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au:Souza Júnior, Arthur Soares

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Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies
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Ferreira, Juliana Carvalho

; Vianna, Arthur Oswaldo de Abreu

; Pinheiro, Bruno Valle

; Maia, Israel Silva

; Baldisserotto, Sérgio Vasconcellos

; Isola, Alexandre Marini

; Cavalcanti, Alexandre Biasi Gama, Ana Maria Casati Nogueira da Rocha, Angelo Roncalli Miranda Oliveira, Antonio Gonçalves de Serpa Neto, Ary Farias, Augusto Manoel de Carvalho Orlando, Bianca Rodrigues Esteves, Bruno da Costa Mazza, Bruno Franco Silveira, Camila de Freitas Martins Soares Carvalho, Carlos Roberto Ribeiro de Toufen Junior, Carlos Barbas, Carmen Silvia Valente Teixeira, Cassiano Silveira, Débora Dutra da Medeiros, Denise Machado Parolo, Edino Costa, Eduardo Leite Vieira Caser, Eliana Bernadete Oliveira, Ellen Pierre de Banholzer, Eric Grieger Carvalho, Erich Vidal Amorim, Fabio Ferreira Saddy, Felipe Gonçalves, Fernanda Alves Ferreira Galas, Filomena Regina Barbosa Gomes Zanatta, Giovanna Carolina Gardini Silva, Gisele Sampaio Westphal, Glauco Adrieno Matos, Gustavo Faissol Janot de Souza, João Claudio Emmerich de Silva Junior, João Manoel Valiatti, Jorge Luis dos Santos Nascimento Junior, José Ribamar do Rocco, Jose Rodolfo Hajjar, Ludhmila Abrahão Forgiarini Junior, Luiz Alberto Malbuisson, Luiz Marcelo Sá Holanda, Marcelo Alcantara Amato, Marcelo Britto Passos Park, Marcelo Oliveira, Marco Antonio da Rosa e Reis, Marco Antonio Soares Tavares, Marcos Soares Souza, Mario Henrique Dutra de Damasceno, Marta Cristina Pauleti Lira-Batista, Marta Maria da Silva Pattacini, Max Morais Assunção, Murillo Santucci Cesar de Oliveira, Neymar Elias de Franzosi, Oellen Stuani Rocco, Patricia Rieken Macedo Caruso, Pedro Silva, Pedro Leme Mendes, Pedro Vitale Duarte, Pericles Almeida Delfino Santa Neto, Renato Fabio Alberto Della Rodrigues, Ricardo Goulart Cordioli, Ricardo Luiz Palazzo, Roberta Fittipaldi Goldwasser, Rosane Pinheiro, Sabrina dos Santos Justino, Sandra Regina Nemer, Sergio Nogueira Oliveira, Vanessa Martins de Silva, Vinicius Zacarias Maldaner da Nedel, Wagner Luis Bellissimo-Rodrigues, Wanessa Teixeira Oliveira Filho, Wilson de

Critical Care Science

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2025, Volume 37 elocation e20250242en

Abstract: En | Text: En | PDF: En

ABSTRACT Mechanical ventilation can be a life-saving intervention, but its implementation requires a multidisciplinary approach, with an understanding of its indications and contraindications due to the potential for complications. The management of mechanical ventilation should be part of the curricula during clinical training; however, trainees and practicing professionals frequently report low confidence in managing mechanical ventilation, often seeking additional sources of knowledge. Review articles, consensus statements and clinical practice guidelines have become important sources of guidance in mechanical ventilation, and although clinical practice guidelines offer rigorously developed recommendations, they take a long time to develop and can address only a limited number of clinical questions. The Associação de Medicina Intensiva Brasileira and the Sociedade Brasileira de Pneumologia e Tisiologia sponsored the development of a joint statement addressing all aspects of mechanical ventilation, which was divided into 38 topics. Seventy-five experts from all regions of Brazil worked in pairs to perform scoping reviews, searching for publications on their specific topic of mechanical ventilation in the last 20 years in the highest impact factor journals in the areas of intensive care, pulmonology, and anesthesiology. Each pair produced suggestions and considerations on their topics, which were presented to the entire group in a plenary session for modification when necessary and approval. The result was a comprehensive document encompassing all aspects of mechanical ventilation to provide guidance at the bedside. In this article, we report the methodology used to produce the document and highlight the most important suggestions and considerations of the document, which has been made available to the public in Portuguese.

https://doi.org/10.62675/2965-2774.20250242-en

“Interstitial lung abnormalities”: translation to and use in Portuguese Interstitial abnormalities abnormalities”
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Yamanari, Tassia Regina

; Auad, Ricardo Valarelli

; Mançano, Alexandre Dias

; Koenigkam-Santos, Marcel

; Santana, Pablo Rydz Pinheiro

; Souza Júnior, Arthur Soares

; Chate, Rodrigo Caruso

; Sawamura, Marcio Valente Yamada

Radiologia Brasileira

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2024, Volume 57 elocation e20230114

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Fazer um levantamento sobre o uso do termo interstitial lung abnormalities nos laudos radiológicos no Brasil, propor uma tradução para o termo e fazer uma breve revisão sobre o tema. Materiais e Métodos: Foi enviada uma pesquisa, por meio de mensagem eletrônica, para diversos radiologistas de todo o Brasil, questionando sobre a familiarização com o termo, qual tradução em português utilizam e se usam os critérios propostos pela diretriz da Sociedade Fleischner. Resultados: Foram recebidas 163 respostas de todas as regiões do Brasil e a grande maioria dos radiologistas respondeu estar familiarizado com o termo interstitial lung abnormalities (88%), mas houve grande variação em relação ao termo utilizado como tradução para o português. Conclusão: Sugerimos a padronização do termo “anormalidades pulmonares intersticiais”, a fim de uniformizar os relatórios radiológicos e difundir esta entidade no País. Objetivo tema Métodos pesquisa eletrônica Fleischner Resultados 16 88%, 88 88% , (88%) Conclusão anormalidades intersticiais, intersticiais intersticiais” País 1 8 (88% (88 (8 (

Abstract Objective: To conduct a survey on the use of the term “interstitial lung abnormalities” in radiology reports in Brazil, propose an appropriate Portuguese-language translation for the term, and provide a brief review of the literature on the topic. Materials and Methods: A survey was sent via electronic message to various radiologists in Brazil, asking about their familiarity with the term, which translation of the term they use in Portuguese, and whether they use the criteria proposed by the Fleischner Society. Results: A total of 163 responses were received, from all regions of Brazil. Although the vast majority (88%) of the respondents stated that they were familiar with the term “interstitial lung abnormalities”, there was considerable variation regarding the equivalent term they used in Portuguese. Conclusion: We suggest that the term “anormalidades pulmonares intersticiais” be used in order to standardize radiology reports and disseminate knowledge of these findings in Brazil. Objective interstitial abnormalities Brazil Portugueselanguage Portuguese language topic Methods Society Results 16 received 88% 88 (88% abnormalities, , Conclusion anormalidades intersticiais 1 8 (88 (8 (

https://doi.org/10.1590/0100-3984.2023.0114-en

CYSTIC PANCREATIC LESIONS: IMAGING VERSUS ANATOMOPATHOLOGICAL FINDINGS-HOW TO IMPROVE DIAGNOSTIC ACCURACY? LESIONS FINDINGSHOW FINDINGS HOW ACCURACY
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Vieira, Rafael Mello Fontolan

; Souza Junior, Arthur Soares de

; Kerche, Leandra Ernst

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2023, Volume 36 elocation e1735

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO RACIONAL: Lesões císticas pancreáticas são um grupo de neoplasias pancreáticas com diferentes comportamentos e riscos de malignidade. O diagnóstico por imagem e a diferenciação dessas lesões constituem um desafio. OBJETIVOS: Avaliar a concordância entre o diagnóstico de imagem pré operatório obtido através da tomografia computadorizada e/ou da ressonância nuclear magnética e o diagnóstico anátomopatológico das lesões císticas pancreáticas, no Hospital de Base de São José do Rio Preto – SP. MÉTODOS: Trinta e nove pacientes com lesões císticas pancreáticas, comprovados cirurgicamente, foram incluídos para o estudo, de 2009 a 2019. O diagnóstico radiológico pré-operatório e o diagnóstico anatomopatológico final foram correlacionadas para medir a acurácia da tomografia computadorizada e/ou da ressonância nuclear magnética. O adenocarcinoma pancreático, o cisto pancreato-coledociano, o cistoadenoma mucinoso, o cistoadenoma seroso, a neoplasia mucinosa papilar intraductal, e o pseudocisto pancreático foram classificados como cistos neoplásicos. As informações foram comparadas e estatisticamente analisadas. RESULTADOS: Vinte e sete pacientes fizeram tomografia computadorizada e ressonância nuclear magnética pré-operatórios (69,23%), 11 pacientes fizeram apenas tomografia computadorizada (28,20%), e 1 paciente fez apenas ressonância nuclear magnética (2,57%). Os achados de tomografia computadorizada para diagnóstico (p=0,47) e para a combinação tomografia computadorizada+RM (p=0,50) mostraram moderada concordância com os achados anatomopatológicos. Houve leve concordância para o diagnóstico de cistoadenoma mucinoso (p=0,3), moderada concordância para intraductal papillary mucinous neoplasms (p=0,41), boa concordância para cistoadenoma seroso (p=0,79) e excelente concordância para pseudocisto pancreático (p=0,84), cisto pancreato-coledociano (p=1) e tumor de Frantz (p=1) (p<0,05). CONCLUSÕES: Os achados de imagem da tomografia computadorizada e/ou ressonância nuclear magnética apresentaram concordância diagnóstica com os exames anatomopatológicos na diferenciação de lesões císticas pancreáticas benignas e malignas, porém a diferença entre o uso apenas da tomografia computadorizada e tomografia computadorizada+ressonância nuclear magnética na melhora da acurácia diagnóstica não apresentou relevância estatística tal como a literatura. RACIONAL malignidade desafio OBJETIVOS eou ou SP MÉTODOS cirurgicamente estudo 200 2019 préoperatório pancreatocoledociano, pancreatocoledociano pancreato coledociano, coledociano neoplásicos analisadas RESULTADOS préoperatórios operatórios 69,23%, 6923 69,23% , 69 23 (69,23%) 28,20%, 2820 28,20% 28 20 (28,20%) 2,57%. 257 2,57% . 2 57 (2,57%) p=0,47 p047 p 0 47 (p=0,47 computadorizadaRM RM p=0,50 p050 50 (p=0,50 p=0,3, p03 p=0,3 3 (p=0,3) p=0,41, p041 p=0,41 41 (p=0,41) p=0,79 p079 79 (p=0,79 p=0,84, p084 p=0,84 84 (p=0,84) p=1 p1 (p=1 p<0,05. p005 p<0,05 05 (p<0,05) CONCLUSÕES malignas computadorizadaressonância literatura 201 692 69,23 6 (69,23% 282 28,20 (28,20% 25 2,57 5 (2,57% p=0,4 p04 4 (p=0,4 p=0,5 p05 (p=0,5 p0 p=0, (p=0,3 (p=0,41 p=0,7 p07 7 (p=0,7 p08 p=0,8 8 (p=0,84 p= (p= p00 p<0,0 (p<0,05 69,2 (69,23 28,2 (28,20 2,5 (2,57 (p=0, p=0 (p=0,8 (p p<0, (p<0,0 69, (69,2 28, (28,2 2, (2,5 (p=0 p<0 (p<0, (69, (28, (2, p< (p<0 (69 (28 (2 (p< (6 (

ABSTRACT BACKGROUND: Pancreatic cystic lesions are a group of pancreatic neoplasms with different behavior and risk of malignancy. Imaging diagnosis and differentiation of these lesions remain a challenge. AIMS: The aim of this study was to evaluate the agreement between computed tomography and/or magnetic resonance imaging and post-operative pathologic diagnoses of Pancreatic cystic lesions in a University Hospital of São Paulo State. METHODS: A total of 39 patients with surgically diagnosed Pancreatic cystic lesions were enrolled, as a study cohort from 2009 to 2019. Preoperative radiological and final pathological diagnosis was correlated to measure computed tomography and/or magnetic resonance imaging diagnostic. Pancreatic adenocarcinoma, choledochal pancreatic cyst, mucinous cystadenoma, serous cystadenoma, intraductal papillary mucinous neoplasms, and pancreatic pseudocyst were classified as neoplastic cysts. RESULTS: It was noted that 27 patients (69.23%) had preoperative computed tomography and magnetic resonance imaging, 11 patients (28.20%) had preoperative computed tomography only, and 1 patient had preoperative magnetic resonance imaging only. The values for diagnoses made only with computed tomography (p=0.47) and from the combination of computed tomography+magnetic resonance imaging (p=0.50) did also point to moderate agreement with the anatomopathological findings. The values pointed to a fair agreement for the diagnosis of mucinous cystadenoma (p=0.3), moderate agreement for intraductal papillary mucinous neoplasms (p= 0.41), good agreement for serous cystadenoma (p=0.79), and excellent agreement for choledochal pancreatic cyst (p=1), pancreatic pseudocyst (p=0.84), and Frantz tumor (p=1) (p<0.05). CONCLUSIONS: The findings of computed tomography and/or magnetic resonance imaging have an equivalent diagnostic agreement with an anatomopathological diagnosis for differentiating benign from malignant Pancreatic cystic lesions and in suggesting a specific diagnosis. There is no statistical difference between the use of computed tomography alone and computed tomography+magnetic resonance imaging in the improvement of diagnostic accuracy. BACKGROUND malignancy challenge AIMS andor or postoperative post operative State METHODS 3 enrolled 200 2019 adenocarcinoma cysts RESULTS 2 69.23% 6923 69 23 (69.23% 28.20% 2820 28 20 (28.20% p=0.47 p047 p 0 47 (p=0.47 tomographymagnetic p=0.50 p050 50 (p=0.50 p=0.3, p03 p=0.3 , (p=0.3) p= (p 0.41, 041 0.41 41 0.41) p=0.79, p079 p=0.79 79 (p=0.79) p=1, p1 p=1 p=0.84, p084 p=0.84 84 (p=0.84) (p=1 p<0.05. p005 p<0.05 . 05 (p<0.05) CONCLUSIONS accuracy 201 69.23 692 6 (69.23 28.20 282 (28.20 p=0.4 p04 4 (p=0.4 p=0.5 p05 5 (p=0.5 p0 p=0. (p=0.3 04 0.4 p07 p=0.7 7 (p=0.79 p08 p=0.8 8 (p=0.84 p00 p<0.0 (p<0.05 69.2 (69.2 28.2 (28.2 (p=0. p=0 0. (p=0.7 (p=0.8 p<0. (p<0.0 69. (69. 28. (28. (p=0 p<0 (p<0. (69 (28 p< (p<0 (6 (2 (p< (

https://doi.org/10.1590/0102-672020230017e1735

Neurofibromatosis type 1: evaluation by chest computed tomography 1
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Alves Júnior, Sérgio Ferreira

; Irion, Klaus Loureiro

; Melo, Alessandro Severo Alves de

; Meirelles, Gustavo de Souza Portes

; Rodrigues, Rosana Souza

; Souza Jr., Arthur Soares

; Hochhegger, Bruno

; Zanetti, Gláucia

; Marchiori, Edson

Radiologia Brasileira

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dec 2021, Volume 54 N. 6 Pages 375 - 380

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: O objetivo deste estudo foi avaliar os achados pulmonares na tomografia computadorizada do tórax de pacientes diagnosticados com neurofibromatose tipo 1 (NF1). Materiais e Métodos Foram revisados, retrospectivamente, os achados tomográficos de 14 pacientes com doença pulmonar difusa associada à NF1 (NF-DPD). A amostra incluiu oito mulheres e seis homens, com idade entre 11 e 75 anos (mediana de idade de 55 anos). O diagnóstico foi estabelecido com base em critérios diagnósticos predeterminados pelo National Institutes of Health dos Estados Unidos. As imagens foram analisadas de forma independente por dois radiologistas, que chegaram a um consenso. Resultados: Os achados tomográficos predominantes foram múltiplos cistos em 13 pacientes (92,9%), enfisema em oito (57,1%) e bolhas subpleurais em seis (42,9%). Achados associados incluíram neurofibromas cutâneos e subcutâneos em 12 pacientes (85,7%), opacidades em vidro fosco em um (7,1%) e neurofibromas traqueobrônquicos em um (7,1%). As anormalidades pulmonares foram bilaterais em 12 casos (85,7%). Houve predomínio nos terços superiores em oito (57,1%) pacientes e se distribuíram randomicamente pelos pulmões em 11 (78,6%). Conclusão: Os achados tomográficos pulmonares mais frequentes na NF-DPD foram os cistos pulmonares, o enfisema e as bolhas subpleurais. Objetivo NF1. NF . (NF1) revisados retrospectivamente NFDPD. NFDPD DPD (NF-DPD) homens 7 mediana 5 anos. anos) Unidos radiologistas consenso Resultados 92,9%, 929 92,9% , 92 9 (92,9%) 57,1% 571 57 (57,1% 42,9%. 429 42,9% 42 (42,9%) 85,7%, 857 85,7% 85 (85,7%) 7,1% 71 (7,1% 7,1%. 85,7%. 78,6%. 786 78,6% 78 6 (78,6%) Conclusão (NF1 (NF-DPD 92,9 (92,9% 57,1 (57,1 42,9 4 (42,9% 85,7 8 (85,7% 7,1 (7,1 78,6 (78,6% (NF 92, (92,9 57, (57, 42, (42,9 85, (85,7 7, (7, 78, (78,6 (92, (57 (42, (85, (7 (78, (92 (5 (42 (85 ( (78 (9 (4 (8

Abstract Objective: The aim of this study was to evaluate chest computed tomography (CT) findings in patients diagnosed with neurofibromatosis type 1 (NF1). Material and Methods: This was a retrospective study in which we reviewed the chest CT scans of 14 patients diagnosed with NF1 and neurofibromatosis-associated diffuse lung disease (NF-DLD). The sample comprised eight women and six men. The median age was 55 years (range, 11-75 years). The diagnosis of NF1 was made on the basis of the diagnostic criteria established by the U.S. National Institutes of Health. The images were analyzed by two chest radiologists, who reached decisions by consensus. Results: The predominant CT finding of NF-DLD was multiple cysts, which were observed in 13 patients (92.9%), followed by emphysema, in eight (57.1%) and subpleural bullae, in six (42.9%). Other findings included subcutaneous neurofibromas, in 12 patients (85.7%), ground-glass opacities, in one (7.1%), and tracheobronchial neurofibromas, in one (7.1%). The pulmonary abnormalities were bilateral in 12 cases (85.7%). The abnormalities were predominantly in the upper lung fields in eight cases (57.1%), and their distribution was random in 11 (78.6%). Conclusion: Pulmonary cysts, emphysema, and subpleural bullae appear to be the chest CT findings that are most characteristic of NF-DLD. Objective (CT NF1. NF . (NF1) Methods neurofibromatosisassociated associated NFDLD. NFDLD DLD (NF-DLD) men 5 range, range (range 1175 75 11-7 years. years) US U S U.S Health radiologists consensus Results cysts 92.9%, 929 92.9% , 92 9 (92.9%) emphysema 57.1% 571 57 (57.1% 42.9%. 429 42.9% 42 (42.9%) neurofibromas 85.7%, 857 85.7% 85 7 (85.7%) groundglass ground glass opacities 7.1%, 71 7.1% (7.1%) 7.1%. 85.7%. 57.1%, 78.6%. 786 78.6% 78 6 (78.6%) Conclusion DLD. (NF1 (NF-DLD 117 11- 92.9 (92.9% 57.1 (57.1 42.9 4 (42.9% 85.7 8 (85.7% 7.1 (7.1% 78.6 (78.6% (NF 92. (92.9 57. (57. 42. (42.9 85. (85.7 7. (7.1 78. (78.6 (92. (57 (42. (85. (7. (78. (92 (5 (42 (85 (7 (78 (9 ( (4 (8

https://doi.org/10.1590/0100-3984.2020.0150

Assessment of pulmonologists’ receptivity to a structured radiology report for interstitial lung disease
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Irion, Klaus Loureiro

; Souza Junior, Arthur Soares

; Marchiori, Edson

; Dalla-Bona, João Pedro da Silveira

; Hochhegger, Bruno

Jornal Brasileiro de Pneumologia

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2020, Volume 46 N. 5 elocation e20200164

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36416/1806-3756/e20200164 236 downloads

Thoracic calcifications on magnetic resonance imaging: correlations with computed tomography
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Zampieri, Juliana Fischman

; Pacini, Gabriel Sartori

; Zanon, Matheus

; Altmayer, Stephan Philip Leonhardt

; Watte, Guilherme

; Barros, Marcelo

; Durayski, Evandra

; Meirelles, Gustavo de Souza Portes

; Guimarães, Marcos Duarte

; Marchiori, Edson

; Souza Junior, Arthur Soares

; Hochhegger, Bruno

Jornal Brasileiro de Pneumologia

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2019, Volume 45 N. 4 elocation e20180168

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Identificar as características das calcificações torácicas na ressonância magnética (RM) e as correlações entre os achados de RM e TC. Métodos: Estudo retrospectivo no qual foram analisados dados referentes a 62 pacientes que foram submetidos a TC e RM de tórax em sete hospitais nos estados do Rio Grande do Sul, São Paulo e Rio de Janeiro entre março de 2014 e junho de 2016 e que apresentaram calcificações na TC. As imagens de RM ponderadas em T1 e T2 (doravante denominadas T1 e T2) foram analisadas semiquantitativamente, e a razão entre a intensidade do sinal da lesão e do músculo (LMSIR, do inglês lesion-to-muscle signal intensity ratio) foi estimada. Diferenças entre lesões neoplásicas e não neoplásicas foram analisadas. Resultados: Foram analisadas 84 lesões calcificadas. A média de densidade das lesões na TC foi de 367 ± 435 UH. A mediana da LMSIR foi de 0,4 [intervalo interquartil (II): 0,1-0,7] em T1 e 0,2 (II: 0,0-0,7) em T2. A maioria das lesões mostrou-se hipointensa em T1 e T2 [n = 52 (61,9%) e n = 39 (46,4%), respectivamente]. Além disso, 19 (22,6%) foram indetectáveis em T1 (LMSIR = 0) e 36 (42,9%) foram indetectáveis em T2 (LMSIR = 0). Finalmente, 15,5% mostraram-se hiperintensas em T1 e 9,5% mostraram-se hiperintensas em T2. A mediana da LMSIR foi significativamente maior nas lesões neoplásicas do que nas não neoplásicas. Houve uma correlação negativa muito fraca e estatisticamente insignificante entre a densidade das lesões na TC e as seguintes variáveis: intensidade do sinal em T1, LMSIR em T1 e intensidade do sinal em T2 (r = −0,13, p = 0,24; r = −0,18, p = 0,10 e r = −0,16, p = 0,16, respectivamente). A densidade das lesões na TC apresentou correlação fraca, porém significativa com a LMSIR em T2 (r = −0,29, p < 0,05). Conclusões: As calcificações torácicas apresentam intensidade de sinal variável em T1 e T2; em alguns casos, mostram-se hiperintensas. A densidade da lesão na TC aparentemente correlaciona-se negativamente com a intensidade do sinal da lesão na RM.

ABSTRACT Objective: To identify the characteristics of thoracic calcifications on magnetic resonance (MR) imaging, as well as correlations between MR imaging and CT findings. Methods: This was a retrospective study including data on 62 patients undergoing CT scans and MR imaging of the chest at any of seven hospitals in the Brazilian states of Rio Grande do Sul, São Paulo, and Rio de Janeiro between March of 2014 and June of 2016 and presenting with calcifications on CT scans. T1- and T2-weighted MR images (T1- and T2-WIs) were semiquantitatively analyzed, and the lesion-to-muscle signal intensity ratio (LMSIR) was estimated. Differences between neoplastic and non-neoplastic lesions were analyzed. Results: Eighty-four calcified lesions were analyzed. Mean lesion density on CT was 367 ± 435 HU. Median LMSIRs on T1- and T2-WIs were 0.4 (interquartile range [IQR], 0.1-0.7) and 0.2 (IQR, 0.0-0.7), respectively. Most of the lesions were hypointense on T1- and T2-WIs (n = 52 [61.9%] and n = 39 [46.4%], respectively). In addition, 19 (22.6%) were undetectable on T1-WIs (LMSIR = 0) and 36 (42.9%) were undetectable on T2-WIs (LMSIR = 0). Finally, 15.5% were hyperintense on T1-WIs and 9.5% were hyperintense on T2-WIs. Median LMSIR was significantly higher for neoplastic lesions than for non-neoplastic lesions. There was a very weak and statistically insignificant negative correlation between lesion density on CT and the following variables: signal intensity on T1-WIs, LMSIR on T1-WIs, and signal intensity on T2-WIs (r = −0.13, p = 0.24; r = −0.18, p = 0.10; and r = −0.16, p = 0.16, respectively). Lesion density on CT was weakly but significantly correlated with LMSIR on T2-WIs (r = −0.29, p < 0.05). Conclusions: Thoracic calcifications have variable signal intensity on T1- and T2-weighted MR images, sometimes appearing hyperintense. Lesion density on CT appears to correlate negatively with lesion signal intensity on MR images.

https://doi.org/10.1590/1806-3713/e20180168 1299 downloads

Analysis of natural history of the diaphragmatic injury on the right in mice
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Caiel, Benedito Aparecido Scapulatempo Neto, Cristovam Souza Júnior, Arthur Soares de Saad Júnior, Roberto

Revista do Colégio Brasileiro de Cirurgiões

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dec 2015, Volume 42 N. 6 Pages 386 - 392

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivo: avaliar a evolução natural do ferimento diafragmático à direita após a retirada cirúrgica de uma porção do hemidiafragma. Métodos: os animais foram submetidos à ressecção de uma porção do hemidiafragma à direita através da laparotomia mediana. Foram operados 40 ratos. As variáveis analisadas foram: herniação, proteção hepática, cicatrização, lesão persistente do diafragma, avaliação da tomografia computadorizada, frequência cardíaca e peso. Resultados: foram analisados 40 ratos. Houve duas mortes no pós-operatório. Dezessete animais tiveram herniação (42,5%) e 23 (57,5%), não. Analisando emprego da tomografia computadorizada na avaliação da hérnia diafragmática, tivemos um método com boa sensibilidade (78,6%), boa especificidade (90,9%) e boa acurácia (86,1%) quando comparados com a necrópsia. Conclusão: houve predomínio de cicatrização do hemidiafragma à direita e o tamanho da lesão inicial não influenciou na ocorrência de proteção hepática ou hérnia em ratos.

Objective: to evaluate natural evolution of right diaphragmatic injury after the surgical removal of a portion from hemi diaphragm. Methods: the animals were submitted to a surgical removal of portion from right hemi diaphragm by median laparotomy. The sample consists of 42 animals being 2 animals from pilot project and 40 operated animals. And the variables of the study were herniation, liver protection, healing, persistent diaphragm injury, evaluation of 16 channels tomography and the variables "heart rate" and "weight". Results: we analyzed 40 mice, we had two post-operative deaths; we had 17 animals in this group suffered from herniation (42.5%) and 23 animals didn't suffer from herniation (57.5%). Analyzing the tomography as image method in the evaluation of diaphragmatic hernia, we had as a method with good sensitivity (78.6%), good specificity (90.9%), and good accuracy (86.1%) when compared to necropsy. Conclusion: there was a predominance of healing of right hemi diaphragm, the size of initial injury didn't have influence on occurrence of the liver protection or hernia in mice.

https://doi.org/10.1590/0100-69912015006007 2454 downloads

Chest magnetic resonance imaging: a protocol suggestion
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Hochhegger, Bruno Souza, Vinícius Valério Silveira de Marchiori, Edson Irion, Klaus Loureiro Souza Jr., Arthur Soares Elias Junior, Jorge Rodrigues, Rosana Souza Barreto, Miriam Menna Escuissato, Dante Luiz Mançano, Alexandre Dias Araujo Neto, César Augusto Guimarães, Marcos Duarte Nin, Carlos Schuler Santos, Marcel Koenigkam Silva, Jorge Luiz Pereira e

Radiologia Brasileira

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dec 2015, Volume 48 N. 6 Pages 373 - 380

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Nos últimos anos, com o desenvolvimento de sequências ultrarrápidas, a ressonância magnética (RM) tem-se estabelecido como uma ferramenta de diagnóstico por imagem de grande valor. Em virtude dos aperfeiçoamentos na velocidade de aquisição e na qualidade das imagens, a RM é atualmente um método apropriado também para o estudo de doenças pulmonares. A principal vantagem da RM é sua combinação única que permite avaliação morfológica e funcional em um mesmo exame de imagem. Neste artigo iremos revisar aspectos técnicos e sugerir um protocolo para a realização de RM do tórax. Também serão descritas as três maiores indicações de RM do tórax: estadiamento para neoplasia pulmonar, avaliação de doença vascular do pulmão e investigação de doenças pulmonares em pacientes que não devem ser expostos à radiação ionizante.

Abstract In the recent years, with the development of ultrafast sequences, magnetic resonance imaging (MRI) has been established as a valuable diagnostic modality in body imaging. Because of improvements in speed and image quality, MRI is now ready for routine clinical use also in the study of pulmonary diseases. The main advantage of MRI of the lungs is its unique combination of morphological and functional assessment in a single imaging session. In this article, the authors review most technical aspects and suggest a protocol for performing chest MRI. The authors also describe the three major clinical indications for MRI of the lungs: staging of lung tumors; evaluation of pulmonary vascular diseases; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.

https://doi.org/10.1590/0100-3984.2014.0017 13538 downloads

Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art
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Guimaraes, Marcos Duarte Hochhegger, Bruno Santos, Marcel Koenigkam Santana, Pablo Rydz Pinheiro Sousa Júnior, Arthur Soares Souza, Luciana Soares Marchiori, Edson

Radiologia Brasileira

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feb 2015, Volume 48 N. 1 Pages 33 - 42

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A ressonância magnética (RM) possui diversas vantagens na avaliação de pacientes oncológicos portadores de lesões torácicas, sejam elas lesões de parede, pleurais, pulmonares, mediastinais, esofagianas, cardíacas ou linfonodais. É uma ferramenta bastante útil no manejo destes pacientes, seja no diagnóstico, no estadiamento, no planejamento cirúrgico, na avaliação de resposta ou no seguimento. No presente artigo os autores contextualizam a importância da RM na avaliação das lesões torácicas de pacientes oncológicos. Por se tratar de um equipamento disponibilizado universalmente, sem os riscos da irradiação ionizante, com elevada resolução de contraste e espacial, aliada a novas técnicas como a cine-RM, a perfusão e a difusão, a RM pode atuar como uma ferramenta alternativa, economicamente viável, e com performance comparável ou complementar aos métodos radiológicos convencionais como a radiografia simples, a tomografia computadorizada e a PET/CT na avaliação dos pacientes portadores de neoplasias torácicas.

Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias.

https://doi.org/10.1590/0100-3984.2013.1921 11790 downloads

10.

Qual o seu diagnóstico?
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Hochhegger, Bruno Irion, Klaus Loureiro Souza Junior, Arthur Soares Rubin, Adalberto Sperb Zanetti, Gláucia

Radiologia Brasileira

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oct 2014, Volume 47 N. 5 Pages 11 - 13

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/0100-3984.2014.47.5qd 1560 downloads

11.

Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules
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Cardoso, Luciana Vargas Souza Júnior, Arthur Soares

Jornal Brasileiro de Pneumologia

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aug 2014, Volume 40 N. 4 Pages 380 - 388

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Investigar a aplicação clínica da TC e da biópsia transtorácica percutânea guiada por TC (BTP-TC) em pacientes com nódulos pulmonares indeterminados (NPIs). MÉTODOS: Foram estudados retrospectivamente 113 pacientes portadores de NPIs submetidos a TC e BTP-TC. Foram analisadas variáveis como sexo, idade ao diagnóstico, tabagismo, achados tomográficos e técnicas de BTP-TC. A análise dos dados foi efetuada por meio do teste t de Student para amostras independentes, teste do qui-quadrado e teste de comparação de duas proporções por aproximação normal. RESULTADOS: Dos 113 pacientes estudados, 68 (60,2%) eram do sexo masculino e 78 (69%) eram tabagistas. O diâmetro das lesões malignas variou de 2,6 a 10,0 cm. A maioria dos NPIs estava localizada na região periférica (85%). O resultado da biópsia foi maligno em 88 pacientes (77,8%) e benigno em 25 (22,2%). O adenocarcinoma foi o tumor maligno mais frequente, acometendo pacientes com idade mais avançada. O diâmetro dos NPIs foi significativamente maior nos pacientes com malignidade (p < 0,001). Houve uma associação significativa entre NPIs com contorno regular e lesões benignas (p = 0,022), enquanto os de tipo espiculado e bocelado foram mais frequentes em pacientes com lesões malignas (50,7% e 28,7%, respectivamente). Atenuação homogênea e necrose foram mais frequentes em pacientes com lesões malignas (51,9% e 26,9%, respectivamente). CONCLUSÕES: A TC e a BTP-TC foram úteis no diagnóstico diferencial entre lesões malignas e benignas nos pacientes com NPIs nesta amostra. Idade mais avançada e tabagismo associaram-se significativamente com malignidade. Houve associações de achados tomográficos (diâmetro maior, contorno espiculado, atenuação homogênea e necrose) com NPIs malignos.

OBJECTIVE: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). METHODS: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. RESULTS: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively) CONCLUSIONS: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy.

https://doi.org/10.1590/S1806-37132014000400005 3257 downloads

12.

Pulmonary interstitial emphysema: a case report and review of the literature
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Amoedo, Mauricio Kauark Souza, Luciana Volpon Soares Souza, Antônio Soares Júnior, Arthur Soares Souza Marchiori, Edson

Radiologia Brasileira

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oct 2013, Volume 46 N. 5 Pages 317 - 319

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O enfisema intersticial pulmonar é uma condição rara que acomete, em geral, recém-nascidos pré-termos de baixo peso submetidos a ventilação mecânica. O prognóstico é variável e dependente do diagnóstico e tratamento precoces, ressaltando-se a importância do radiologista neste cenário. Os autores relatam um caso de enfisema intersticial pulmonar persistente, abordando as principais características desta entidade.

Pulmonary interstitial emphysema is a rare condition that generally affects low-weight preterm infants submitted to mechanical ventilation. The prognosis is variable, depending on early diagnosis and treatment. The radiologist plays a key role in this scenario. The authors report a case of persistent pulmonary interstitial emphysema, describing the main characteristics of such entity.

https://doi.org/10.1590/S0100-39842013000500009 12773 downloads

13.

Tomografia computadorizada na avaliação tardia do tratamento cirúrgico da conexão anômala total de veias pulmonares
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Croti, Ulisses Alexandre Beani, Lilian Moscardini, Airton Camacho Souza Júnior, Arthur Soares Souza, Antônio Soares Hassem Sobrinho, Sírio De Marchi, Carlos Henrique Godoy, Moacir Fernandes de Braile, Domingo Marcolino

Brazilian Journal of Cardiovascular Surgery

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dec 2011, Volume 26 N. 4 Pages 532 - 543

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Verificar se os achados da tomografia computadorizada de múltiplos detectores (TCMD) apresentam associação com os parâmetros clínicos e exames complementares rotineiramente empregados na avaliação tardia das crianças submetidas ao tratamento cirúrgico da conexão anômala total de veias pulmonares (CATVP). MÉTODOS: No período de janeiro 2002 a dezembro de 2007, 12 pacientes operados de CATVP foram avaliados tardiamente com anamnese, exame físico, radiografia de tórax, eletrocardiograma, ecocardiograma e TCMD. Alterações específicas de cada um desses exames foram identificadas e comparadas com os achados qualitativos da TCMD. RESULTADOS: Onze pacientes estavam em classe funcional I (NYHA), três apresentavam sopros inespecíficos, três estavam abaixo do percentil 15 de desenvolvimento pôndero-estatural. À radiografia de tórax, dois pacientes tinham alteração dos campos pulmonares e três, aumento discreto da área cardíaca. Ao eletrocardiograma, um paciente apresentava sobrecarga ventricular direita e um, ritmo juncional. Todos os ecocardiogramas mostraram-se dentro dos limites de normalidade, exceto em um paciente com estenose entre a veia cava superior e o átrio direito. A TCMD foi totalmente normal em quatro pacientes, em três demonstrou compressão de veias pulmonares e em quatro, redução de calibre considerada significativa, as quais se correlacionaram com os demais achados. Assim, a TCMD para demonstrar alterações anatômicas, quando comparadas a alterações do exame físico ou outros exames complementares testados, apresentou sensibilidade de 87,5%, especificidade de 75%, valor preditivo positivo 87,5%, valor preditivo negativo de 75% e acurácia de 83,3%. CONCLUSÃO: No acompanhamento tardio dos pacientes submetidos à correção cirúrgica de CATVP, a TCMD pode fornecer subsídios valiosos e complementar o diagnóstico de eventuais alterações anatômicas e funcionais.

OBJECTIVE: To evaluate if the findings of multislice computed tomography (MSCT) are associated with clinical and laboratory tests routinely used in the late follow-up of children undergoing surgical treatment of total anomalous pulmonary venous connection (TAPVC). METHODS: From January 2002 to December 2007, 12 patients operated due to CATVP were evaluated with history, physical examination, chest X-ray, electrocardiogram, echocardiography and MSCT. Specific changes observed in each one of these tests were identified and compared with MSCT qualitative findings. RESULTS: Eleven patients were in functional class I (NYHA), three had nonspecific murmurs, and three were below the 15th percentile of weight and height. Two had pulmonary field abnormalities and three had a slight increase of the cardiac area in the X-ray examination. In the electrocardiogram, one patient had right ventricular overload and one had junctional rhythm. All echocardiograms were within the normal range, except for one patient with stenosis between the superior vena cava and right atrium. MSCT was completely normal in four patients, three had compression of the pulmonary veins and four had significant caliber reduction, which correlated with the other findings. Thus, MSCT showed a sensitivity of 87.5%, specificity of 0.75%, positive predictive value of 87.5%, negative predictive value of 75% and accuracy of 83.3% to demonstrate anatomic changes compared to changes in the physical examination or other additional tests. CONCLUSION: MSTC may provide valuable information and complement the diagnosis of possible anatomical and functional changes in the late follow-up of patients undergoing surgical repair of TAPVC.

https://doi.org/10.5935/1678-9741.20110042 4508 downloads

14.

Cirurgia de revascularização miocárdica após infarto agudo do miocárdio causado por trombose de aneurisma coronariano
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Ferreira, Victor Rodrigues Ribeiro Sternieri, Valéria B. Braile Leal, João Carlos Ferreira Avanci, Luis Ernesto Abelaira Filho, Achilles Spotti, Mariane Souza Junior, Arthur Soares Braile, Domingo Marcolino

Brazilian Journal of Cardiovascular Surgery

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dec 2011, Volume 26 N. 4 Pages 667 - 669

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A morfologia do aneurisma coronariano configura um fator predisponente para formação de trombos. Porém, a estase sanguínea causada pela alteração do fluxo pode não ser o suficiente para causar fenômenos tromboembólicos.

The morphology of coronary aneurysm sets a predisposing factor to thrombus formation. However, the blood stasis caused by the change in flow may not be enough to cause thromboembolic events.

https://doi.org/10.5935/1678-9741.20110061 4567 downloads

15.

Consenso brasileiro ilustrado sobre a terminologia dos descritores e padrões fundamentais da TC de tórax
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Silva, C. Isabela S. Marchiori, Edson Souza Júnior, Arthur Soares Müller, Nestor L.

Jornal Brasileiro de Pneumologia

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feb 2010, Volume 36 N. 1 Pages 99 - 123

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O objetivo deste novo consenso brasileiro é atualizar e dar continuidade à padronização da terminologia dos principais descritores e padrões fundamentais da TC de tórax em língua portuguesa. Este consenso contém uma descrição sucinta dos principais termos utilizados na TC de tórax e ilustrações de exemplos clássicos. O grupo de autores é formado por médicos radiologistas membros do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, especializados em radiologia torácica, e por pneumologistas membros da Sociedade Brasileira de Pneumologia e Tisiologia, com particular interesse em diagnóstico por imagem.

The objective of this new Brazilian consensus is to update and to continue the standardization of the principal terms and fundamental patterns in chest CT scans in Portuguese. There is a succinct definition of the principal terms used to describe chest CT findings, as well as illustrations of classic examples. The group of authors comprised radiologists specializing in chest radiology and holding membership in the Brazilian College of Radiology and Diagnostic Imaging, as well as pulmonologists having a special interest in diagnostic imaging and holding membership in the Brazilian Thoracic Association.

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