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Radiology in the age of artificial intelligence: challenges and opportunities intelligence
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Macedo, Tulio Augusto Alves

; Rocha, Manoel de Souza

Radiologia Brasileira

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2024, Volume 57 elocation e1en

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

https://doi.org/10.1590/0100-3984.2024.57.e1-en

HEPATOSPLENIC SCHISTOSOMIASIS-ASSOCIATED CHRONIC PORTAL VEIN THROMBOSIS: RISK FACTOR FOR HEPATOCELLULAR CARCINOMA?
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Darce, George Felipe Bezerra

; Makdissi, Fabio Ferrari

; Ando, Sabrina de Mello

; Fonseca, Gilton Marques

; Kruger, Jaime Arthur Pirola

; Coelho, Fabricio Ferreira

; Rocha, Manoel de Souza

; Herman, Paulo

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2023, Volume 36 elocation e1763

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

ABSTRACT BACKGROUND: Hepatosplenic schistosomiasis is an endemic disease prevalent in tropical countries and is associated with a high incidence of portal vein thrombosis. Inflammatory changes caused by both parasitic infection and portal thrombosis can lead to the development of chronic liver disease with potential carcinogenesis. AIMS: To assess the incidence of portal vein thrombosis and hepatocellular carcinoma in patients with schistosomiasis during long-term follow-up. METHODS: A retrospective study was conducted involving patients with schistosomiasis followed up at our institution between 1990 and 2021. RESULTS: A total of 126 patients with schistosomiasis were evaluated in the study. The mean follow-up time was 16 years (range 5–31). Of the total, 73 (57.9%) patients presented portal vein thrombosis during follow-up. Six (8.1%) of them were diagnosed with hepatocellular carcinoma, all with portal vein thrombosis diagnosed more than ten years before. CONCLUSIONS: The incidence of hepatocellular carcinoma in patients with schistosomiasis and chronic portal vein thrombosis highlights the importance of a systematic long-term follow-up in this group of patients.

RESUMO RACIONAL: A esquistossomose hepatoesplênica é uma doença endêmica prevalente em países tropicais e está associada a uma alta incidência de trombose da veia porta. Alterações inflamatórias causadas tanto pela infecção parasitária quanto pela trombose portal podem levar ao desenvolvimento de doença hepática crônica com potencial carcinogênico. OBJETIVOS: Avaliar a incidência de trombose da veia porta e carcinoma hepatocelular em pacientes com esquistossomose durante um seguimento de longo prazo. MÉTODOS: Foi realizado estudo retrospectivo envolvendo pacientes com esquistossomose acompanhados em nossa instituição entre 1990 e 2021. RESULTADOS: Um total de 126 pacientes com esquistossomose foram avaliados no estudo. O tempo médio de acompanhamento foi de 16 anos (variando de 5 a 31). Do total, 73 (57,9%) pacientes apresentaram trombose da veia porta durante o seguimento e seis (8,1%) deles foram diagnosticados com carcinoma hepatocelular, todos com trombose da veia porta diagnosticada há mais de 10 anos. CONCLUSÕES: A incidência de carcinoma hepatocelular em pacientes com esquistossomose e trombose da veia porta crônica destaca a importância de um acompanhamento sistemático de longo prazo nesse grupo de pacientes.

https://doi.org/10.1590/0102-672020230045e1763

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

Incidental findings on imaging exams: what is the essential nature of radiology?
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Yamauchi, Fernando Ide

; Leão Filho, Hilton Muniz

; Rocha, Manoel de Souza

; Mayo-Smith, W. W.

Radiologia Brasileira

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apr 2019, Volume 52 N. 2

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0100-3984.2019.52.2e3 1116 downloads

I BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 2: APPROACH TO RESECTABLE METASTASES
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RIBEIRO, Héber Salvador de Castro TORRES, Orlando Jorge Martins MARQUES, Márcio Carmona HERMAN, Paulo KALIL, Antonio Nocchi FERNANDES, Eduardo de Souza Martins OLIVEIRA, Fábio Ferreira de CASTRO, Leonaldson dos Santos HANRIOT, Rodrigo OLIVEIRA, Suilane Coelho Ribeiro BOFF, Marcio Fernando COSTA Jr, Wilson Luiz da GIL, Roberto de Almeida PFIFFER, Tulio Eduardo Flesch MAKDISSI, Fabio Ferrari ROCHA, Manoel de Souza AMARAL, Paulo Cezar Galvão do COSTA, Leonardo Atem Gonçalves de Araújo ALOIA, Tomas A. D'ALBUQUERQUE, Luiz Augusto Carneiro COIMBRA, Felipe José Fernandez

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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mar 2016, Volume 29 N. 1 Pages 9 - 13

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

Racional: As metástases hepáticas de câncer colorretal são evento frequente e potencialmente fatal na evolução dos pacientes. Objetivo : No segundo módulo desse consenso, foi discutido o manejo de metástases hepáticas ressecáveis. Método : Foi definido o conceito de metástases síncrônicas e metacrônicas, e ambos os cenários foram discutidos separadamente de acordo com as suas peculiaridades prognósticas e terapêuticas. Resultados : Foi dada especial atenção às missing metástases em resposta ao tratamento pré-operatório sistêmico, com ênfase em estratégias para evitar sua recorrência e como gerenciar as lesões desaparecidas. Conclusão : Foram apresentadas e validadas estratégias de ressecção em várias circunstâncias, para serem aplicadas na prática clínica.

Background : Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients. Aim : In the second module of this consensus, management of resectable liver metastases was discussed. Method : Concept of synchronous and metachronous metastases was determined, and both scenarius were discussed separately according its prognostic and therapeutic peculiarities. Results : Special attention was given to the missing metastases due to systemic preoperative treatment response, with emphasis in strategies to avoid its reccurrence and how to manage disappeared lesions. Conclusion : Were presented validated ressectional strategies, to be taken into account in clinical practice.

https://doi.org/10.1590/0102-6720201600010003 4172 downloads

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

Clinical and pathological evaluation of fibrolamellar hepatocellular carcinoma: a single center study of 21 cases
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Chagas, Aline Lopes Kikuchi, Luciana Herman, Paulo Alencar, Regiane S.S.M. Tani, Claudia M. Diniz, Márcio Augusto Pugliese, Vincenzo Rocha, Manoel de Souza D′Albuquerque, Luiz Augusto Carneiro Carrilho, Flair Jose Alves, Venancio A.F.

Clinics

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mar 2015, Volume 70 N. 3 Pages 207 - 213

Abstract: En | Text: En | PDF: En

OBJECTIVES: Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor that differs from conventional hepatocellular carcinoma in several aspects. The aim of this study was to describe the clinical, surgical and histopathological features of fibrolamellar hepatocellular carcinoma and to analyze the factors associated with survival. METHODS: We identified 21 patients with histopathologically diagnosed fibrolamellar hepatocellular carcinoma over a 22-year period. Clinical information was collected from medical records and biopsies, and surgical specimens were reviewed. RESULTS: The median age at diagnosis was 20 years. Most patients were female (67%) and did not have associated chronic liver disease. Most patients had a single nodule, and the median tumor size was 120 mm. Vascular invasion was present in 31% of patients, and extra-hepatic metastases were present in 53%. Fourteen patients underwent surgery as the first-line therapy, three received chemotherapy, and four received palliative care. Eighteen patients had “pure fibrolamellar hepatocellular carcinoma,” whereas three had a distinct area of conventional hepatocellular carcinoma and were classified as having “mixed fibrolamellar hepatocellular carcinoma.” The median overall survival was 36 months. The presence of “mixed fibrolamellar hepatocellular carcinoma” and macrovascular invasion were predictors of poor survival. Vascular invasion was associated with an increased risk of recurrence in patients who underwent surgery. CONCLUSION: Fibrolamellar hepatocellular carcinoma was more common in young female patients without chronic liver disease. Surgery was the first therapeutic option to achieve disease control, even in advanced cases. Vascular invasion was a risk factor for tumor recurrence. The presence of macrovascular invasion and areas of conventional hepatocellular carcinoma were directly related to poor survival.

https://doi.org/10.6061/clinics/2015(03)10 2146 downloads

Necrose pancreática delimitada e outros conceitos atuais na avaliação radiológica da pancreatite aguda
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Cunha, Elen Freitas de Cerqueira Rocha, Manoel de Souza Pereira, Fábio Payão Blasbalg, Roberto Baroni, Ronaldo Hueb

Radiologia Brasileira

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jun 2014, Volume 47 N. 3 Pages 165 - 175

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

A pancreatite aguda é uma condição inflamatória causada por ativação intracelular e extravasamento inapropriado de enzimas proteolíticas que determinam destruição do parênquima pancreático e dos tecidos peripancreáticos. Consiste em uma condição clínica bastante frequente, identificando-se duas formas principais de apresentação: a forma edematosa, menos intensa, e a forma necrosante, a forma grave da doença que acomete uma proporção significativa dos pacientes. A avaliação radiológica, sobretudo por tomografia computadorizada, tem papel fundamental na definição da conduta nos casos graves, sobretudo no que diz respeito à caracterização das complicações locais, que têm implicação prognóstica, e na determinação do tipo de abordagem terapêutica. Novos conceitos incluem a subdivisão da pancreatite necrosante nas formas de necrose do parênquima pancreático concomitante com necrose dos tecidos peripancreáticos ou necrose restrita aos tecidos peripancreáticos. Além disso, houve sistematização dos termos: acúmulos líquidos agudos peripancreáticos, pseudocisto, alterações pós-necróticas pancreáticas/peripancreáticas e necrose pancreática delimitada. Tal conhecimento é de extrema relevância no sentido de uniformizar a linguagem entre os especialistas envolvidos no diagnóstico e tratamento desses pacientes.

Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation -, and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly by computed tomography, plays a fundamental role in the definition of the management of severe cases, especially regarding the characterization of local complications with implications in the prognosis and in the definition of the therapeutic approach. New concepts include the subdivision of necrotizing pancreatitis into the following presentations: pancreatic parenchymal necrosis with concomitant peripancreatic tissue necrosis, and necrosis restricted to peripancreatic tissues. Moreover, there was a systematization of the terms acute peripancreatic fluid collection, pseudocyst, post-necrotic pancreatic/peripancreatic fluid collections and walled-off pancreatic necrosis. The knowledge about such terms is extremely relevant to standardize the terminology utilized by specialists involved in the diagnosis and treatment of these patients.

https://doi.org/10.1590/0100-3984.2012.1565 48314 downloads

Abscessos hepáticos secundários a colangite aguda
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Rocha, Manoel de Souza

Radiologia Brasileira

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apr 2013, Volume 46 N. 2 Pages xi - xi

Abstract: Pt | Text: Pt | PDF: Pt

3502 downloads

10.

Sclerosing mesenteritis as an unusual cause of fever of unknown origin: a case report and review
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Avelino-Silva, Vivian Iida Leal, Fabio Eudes Coelho-Netto, Caio Cotti, Guilherme Cutait de Castro Souza, Ricardo A. S. Azambuja, Rodrigo Lautert Rocha, Manoel de Souza Kallas, Esper Georges

Clinics

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2012, Volume 67 N. 3 Pages 293 - 295

Abstract: En | Text: En | PDF: En

https://doi.org/10.6061/clinics/2012(03)16 3158 downloads Cited 1 time in SciELO

11.

Sarcoma de Kaposi relacionado à síndrome da imunodeficiência adquirida: características do comprometimento hepático na tomografia computadorizada e na ressonância magnética
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Costa, Daniel Nobrega da Viana, Publio Cesar Cavalcante Maciel, Rosângela Pereira Gebrim, Eloisa Maria Mello Santiago Rocha, Manoel de Souza

Radiologia Brasileira

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apr 2008, Volume 41 N. 2 Pages 139 - 140

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

Sarcoma de Kaposi é uma neoplasia associada a condições de imunossupressão que acomete os vasos linfáticos e sanguíneos. É a neoplasia intra-hepática mais comum na síndrome da imunodeficiência adquirida. A tomografia computadorizada e a ressonância magnética revelam múltiplos pequenos nódulos, proeminência e realce dos planos periportais, devido à presença de tecido neoplásico. Os autores descrevem um caso de paciente masculino, de 47 anos de idade, com síndrome da imunodeficiência adquirida e sarcoma de Kaposi disseminado.

Kaposi sarcoma is a neoplasm associated with immunosuppressive conditions, and involving blood and lymphatic vessels. It is the most frequent intrahepatic neoplasm in patients with acquired immunodeficiency syndrome. Computed tomography and magnetic resonance imaging demonstrate multiple small nodules, prominence and contrast-enhancement of periportal branches due to the presence of the neoplastic tissue. The authors report a case of a 47-year-old male patient with acquired immunodeficiency syndrome presenting disseminated Kaposi sarcoma.

8245 downloads

12.

Tumor do estroma gastrintestinal (GIST)
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Rocha, Manoel de Souza

Radiologia Brasileira

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jun 2007, Volume 40 N. 3 Pages V - VI

Abstract: Pt | Text: Pt | PDF: Pt

3752 downloads

13.

Validação de métodos de estimativa da gordura corporal em portadores do HIV/Aids
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Florindo, Alex Antonio Latorre, Maria do Rosario Dias de Oliveira Santos, Elisabete Cristina Morandi dos Borelli, Aurélio Rocha, Manoel de Souza Segurado, Aluisio Augusto Cotrim

Revista de Saúde Pública

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oct 2004, Volume 38 N. 5 Pages 643 - 649

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

OBJETIVO: Validar métodos de estimativas da gordura corporal (somatória de espessura de dobras cutâneas, circunferência da cintura (CC) e razão cintura-quadril (RCQ)) em portadores do HIV/Aids, tendo como padrão ouro a absortometria por dupla emissão de raios-X (Dexa) e a tomografia computadorizada de abdômen (TCA). MÉTODOS: Foram estudados 15 portadores do HIV/Aids tratados em uma unidade de saúde coligada a um hospital público universitário, São Paulo. Foram medidas a gordura subcutânea total (GST) mediante a somatória da espessura de sete dobras (bíceps, tríceps, subescapular, axilar média, supra-ilíaca, abdominal e panturrilha medial), a gordura subcutânea central (GSC) (somatória da espessura de quatro dobras) e a gordura subcutânea de membros (GSM) (somatória da espessura de três dobras). A GST, GSC e GSM foram comparadas com as medidas de gordura obtidas pela Dexa. A CC, a RCQ e a GSC foram comparadas com as medidas de gordura obtidas pela TCA. Na análise estatística, utilizou-se o coeficiente de correlação de Pearson (r) e foi utilizado o teste de Mann-Whitney. RESULTADOS: A gordura medida pela Dexa foi correlacionada com GST, a GSC e GSM, mesmo após o ajuste pela idade (r>0,80 para todos). A gordura total de abdômen medida pela TCA foi correlacionada com a CC, RCQ e a GSC após o ajuste pela idade (r>0,80 para todos). CONCLUSÕES: Os métodos de estimativa da gordura corporal devem ser escolhidos de acordo com o tipo de gordura a ser avaliada e podem ser utilizados em pesquisas e nos serviços de saúde como alternativa à Dexa e TCA para portadores do HIV/Aids.

OBJECTIVE: To validate different methods for estimating HIV/Aids patients' body fat: total body skinfold thickness, central (trunk) skinfold thickness, peripheral (limb) skinfold thickness, waist circumference (WC) and waist-to-hip ratio (WHR). Dual-energy X-ray absorptiometry (DEXA) and computed tomography of the abdomen (CTA) were used as the gold standard. METHODS: An analysis was done on 15 adult HIV/Aids patients (10 men and 5 women) who were being treated at an Aids clinic at a public university hospital, Sao Paulo, Brazil. Their total subcutaneous fat (TSF) was estimated from the sum of the thicknesses of the biceps, triceps, subscapular, midaxillary, suprailiac, abdominal and medial calf skinfolds. The central subcutaneous fat (CSF) was estimated by summing the subscapular, axillary, suprailiac and abdominal skinfold measurements. The peripheral subcutaneous fat (PSF) was estimated by summing the biceps, triceps and medial calf skinfold measurements. These were compared with Dexa. The WC, WHR and CSF were compared with CTA. In the statistical analysis, the Pearson correlation coefficient (r) and Mann-Whitney test were utilized. RESULTS: There was a correlation between fat mass measured by DEXA and by TSF, CSF and PSF, even after adjusting for age (r>0.80 for all). WC, WHR and CSF presented correlation with total abdominal fat measured by CTA, even after adjusting for age (r>0.80 for all). CONCLUSIONS: The methods for estimating body fat should be chosen according to the type of fat to be evaluated and can be used in research and healthcare services instead of DEXA and CTA for HIV/AIDS patients.

6185 downloads Cited 7 times in SciELO

14.

Validação de métodos de estimativa da gordura corporal em portadores do HIV/Aids
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Florindo, Alex Antonio Latorre, Maria do Rosario Dias de Oliveira Santos, Elisabete Cristina Morandi dos Borelli, Aurélio Rocha, Manoel de Souza Segurado, Aluisio Augusto Cotrim

Revista de Saúde Pública

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oct 2004, Volume 38 N. 5 Pages 643 - 649

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

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Treatment by splenectomy of a portal vein aneurysm in hepatosplenic schistosomiasis
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MUCENIC, Marcos ROCHA, Manoel de Souza LAUDANNA, Antônio Atílio CANÇADO, Eduardo Luiz Rachid

Revista do Instituto de Medicina Tropical de São Paulo

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oct 2002, Volume 44 N. 5 Pages 261 - 264

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

Aneurismas venosos portais são uma entidade médica rara, ao passo que as esquistossomoses ainda constituem uma pandemia. Descrevemos um paciente de 46 anos, com esquistossomose hépato-esplênica e um aneurisma intra-hepático confirmado por vários métodos de imagem. Após a esplenectomia, o diâmetro do aneurisma diminuiu significativamente.

Portal vein aneurysm is a rare medical entity that can be caused by chronic hepatic diseases with portal hypertension. We describe a 45-year-old man with variceal bleeding from hepatosplenic schistosomiasis and an incidentally found intrahepatic aneurysm. Diagnosis was confirmed with non-invasive imaging exams, arteriography and liver biopsy. Following splenectomy, the aneurysm diameter decreased substantially.

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