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Radiomic analysis of MRI to Predict Sustained Complete Response after Radiofrequency Ablation in Patients with Hepatocellular Carcinoma - A Pilot Study
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Horvat, Natally

; Araujo-Filho, Jose de Arimateia B.

; Assuncao-Jr, Antonildes N.

; Machado, Felipe Augusto de M.

; Sims, John A.

; Rocha, Camila Carlos Tavares

; Oliveira, Brunna Clemente

; Horvat, Joao Vicente

; Maccali, Claudia

; Puga, Anna Luísa Boschiroli Lamanna

; Chagas, Aline Lopes

; Menezes, Marcos Roberto

; Cerri, Giovanni Guido

Clinics

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2021, Volume 76 elocation e2888

Abstract: En | Text: En | PDF: En

OBJECTIVES: To investigate whether quantitative textural features, extracted from pretreatment MRI, can predict sustained complete response to radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). METHODS: In this IRB-approved study, patients were selected from a maintained six-year database of consecutive patients who underwent both pretreatment MRI imaging with a probable or definitive imaging diagnosis of HCC (LI-RADS 4 or 5) and loco-regional treatment with RFA. An experienced radiologist manually segmented the hepatic nodules in MRI arterial and equilibrium phases to obtain the volume of interest (VOI) for extraction of 107 quantitative textural features, including shape and first- and second-order features. Statistical analysis was performed to evaluate associations between textural features and complete response. RESULTS: The study consisted of 34 patients with 51 treated hepatic nodules. Sustained complete response was achieved by 6 patients (4 with single nodule and 2 with multiple nodules). Of the 107 features from the arterial and equilibrium phases, 20 (18%) and 25 (23%) achieved AUC >0.7, respectively. The three best performing features were found in the equilibrium phase: Dependence Non-Uniformity Normalized and Dependence Variance (both GLDM class, with AUC of 0.78 and 0.76, respectively) and Maximum Probability (GLCM class, AUC of 0.76). CONCLUSIONS: This pilot study demonstrates that a radiomic analysis of pre-treatment MRI might be useful in identifying patients with HCC who are most likely to have a sustained complete response to RFA. Second-order features (GLDM and GLCM) extracted from equilibrium phase obtained highest discriminatory performance.

https://doi.org/10.6061/clinics/2021/e2888 224 downloads

Microwave ablation: initial experience in Brazil
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Rovella, Marcello Silveira

; Fiore, Lucas

; Allegro Filho, Alfredo Enzo

; Martins, Guilherme Lopes Pinheiro

; Menezes, Marcos Roberto

Radiologia Brasileira

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aug 2020, Volume 53 N. 4 Pages 279 - 280

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

https://doi.org/10.1590/0100-3984.2019.0096 919 downloads

Management of Hepatocellular Carcinoma during the COVID-19 Pandemic - São Paulo Clínicas Liver Cancer Group Multidisciplinary Consensus Statement
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Chagas, Aline Lopes

; da Fonseca, Leonardo Gomes

; Coelho, Fabricio Ferreira

; da Cunha Saud, Lisa Rodrigues

; Abdala, Edson

; Andraus, Wellington

; Fiore, Lucas

; Moreira, Airton Mota

; Menezes, Marcos Roberto

; Carnevale, Francisco César

; Tani, Claudia Megumi

; Alencar, Regiane S.S.M

; D'Albuquerque, Luiz Augusto Carneiro

; Herman, Paulo

; Carrilho, Flair José

Clinics

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2020, Volume 75 elocation e2192

Abstract: En | Text: En | PDF: En

More than 18 million people in 188 countries have been diagnosed as having coronavirus disease (COVID-19), and COVID-19 has been responsible for more than 600,000 deaths worldwide. Brazil is now the second most affected country globally. Faced with this scenario, various public health measures and changes in the daily routines of hospitals were implemented to stop the pandemic. Patients with hepatocellular carcinoma (HCC) are at an increased risk for severe COVID-19 as they present with two major diseases: cancer and concomitant chronic liver disease. The COVID-19 pandemic can significantly impact the management of HCC patients from diagnosis to treatment strategies. These patients need special attention and assistance at this time, especially since treatment for tumors cannot be delayed in most cases. The aim of this guideline was to standardize the management of HCC patients during the COVID-19 pandemic. This document was developed, on the basis of the best evidence available, by a multidisciplinary team from Instituto do Câncer do Estado de São Paulo (ICESP), and Instituto Central of the Hospital das Clínicas da Universidade de São Paulo (HC-FMUSP), which are members of the São Paulo Clínicas Liver Cancer Group.

https://doi.org/10.6061/clinics/2020/e2192 361 downloads

BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF HEPATOCELLULAR CARCINOMA
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CHAGAS, Aline Lopes

; MATTOS, Angelo Alves de

; CARRILHO, Flair José

; BITTENCOURT, Paulo Lisboa

; VEZOZZO, Denise Cerqueira Paranaguá

; HORVAT, Natally

; ROCHA, Manoel de Souza

; ALVES, Venâncio Avancini Ferreira

; CORAL, Gabriela Perdomo

; ALVARES-DA-SILVA, Mario Reis

; BARROS, Fabio Marinho do Rego

; MENEZES, Marcos Roberto

; MONSIGNORE, Lucas Moretti

; COELHO, Fabricio Ferreira

; SILVA, Renato Ferreira da

; SILVA, Rita de Cássia Martins Alves

; BOIN, Ilka de Fatima Santana Ferreira

; D`ALBUQUERQUE, Luiz Augusto Carneiro

; GARCIA, José Huygens Parente

; FELGA, Guilherme Eduardo Gonçalves

; MOREIRA, Airton Mota

; BRAGHIROLI, Maria Ignez Freitas Melro

; HOFF, Paulo Marcelo Gehm

; MELLO, Vivianne Barretto de

; DOTTORI, Mariana Fonseca

; BRANCO, Tiago Pugliese

; SCHIAVON, Leonardo de Lucca

; COSTA, Thaisa de Fátima Almeida

Arquivos de Gastroenterologia

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2020, Volume 57 Suppl. 1 Pages 1 - 20

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

RESUMO O carcinoma hepatocelular (CHC) é uma das principais causas de mortalidade relacionada a câncer no Brasil e no mundo. A Sociedade Brasileira de Hepatologia (SBH) publicou em 2015 suas primeiras recomendações sobre a abordagem do CHC. Desde então, novas evidências sobre o diagnóstico e tratamento do CHC foram relatadas na literatura médica, levando a diretoria da SBH a promover uma reunião monotemática sobre câncer primário de fígado em agosto de 2018 com o intuito de atualizar as recomendações sobre o manejo da neoplasia. Um grupo de experts foi convidado para realizar uma revisão sistemática da literatura e apresentar uma atualização baseada em evidências científicas visando que pudesse nortear a prática clínica multidisciplinar do CHC. O texto resultante foi submetido a avaliação e aprovação de todos membros da SBH através de sua homepage. O documento atual é a versão final que contêm as recomendações atualizadas e revisadas da SBH.

ABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

https://doi.org/10.1590/s0004-2803.202000000-20 4088 downloads

RECOMMENDATIONS FOR INVASIVE PROCEDURES IN PATIENTS WITH DISEASES OF THE LIVER AND BILIARY TRACT: REPORT OF A JOINT MEETING OF THE BRAZILIAN SOCIETY OF HEPATOLOGY (SBH), BRAZILIAN SOCIETY OF DIGESTIVE ENDOSCOPY (SOBED) AND BRAZILIAN SOCIETY OF INTERVENTIONAL RADIOLOGY AND ENDOVASCULAR SURGERY (SOBRICE)
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SCHIAVON, Leonardo de Lucca

; EJIMA, Flávio Hayato

; MENEZES, Marcos Roberto de

; BITTENCOURT, Paulo Lisboa

; MOREIRA, Aírton Mota

; FARIAS, Alberto Queiroz

; CHAGAS, Aline Lopes

; ASSIS, André Moreira de

; MATTOS, Ângelo Zambam de

; SALOMÃO, Bruno Chaves

; TERRA, Carlos

; MARTINS, Fernanda Prata Borges

; CARNEVALE, Francisco Cesar

; REZENDE, Guilherme Ferreira da Motta

; PAULO, Gustavo Andrade de

; PEREIRA, Gustavo Henrique Santos

; MOTTA-LEAL-FILHO, Joaquim Maurício da

; MENESES, Juliana de

; COSTA, Lucas Santana Nova da

; CARNEIRO, Marcos de Vasconcelos

; ÁLVARES-DA-SILVA, Mário Reis

; SOARES, Mayra Veloso Ayrimoraes

; PEREIRA, Osvaldo Ignácio

; XIMENES, Rafael Oliveira

; DURANTE, Renata Filardi Simiqueli

; FERREIRA, Valério Alves

; LIMA, Vinícius Machado de

Arquivos de Gastroenterologia

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jun 2019, Volume 56 N. 2 Pages 213 - 231

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

RESUMO As doenças do fígado e das vias biliares são causas comuns de morbidade e mortalidade. Procedimentos invasivos com finalidade diagnóstica e terapêutica são frequentemente recomendados nos casos de doenças hepatobiliares. O reconhecimento das indicações e limitações das técnicas comumente empregadas é crucial para uma adequada seleção dos pacientes, maximizando os resultados positivos e reduzindo o risco de complicações. Em 2018, a Sociedade Brasileira de Hepatologia (SBH), em colaboração com a Sociedade Brasileira de Radiologia Intervencionista e Cirurgia Endovascular (SOBRICE) e a Sociedade Brasileira de Endoscopia Digestiva (SOBED) realizaram um encontro exclusivamente voltado para a discussão dos procedimentos invasivos nas doenças hepatobiliares. Este texto resume as principais recomendações discutidas durante o evento, e tem a intenção de auxiliar clínicos, gastroenterologistas, hepatologistas, radiologistas e endoscopistas no uso adequado dos procedimentos invasivos para manejo de pacientes com doenças hepatobiliares.

ABSTRACT Liver and biliary tract diseases are common causes of morbidity and mortality worldwide. Invasive procedures are usually performed in those patients with hepatobiliary diseases for both diagnostic and therapeutic purposes. Defining proper indications and restraints of commonly used techniques is crucial for proper patient selection, maximizing positive results and limiting complications. In 2018, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Society of Interventional Radiology and Endovascular surgery (SOBRICE) and the Brazilian Society of Digestive Endoscopy (SOBED) sponsored a joint single-topic meeting on invasive procedures in patients with hepatobiliary diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to guide clinicians, gastroenterologists, hepatologists, radiologists, and endoscopists for the proper use of invasive procedures for management of patients with hepatobiliary diseases.

https://doi.org/10.1590/s0004-2803.201900000-42 2181 downloads

18F-FDG PET/CT performed immediately after percutaneous ablation to evaluate outcomes of the procedure: preliminary results
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Romanato, Juliana

; Menezes, Marcos Roberto

; Santos, Allan de Oliveira

; Bezerra, Regis Otaviano Franca

; Lima, Mariana Cunha Lopes

; Etchebehere, Elba

Radiologia Brasileira

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feb 2019, Volume 52 N. 1 Pages 24 - 32

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

Resumo Objetivo: Demonstrar se a tomografia por emissão de pósitrons acoplada a tomografia computadorizada usando-se fluorodesoxiglicose marcada com flúor-18 realizada imediatamente após ablação percutânea (iAP18F-FDG PET/CT) pode ser útil na avaliação do resultado desse tratamento. Materiais e Métodos: Foram avaliados, retrospectivamente, 20 pacientes (13 homens e 7 mulheres; média de idade: 65,8 ± 12,1 anos) submetidos a ablação percutânea de metástases apresentando captação de 18F-FDG no exame de PET/CT. Os tumores primários foram, principalmente, câncer colorretal (45%) ou câncer de pulmão (40%). A iAP18F-FDG PET/CT foi realizada para avaliar tumor residual viável. O tratamento foi considerado sucesso (sem lesão viável) se nenhuma captação de 18F-FDG fosse observada na iAP18F-FDG PET/CT. Resultados: Vinte e seis lesões foram submetidas a ablação percutânea por meio de crioablação (n = 7) ou radiofrequência (n = 19). O tamanho médio das lesões era de 2,52 ± 1,49 cm. A iAP18F-FDG PET/CT detectou tumor viável com sensibilidade, especificidade, acurácia, valor preditivo positivo e valor preditivo negativo de 66,7%, 95%, 88,5%, 80% e 90,5%, respectivamente. Houve correlação significativa entre os achados da iAP18F-FDG PET/CT e os resultados do seguimento clínico dos pacientes (kappa = 0,66; p < 0,01). Conclusão: A iAP18F-FDG PET/CT é capaz de avaliar o resultado da ablação percutânea e poderá permitir reintervenção precoce de lesões residuais viáveis, reduzindo a morbidade. Um número maior de pacientes é necessário para confirmar esses achados.

Abstract Objective: To determine whether 18F-fluorodeoxyglucose positron emission tomography/computed tomography performed immediately after percutaneous ablation (iPA18F-FDG PET/CT) is useful in evaluating the outcomes of the procedure. Materials and Methods: This was a retrospective study of 20 patients (13 males, 7 females; mean age, 65.8 ± 12.1 years) submitted to percutaneous ablation of metastases. All of the lesions treated had shown focal uptake on a 18F-FDG PET/CT scan obtained at baseline. The primary tumors were mainly colorectal cancer (in 45%) or lung cancer (in 40%). iPA18F-FDG PET/CT was performed to identify any residual viable tumor cells. The treatment was considered a success (no viable tumor cells present) if no uptake of 18F-FDG was noted on the iPA18F-FDG PET/CT scan. Results: Twenty-six lesions were submitted to percutaneous ablation with either cryoablation (n = 7) or radiofrequency ablation (n = 19). The mean lesion diameter was 2.52 ± 1.49 cm. For the detection of viable tumor cells, iPA18F-FDG PET/CT had a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 66.7%, 95%, 88.5%, 80%, and 90.5%, respectively. There was a significant correlation between the iPA18F-FDG PET/CT findings and the results of the follow-up studies (kappa = 0.66; p < 0.01). Conclusion: iPA18F-FDG PET/CT studies appear to constitute a useful means of evaluating the outcomes of percutaneous ablation. By detecting residual viable tumor cells, this strategy might allow early re-intervention, thus reducing morbidity. Studies involving larger numbers of patients are needed in order to confirm our findings.

https://doi.org/10.1590/0100-3984.2018.0010 906 downloads

Hepatocyte-specific contrast agent-enhanced magnetic resonance cholangiography: perioperative evaluation of the biliary tree
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Zattar-Ramos, Luciana Carmen

; Bezerra, Regis Otaviano Franca

; Siqueira, Luis Tenório de Brito

; Menezes, Marcos Roberto

; Leite, Claudia da Costa

; Cerri, Giovanni Guido

Radiologia Brasileira

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dec 2017, Volume 50 N. 6 Pages 389 - 394

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

Resumo Recentemente, um grande número de quelantes de gadolínio tem sido testado em ensaios laboratoriais. Alguns deles já foram inclusive aprovados para uso clínico nos Estados Unidos e na Europa. Com isso, novas perspectivas diagnósticas foram incorporadas nos estudos de ressonância magnética. Dentre estes quelantes de gadolínio, os contrastes hepatobiliares específicos (CHBEs) têm sido amplamente utilizados para a caracterização e detecção de lesões focais hepáticas, essencialmente pela propriedade de serem captados pelos hepatócitos e excretados na via biliar. Além disso, os CHBEs trouxeram novas informações na avaliação da árvore biliar quando comparados à colangiorressonância convencional, proporcionando uma maior resolução espacial e melhor avaliação da anatomia da árvore biliar não dilatada. A avaliação da anatomia biliar é de fundamental importância em cirurgias hepáticas, como ressecções complexas em tumores colorretais ou no transplante hepático com doador vivo, porém, o uso dos CHBEs ainda é restrito para estes propósitos. Em razão da escassa literatura sobre o tema e da pouca familiaridade dos radiologistas com as principais indicações, o presente ensaio iconográfico tem por objetivo demonstrar o uso de CHBEs na avaliação perioperatória das vias biliares, ressaltando a avaliação anatômica, as indicações e os principais achados de imagem.

Abstract A large number of gadolinium chelates have recently been tested in clinical trials. Some of those have already been approved for clinical use in the United States and Europe. Thus, new diagnostic perspectives have been incorporated into magnetic resonance imaging studies. Among such gadolinium chelates are hepatobiliary-specific contrast agents (HSCAs), which, due to their property of being selectively taken up by hepatocytes and excreted by the biliary ducts, have been widely used for the detection and characterization of focal hepatic lesions. In comparison with conventional magnetic resonance cholangiography (MRC), HSCA-enhanced MRC provides additional information, with higher spatial resolution and better anatomic evaluation of a non-dilated biliary tree. A thorough anatomic assessment of the biliary tree is crucial in various hepatic surgical procedures, such as complex resection in patients with colorectal cancer and living-donor liver transplantation. However, the use of HSCA-enhanced MRC is still limited, because of a lack of data in the literature and the poor familiarity of radiologists regarding its main indications. This pictorial essay aims to demonstrate the use of HSCA-enhanced MRC, with particular emphasis on anatomical analysis of the biliary tree, clinical applications, and the most important imaging findings.

https://doi.org/10.1590/0100-3984.2015.0213 9114 downloads

Paracoccidioidomycosis in a liver transplant recipient
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Lima, Thais Carneiro

; Bezerra, Regis Otaviano Franca

; Siqueira, Luiz Tenório de Brito

; Menezes, Marcos Roberto de

; Leite, Claudia da Costa

; Porta, Gilda

; Cerri, Giovanni Guido

Revista da Sociedade Brasileira de Medicina Tropical

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feb 2017, Volume 50 N. 1 Pages 138 - 140

Abstract: En | Text: En | PDF: En

ABSTRACT Paracoccidioidomycosis is a granulomatous systemic mycosis that is endemic in Latin America; it is an extremely rare infection following solid organ transplantation. In this study, we describe the first report of disseminated paracoccidioidomycosis in a 3-year-old girl who underwent liver transplantation 2 years previously. The radiologic diagnosis and patient follow-up are described. In addition, we review the clinical evolution and treatment regimens for this infection.

https://doi.org/10.1590/0037-8682-0282-2016 1410 downloads

Image-guided pancreatic biopsy; can we trust it as a diagnostic alternative?
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Queroz, Thiago

; Bernardo, Wanderley Marques

; Menezes, Marcos Roberto de

Revista da Associação Médica Brasileira

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oct 2016, Volume 62 N. 7 Pages 616 - 617

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.62.07.616 779 downloads

10.

Long-term Results after CT-Guided Percutaneous Ethanol Ablation for the Treatment of Hyperfunctioning Adrenal Disorders
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Frenk, Nathan Elie

; Sebastianes, Fernando

; Lerario, Antonio Marcondes

; Fragoso, Maria Candida Barisson Villares

; Mendonca, Berenice Bilharinho

; Menezes, Marcos Roberto de

Clinics

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oct 2016, Volume 71 N. 10 Pages 600 - 605

Abstract: En | Text: En | PDF: En

OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. RESULTS: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macronodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. CONCLUSION: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyperfunctioning adrenal disorders and is not without risks.

https://doi.org/10.6061/clinics/2016(10)08 822 downloads

11.

Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts
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Menezes, Marcos Roberto de

; Viana, Publio Cesar Cavalcante

; Yamanari, Tássia Regina

; Reis, Leonardo Oliveira

; Nahas, William

International braz j urol

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jun 2016, Volume 42 N. 3 Pages 456 - 463

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose To describe our initial experience with radiofrequency ablation (RFA) of Bosniak IV renal cysts. Materials and Methods From 2010 to 2014, 154 renal tumor cases were treated with percutaneous thermal ablation, of which 10 cases (6.4%) from nine patients were complex renal cysts and were treated with radiofrequency ablation. Results All complex cysts were classified as Bosniak IV (four women and five men; mean age: 63.6 yrs, range: 33–83 years). One patient had a single kidney. Lesion size ranged from 1.5 to 4.1cm (mean: 2.5cm) and biopsy was performed on four cysts immediately before the procedure, all of which were malignant (two clear cell and two papillary carcinoma). Mean volume reduction of complex cysts was 25% (range: 10–40%). No patients required retreatment with RFA and no immediate or late complications were observed. The follow-up of Bosniak IV cysts had a median of 27 months (interquartile range [IQR], 23 to 38) and no recurrence or significant loss of renal function were observed. Conclusions Mid-term follow-up of the cases in our database suggests that image-guided percutaneous RFA can treat Bosniak IV cysts with very low complication rates and satisfactorily maintain renal function.

https://doi.org/10.1590/S1677-5538.IBJU.2015.0444 1761 downloads

12.

Magnetic resonance imaging of the vagina: an overview for radiologists with emphasis on clinical decision making
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Ferreira, Daian Miranda

; Bezerra, Régis Otaviano França

; Ortega, Cinthia Denise

; Blasbalg, Roberto

; Viana, Públio César Cavalcante

; Menezes, Marcos Roberto de

; Rocha, Manoel de Souza

Radiologia Brasileira

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aug 2015, Volume 48 N. 4 Pages 249 - 259

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

Resumo A ressonância magnética é um método com alta resolução de contraste e por isso muito utilizada na avaliação de doenças ginecológicas pélvicas. No entanto, seu potencial para diagnóstico de lesões vaginais ainda é subestimado, provavelmente em razão da escassa literatura referente ao tema, da pouca familiaridade dos radiologistas com doenças vaginais, algumas delas relativamente raras, e das muitas peculiaridades em um exame para avaliação desta víscera oca. Desta forma, ilustraremos neste estudo o papel da ressonância magnética na avaliação das doenças vaginais e os principais achados relevantes para a conduta clínica.

Abstract Magnetic resonance imaging is a method with high contrast resolution widely used in the assessment of pelvic gynecological diseases. However, the potential of such method to diagnose vaginal lesions is still underestimated, probably due to the scarce literature approaching the theme, the poor familiarity of radiologists with vaginal diseases, some of them relatively rare, and to the many peculiarities involved in the assessment of the vagina. Thus, the authors illustrate the role of magnetic resonance imaging in the evaluation of vaginal diseases and the main relevant findings to be considered in the clinical decision making process.

https://doi.org/10.1590/0100-3984.2013.1726 70268 downloads

13.

Intervenção orientada por imagem
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Menezes, Marcos Roberto de

Radiologia Brasileira

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aug 2006, Volume 39 N. 4 Pages III - III

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2030 downloads

14.

Tomografia computadorizada multidetectores não-contrastada na avaliação do abdome agudo: um novo paradigma no pronto-socorro?
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Menezes, Marcos Roberto de

; Kay, Fernando Uliana

Radiologia Brasileira

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apr 2006, Volume 39 N. 2 Pages IV - V

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7113 downloads Cited 1 time in SciELO

15.

Qual o seu diagnóstico?
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Teixeira, Racine Procópio

; Matos, João Roberto de

; Melo, Ernesto Lima Araújo

; Menezes, Marcos Roberto de

; Albertotti, Cezar José

; Cerri, Giovanni Guido

Radiologia Brasileira

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feb 2006, Volume 39 N. 1 Pages V - VI

Abstract: Pt | Text: Pt | PDF: Pt

23728 downloads

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