased significantly in the first week after the procedure (P?< .001) and remained stable during further follow-up. CONCLUSIONS: In patients with Conn syndrome or Cushing syndrome, percutaneous RF ablation of functioning adrenal adenomas may result in normalization of hormone secretion, improvement in blood pressure, and reduced need for antihypertensive drugs.
- ItemSomente MetadadadosAvaliação das alterações esqueléticas na cavidade nasal em pacientes submetidos a disjunção maxilar ortopédica(Universidade Federal de São Paulo (UNIFESP), 2014-06-25) Francisco, Sheila Marcia [UNIFESP]; Fujita, Reginaldo Raimundo Fujita [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Maxillary atresia is a skeletal condition characterized by a transversal growth deficiency of the upper arch, with high prevalence in childhood, which demand intervention as early as it is possible, since it may be associated with breathing disorders, in some cases. Objectives: This study had the purpose to evaluate the dimensional changes of the nasal cavity on its height, width and volume previously and after Orthopedic Maxillary Expansion (OME) in mouth-breathing patients. Method: To this research, 18 patients were selected with clinical diagnosis of maxillary transversal deficiency and treated with OME, at the ambulatory of the Mouth Breather Center of the Pediatric Otorhinolaryngology department of the Federal University of São Paulo, 9 (50.0%) were male, with average age of 9.6 years old, with range between 6.4 and 14.2 years, with Standard Deviation of 2.6 years prior to the OME, the remaining 9 individual (50%), were females, with average age of 9.4 years old, ranging from 6.4 and 12.4 years, with Standard Deviation of 2.1 years prior to de OME. The included patients went through two facial Computed Tomography (CT) exam, previously and also 3 months after of the end of the active phase of the OME, and measurement of nasal height, width and volume where obtained through the software Implantviewer ® version 2.817 and the software for image treatment, Dolphing® Imaging version 11.7. Results: The results showed a statistically significant increase of nasal height previous and after OME, from 43.58 mm and 46.00 mm. The average nasal width prior to the OME was 21.7mm and 23.73mm after. The nasal volume increased from 33764.9 mm3 to 37932.5 mm3 after the treatment with OME. Conclusion: Based on the results, the Orthopedic Maxillary Expansion leads to an increase of the tested nasal characteristics.
- ItemSomente MetadadadosAvaliação volumétrica do seio maxilar em pacientes submetidos à disjunção maxilar ortopédica(Universidade Federal de São Paulo (UNIFESP), 2015-06-30) Alves, Fabio Eduardo Maiello Monteiro [UNIFESP]; Fujita, Reginaldo Raimundo Fujita [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Due to the high occurrence of maxillary atresia in children treatment should be done as early as possible. Objective: This study aimed to assess the volumetric changes of the maxillary sinuses pre and post disjunction orthopedic jaw (BMD) in mouth breathing patients. Methods
- ItemAcesso aberto (Open Access)Basal encephalocele associated with morning glory syndrome: case report(Academia Brasileira de Neurologia - ABNEURO, 2007-12-01) Minotto, Ivanete [UNIFESP]; Abdala, Nitamar [UNIFESP]; Miachon, Adriana Aparecida Siviero [UNIFESP]; Spinola-Castro, Angela Maria [UNIFESP]; Imamura, Paulo [UNIFESP]; Nogueira, Roberto Gomes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The basal encephaloceles refer to rare entities and they correspond to herniation of brain tissue through defects of skull along the cribiform plate or the sphenoid bone. A rare morning glory syndrome, with characteristic retinal defect has been reported in association with basal encephaloceles. Hypophysis hormonal deficiencies may occur. We accounted for a pituitary dwarfism with delayed diagnosed transsphenoidal encephalocele associated with morning glory syndrome, showing the alterations found in retinography, computed tomography and magnetic resonance imaging.
- ItemAcesso aberto (Open Access)Contribuição dos métodos de diagnóstico por imagem na avaliação da espondilólise(Sociedade Brasileira de Reumatologia, 2006-08-01) Zoner, Cristiane Soares [UNIFESP]; Amaral, Denise Tokechi do [UNIFESP]; Natour, Jamil [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
- ItemSomente MetadadadosA fase inspiratória é desnecessária na avaliação tomográfica de pacientes com bronquiolite obliterante pós-transplante de medula óssea(Universidade Federal de São Paulo (UNIFESP), 2015-08-19) Togni Filho, Paulo Henrique Alves [UNIFESP]; Lederman, Henrique Manoel Lederman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: Avaliar a necessidade da fase inspiratória na tomografia computadorizada de tórax em pacientes com bronquiolite obliterante pós-transplante de medula óssea. Métodos: Estudo retrospectivo, observacional, transversal. Foram selecionados pacientes que realizaram TMO e TC de tórax, com idade entre 3 meses e 20,7 anos, de ambos os sexos, durante 12 anos e 9 meses (entre os dias 01/03/2002 a 12/12/2014). Todos os exames foram realizados no Centro de Diagnóstico por Imagem (CDI) do IOP/GRAACC, com qualidade técnica adequada para análise pelos radiologistas. As imagens foram analisadas em consenso por um radiologista com grande experiência em radiologia pediátrica (HML) e um radiologista em treinamento (PHATF), avaliando aspectos específicos das imagens como aprisionamento aéreo/atenuação em mosaico, bronquiectasia, opacidade, nódulos inespecíficos e atelectasia, com critérios objetivos. Resultados: Foram avaliados 222 exames no total (média de 5,4 ± 4,5 exames por paciente). A fase expiratória encontrou os mesmos achados que as duas fases em conjunto, excetuando um único nódulo identificado somente na fase inspiratória. A fase expiratória identificou um número estatisticamente superior de aprisionamento aéreo/atenuação em mosaico em relação à fase inspiratória e um número maior de atelectasia, porém sem diferença significativa. Conclusão: Concluímos que a fase inspiratória pode ser excluída do protocolo para avaliação de crianças pós TMO com suspeita de bronquiolite obliterante, reduzindo assim pela metade a quantidade de radiação a qual essas crianças são expostas.
- ItemAcesso aberto (Open Access)Fístula labiríntica na otite média crônica colesteatomatosa(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2003-08-01) Penido, Norma de Oliveira [UNIFESP]; Barros, Flávia A. [UNIFESP]; Iha, Luiz C. N. [UNIFESP]; Abreu, Carlos E.c. [UNIFESP]; Silva, Rogério N. [UNIFESP]; Park, Sung W. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The chronic otitis media with cholesteatoma (COMC) may evoluate to intracranial and extra cranial complications, including the labyrithine fístulae. In this study, we present the evolution of our patients with labyrinthine fístulae. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: Ten out 82 patients with COMC had labyrinthine fístulae and underwent surgery from January/2001 to April/2002. They were assessed by clinical exam, computed tomography scans, and pre and postoperative audiogram. RESULTS: Hearing loss, otorrhea, tinnitus and dizziness were present in 100%, 90%,80%, and 40% of the cases. In one patient the fístulae was seen only in the coronal CT-scan, in another patient the fístulae was not seen neither in coronal nor axial images. Among the patients who had tinnitus, 66% referred improvement of this complaint after surgery. DISCUSSION: in the cases without invasion of the perilymphatic space, we noticed a tendency of improvement of the postoperative audiogram pattern and clinical outcome. In the extensive fístulae, on the other hand, there were no clinical changes. CONCLUSION: The CT-scan remains the best exam to assess the COMC with 90% of sensitivity for labyrinthine fístulae. In the stage II we had a good postoperative outcome.
- ItemAcesso aberto (Open Access)Germinoma localizado nos núcleos da base e tálamo com invasão do tronco cerebral: relato de caso(Academia Brasileira de Neurologia - ABNEURO, 1998-09-01) Nogueira, Roberto Gomes [UNIFESP]; Toscano, Vanessa Granato [UNIFESP]; Abdala, Nitamar [UNIFESP]; Stávale, João Norberto [UNIFESP]; Malheiros, Suzana Maria Fleury [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We report an unusual case of germinoma arising from the basal ganglia and thalamus with brain stem invasion, with emphasis on computed tomography and magnetic resonance findings. Diagnosis was confirmed by histopathologic examination. Early detection of this tumor is important due to its potential response to treatment.
- ItemAcesso aberto (Open Access)Hemorragia subaracnoídea com tomografia de crânio sem sinais de sangramento(Academia Brasileira de Neurologia - ABNEURO, 1997-09-01) Francisco, Silvio [UNIFESP]; Reis-Filho, João Baptista dos [UNIFESP]; Neves, Afonso Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We observed 23 pacients with clinical hypothesis of subarachnoidal hemorrhage (SAH) having cranial tomography (CT) without bleeding signals. The final diagnosis of SAH was made upon the cerebrospinal fluid (CSF) results. Twenty cases were submitted to brain angiography. They were focused under the clinical classification of Hunt & Hess. The main results were: 1) 1/3 of patients had interval time between 24 and 48 hours after ictus and before CT and CSF making; this was the most sensitive CT time; 2) 55% of patients with brain angiography had aneurysm predominantly in the carotid and anterior cerebral artery territory; 3) the dominant clinical degree was Hunt & Hess I e II. Conclusion: the results demonstrate the need of CSF test in case of SAH clinical diagnosis with CT showing no bleeding signals.
- ItemAcesso aberto (Open Access)Papiloma invertido bilateral: relato de caso e revisão da literatura(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2008-04-01) Salomone, Raquel; Matsuyama, Cicero [UNIFESP]; Giannotti Filho, Osvaldo [UNIFESP]; Alvarenga, Marcia Lanzoni de [UNIFESP]; Martinez Neto, Eulógio Emílio; Chaves, Adriana Gonzaga; Hospital CEMA; Universidade Federal de São Paulo (UNIFESP)The inverted papilloma is an uncommon unilateral nasosinusal benign tumor. The clinical picture presents nonspecific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. The diagnosis is established by anamnesis, physical exam, computed tomography and magnetic resonance imaging. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral inverted nasal papilloma and making a literature review.
- ItemAcesso aberto (Open Access)Post-traumatic temporal lobe lesions: surgical decision making based on CT scan findings(Academia Brasileira de Neurologia - ABNEURO, 2005-06-01) Giannetti, Alexandre Varella; Prandini, Mirto Nelso [UNIFESP]; Araujo, Audrey Beatriz Santos; Herval, Lina Márcia De Araujo; FHEMIG Hospital João XXIII; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The indication for surgical treatment of post-traumatic parenchymal lesions in the temporal lobe remains controversial. OBJECTIVE: We reviewd the tomographic parameters that might be useful in making surgical decisions. METHOD: The tomographic findings of 69 patients were analyzed in a retrospective manner considering: 1) the effects of the lesion (classified into 4 variables: midline shift, status of the cisterns, status of the ventricles, and status of the peripheral sulci); and 2) the characteristics of the lesion: anterior, posterior or anteroposterior location (as defined by a coronal plane tangent to the cerebral peduncles) and its mediolateral diameter. RESULTS: When none or only one of the aforementioned variables was found to be altered, conservative treatment was instituted (22 out of 38 lesions). In two cases, all four variables were altered, and surgery was performed in both. Anterior, anteroposterior and posterior lesions measuring 21, 23 and 28 mm in diameter, respectively, had a 50% chance of surgical removal. CONCLUSION: Amongst the patients who underwent surgical intervention, the more anterior the location of the temporal lobe lesion, the smaller the diameter.
- ItemAcesso aberto (Open Access)Relação anatômica do nervo óptico com o seio esfenoidal: estudo por tomografia computadorizada(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2004-10-01) Dias, Paulo Cesar J.; Mangabeira-Albernaz, Pedro Luiz [UNIFESP]; Yamashida, Hélio K. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The sphenoid sinus, out of the facial sinuses, is certainly the most neglected as far as diagnosis is concerned. The surgical approach requires a detailed anatomical knowledge, considering the serious complications resulting from injuries of vital structures adjacent to this region. AIM: The objective of our research is to evaluate the anatomic relationship of the optic nerve with the sphenoid sinus making use of the computed tomography. STUDY DESIGN: Serie report. MATERIAL AND METHOD: The authors present a retrospective analysis of 203 computed tomographies of facial sinus belonging to individuals of both sexes aged 14 and over. The examinations were evaluated observing the course of the optic nerve, obtained through the degree of its projection on the wall of the sphenoid sinus. The method used was the modified classification of Delano, evaluating the absence of bone reduction (dehiscence) of the optic nerve in the sphenoid sinus. We analysed the degree of pneumatization of the sphenoid sinus, using Hammer's classification adapted by Guerrero, apart from the pneumatization of the anterior clinoidal process and pterigoid and the presence of the Onodi cell. RESULTS: Most of the patients (78.96%) presented their optic nerve with a Type 1 course. Type 2 was observed in 16.83% of the patients, Type 3 in 3.47% and Type 4 in 0.74%. The presence of dehiscence of the optic nerve in the wall of the sphenoid sinus was evidenced in 21.29% of the cases. Related to pneumatization, we noticed that the pre-selar type was observed in 6.44%, the post-selar type appeared in 39.11%, the selar type appeared in 54.45%, and the apneumatized type was not observed in any of the cases. The pneumatization of the anterior clinoidal process was verified in 10.64% of the cases, while the pterigoid process was apparent in 21.29% of the cases. The Onodi cell (sphenoetmoidal) was found in 7.92% of the cases. CONCLUSION: The presence of dehiscence of the optic nerve is related with the degree of pneumatization of the anterior clinoid and the pterigoid processes, the presence of the Onodi cell (sphenoetmoidal) and Course Types 2, 3 and 4 considered the relationship between the optic nerve and the sphenoid sinus.
- ItemAcesso aberto (Open Access)Tomografia computadorizada da matriz óssea mineralizada heteróloga fragmentada e metilmetacrilato na reparação de falhas ósseas segmentares produzidas em tíbia de coelhos(Universidade Federal de Minas Gerais, Escola de Veterinária, 2012-12-01) Freitas, Silvio Henrique; Dória, Renata Gebara Sampaio; Mendonça, Fábio Souza; Santos, Marcelos Diniz dos; Moreira, Roberto; Simões, Ricardo dos Santos; Camargo, Lázaro Manoel [UNIFESP]; Marques, Alessando Tadeu Corrêa; Simões, Manuel de Jesus [UNIFESP]; Universidade de São Paulo (USP); Universidade de Cuiabá; Universidade Federal de São Paulo (UNIFESP)A 6mm segmental defect was performed on the metaphyseal region of the tibia of 12 rabbits and the autoclaved fragmented heterolog cortical bone conserved in glycerin (98%) and methylmethacrylate was used as a bone graft for the reconstruction. The graft was placed in the receptor bed and its integration was evaluated by computed tomography after 30, 60 and 90 days. There was gradual bone graft incorporation in the receptor bed during the time in 100% of the cases. Fragmented cortical bone heterograft and methylmethacrylate was biologically compatible and promotes bone defect reparation without signs of infection, migration and or rejection, featuring a new option of osseous substitute to fill in bone defects.