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au:Hueb, Marcelo

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Accuracy of 68Ga-PSMA PET-CT and PET-MRI in lymph node staging for localized prostate cancer
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Barbosa, Álan Roger Gomes

; Amaral, Breno Santos

; Lourenço, Danilo Budib

; Bianco, Bianca

; Gushiken, Felipe Arakaki

; Apezzato, Marcelo

; Silva, Júlia Francisco

; Cunha, Marcelo Livorsi da

; Filippi, Reneé Zon

; Baroni, Ronaldo Hueb

; Lemos, Gustavo Caserta

; Carneiro, Arie

einstein (São Paulo)

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2022, Volume 20 elocation eAO6599

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To evaluate the predictive value of positron emission computed tomography or magnetic resonance (PET-CT and PET-MRI) using gallium-68-labeled prostate-specific membrane antigen (68Ga-PSMA) in lymph node involvement in prostate cancer. Methods A retrospective study comprising 91 patients diagnosed with prostate cancer between 2016 to 2020, who underwent 68Ga-PSMA PET-CT or PET-MRI for staging before prostatectomy. The patients were divided into Group 1, with 65 patients with satisfactory pathological lymph node analysis, and Group 2, with 91 patients representing the sum of patients with pathological lymph node analysis and those with postoperative prostate-specific antigen within 60 days after surgery. Receiver Operating Characteristic curves were used to assess accuracy of predictive capacity of imaging exams for lymph node involvement. Results Regarding local clinical staging, the groups showed similar results, and 50% were classified as staging T2a. The accuracy of 68Ga-PSMA PET-CT for prostate cancer lymph node staging was 86.5% (95%CI 0.74-0.94; p=0.06), with a sensitivity of 58.3% and specificity of 95%. The accuracy of 68Ga-PSMA PET-MRI was 84.6% (95%CI 0.69-0.94; p=0.09), with a sensitivity of 40% and specificity of 100%. Considering both 68Ga-PSMA PET-CT and PET-MRI, the accuracy was 85.7% (95%CI 0.76-0.92; p=0.015), with sensitivity of 50% and specificity of 97%. Conclusion The imaging tests 68Ga-PSMA PET-CT and PET-MRI were highly accurate to detect preoperative lymph node involvement, and could be useful tools to indicate the need for extended lymph node dissection during radical prostatectomy.

https://doi.org/10.31744/einstein_journal/2022ao6599

T2-weighted imaging hypointensity in an ovarian lesion: is it a benign finding?
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Alcala, Juan Marcelo Fernandez

; Mussi, Thais Caldara

; Raiza, Luciana Cristina Pasquini

; Baroni, Ronaldo Hueb

einstein (São Paulo)

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2022, Volume 20 elocation eAO6851

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To evaluate whether the presence of a hypointense signal at T2-weighted imaging in a solid ovarian lesion on magnetic resonance imaging is a predictor of stability and benignity. Methods This is a single center study, prospectively read with retrospective acquired data. The database was searched for patients who underwent magnetic resonance imaging between January 2008 and October 2019 and whose reports mentioned solid ovarian lesions with low signal on T2-weighted imaging. A total of 47 nodules were included. A radiologist who was blinded to the clinical indication for magnetic resonance imaging and original reports evaluated the cases. Objective and subjective criteria of ovarian lesions in magnetic resonance imaging were evaluated. Results Thirty-five nodules were considered benign/stable and 12 were considered non-stable. The analysis showed that the non-stable lesions showed statistically more hyperintensity at T1-weighted imaging compared to the stable lesions. Conclusion T2-weighted imaging hypointensity can be considered a predictor of stability in solid ovarian lesions when associated with iso/hypointensity in T1-weighted imaging.

https://doi.org/10.31744/einstein_journal/2022ao6851

Abdominal symptoms as initial manifestation of COVID-19: a case series
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Amaral, Lucas Tadashi Wada

; Brito, Vanessa Mizubuti

; Beraldo, Gabriel Laverdi

; Fonseca, Eduardo Kaiser Ururahy Nunes

; Yokoo, Patrícia

; Talans, Aley

; Oranges Filho, Marcelo

; Chate, Rodrigo Caruso

; Baroni, Ronaldo Hueb

; Szarf, Gilberto

einstein (São Paulo)

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2020, Volume 18 elocation eRC5831

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

RESUMO A COVID-19 foi declarada uma pandemia no início de 2020. Constatou-se, inicialmente, que as principais manifestações desse novo vírus ocorrem por meio de sintomas respiratórios e constitucionais. A tomografia do tórax foi eleita o exame de imagem para avaliar a extensão do comprometimento pulmonar e como um fator preditivo do prognóstico para a doença. No entanto, à medida que novos estudos são produzidos, o envolvimento gastrointestinal da COVID-19 torna-se mais evidente, com relatos de pacientes que manifestaram principalmente ou apenas sintomas gastrointestinais no decorrer da doença. Em alguns casos, a investigação inicial é realizada no pronto-socorro, com tomografia computadorizada do abdome. Relatamos uma série de casos de dez pacientes que compareceram ao serviço de emergência da instituição com uma queixa principal gastrointestinal e foram submetidos inicialmente a uma tomografia computadorizada de abdome como primeira investigação. Embora a maioria dos pacientes não tenha apresentado alterações significativas nas imagens abdominais, eles apresentaram achados pulmonares visualizados nas bases pulmonares, que depois foram caracterizadas como achados pulmonares típicos de COVID-19 nas tomografias de tórax subsequentes. Apenas um paciente apresentou achados atípicos para COVID-19 na tomografia. Todos os pacientes tiveram reação em cadeia da polimerase em tempo real positiva para o novo coronavírus. É muito importante alertar os radiologistas, principalmente os radiologistas abdominais, da possibilidade de sintomas gastrointestinais isolados no contexto da COVID-19. Além disso, deve ser um hábito para todos os radiologistas avaliar as bases pulmonares nas tomografias de abdome, local comumente afetado pela COVID-19.

ABSTRACT The COVID-19 became a pandemic in early 2020. It was found, at first, that the main manifestations of this new virus occur through respiratory and constitutional symptoms. Therefore, chest tomography was elected as the best imaging test to assess the extent of pulmonary involvement and as a good prognostic predictor for the disease. However, as new studies were produced, the gastrointestinal involvement of COVID-19 becomes more evident, with reports from patients who manifested mainly or only gastrointestinal symptoms in the course of the disease. Thus, in some cases, the initial investigation is carried out at the emergency department with an abdominal computed tomography. We report a case series of ten patients who came to the emergency department of our institution with a chief gastrointestinal complaint, and were initially submitted to an abdominal computed tomography as the first investigation. Although most of the patients did not have significant changes in the abdominal images, most reported patients had pulmonary findings visualized at the lung bases, which were later designated as typical COVID-19 pulmonary findings on chest computed tomography. Only one patient had atypical COVID-19 lung changes on chest computed tomography. All patients had a positive real-time polymerase chain reaction for COVID-19. It is imperative to alert radiologists, especially abdominal radiologists, with the possibility of COVID-19 isolated gastrointestinal symptoms. Besides, it must become a habit to radiologists to assess the pulmonary basis on abdominal scans, a site commonly affected by the new coronavirus.

https://doi.org/10.31744/einstein_journal/2020rc5831 28737 downloads

Penile emergencies: a review of the main conditions
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Dantas, George Caldas

; Cavalcante Jr., Francisco

; Yamauchi, Fernando Ide

; Racy, Marcelo C. J.

; Rahal Jr., Antônio

; Baroni, Ronaldo Hueb

Radiologia Brasileira

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apr 2019, Volume 52 N. 2 Pages 123 - 127

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

Resumo As condições agudas do pênis são raras, geralmente relacionadas a causas traumáticas, vasculares ou infecciosas, e muitas vezes requerem avaliação médica imediata. As emergências penianas podem ter tratamento conservador ou cirúrgico e muitas vezes dependem dos exames de imagem. A ultrassonografia é a modalidade de imagem de escolha na avaliação inicial das emergências penianas, em virtude da alta resolução espacial, ampla disponibilidade e ausência de radiação ionizante desse método. A ressonância magnética deve ser considerada em casos inconclusivos, oferecendo maior campo de visão e detalhes precisos sobre o local e extensão das lesões. O principal objetivo deste ensaio iconográfico é revisar as principais emergências do pênis por meio de casos ilustrativos, com foco nos achados radiológicos e no papel dos métodos de imagem.

Abstract Acute penile conditions, which typically have a traumatic, vascular, or infectious etiology, are rather uncommon and often require prompt medical evaluation. Penile emergencies can be treated conservatively or surgically, and their management often relies on the results of imaging examinations. Because of its high spatial resolution and wide availability, as well as the fact that it does not involve the use of ionizing radiation, ultrasound is the imaging modality of choice in the initial evaluation of penile emergencies. Inconclusive cases can be further evaluated with magnetic resonance imaging. The main purpose of this pictorial essay is to review the main penile emergencies, by presenting illustrative cases, focusing on radiologic findings, and discussing the roles played by the various imaging methods.

https://doi.org/10.1590/0100-3984.2017.0072 2214 downloads

Marsupial vena cava mimicking lymph node enlargement on tomography
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Reis Filho, Antonio José Souza

; Rocha, Marcelo Assis

; Lemos, George Ramos

; Yamauchi, Fernando Ide

; Tachibana, Adriano

; Baroni, Ronaldo Hueb

einstein (São Paulo)

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2018, Volume 16 N. 3 elocation eAI4394

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

https://doi.org/10.1590/s1679-45082018ai4394 1091 downloads

Multifocal nodular steatosis mimicking liver metastasis
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Fonseca, Eduardo Kaiser Ururahy Nunes

; Magdalena, Thiago Raspa Freitas

; Yamauchi, Fernando Ide

; Racy, Marcelo de Castro Jorge

; Tridente, Cássia Franco

; Baroni, Ronaldo Hueb

einstein (São Paulo)

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jun 2017, Volume 15 N. 2 Pages 239 - 240

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

https://doi.org/10.1590/s1679-45082017ai3869 4980 downloads

PET/MRI: a novel hybrid imaging technique. Major clinical indications and preliminary experience in Brazil
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Vitor, Taise

; Martins, Karine Minaif

; Ionescu, Tudor Mihai

; Cunha, Marcelo Livorsi da

; Baroni, Ronaldo Hueb

; Garcia, Marcio Ricardo Taveira

; Wagner, Jairo

; Campos Neto, Guilherme de Carvalho

; Nogueira, Solange Amorim

; Guerra, Elaine Gonçalves

; Amaro Junior, Edson

einstein (São Paulo)

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mar 2017, Volume 15 N. 1 Pages 115 - 118

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

RESUMO Nos últimos anos, imagens médicas com tecnologias híbridas tornaram-se amplamente aceitas e utilizadas na prática clínica. O PET/RM possui vantagens importantes, incluindo excelentes contrastes e resolução, e menor radiação ionizante, em comparação ao PET/TC. Por isto, é uma modalidade promissora para exames de imagem de pacientes oncológicos, para avaliar o cérebro, cabeça e pescoço, o fígado e a pelve. O objetivo deste artigo foi analisar as situações clínicas que se beneficiariam de exames de PET/RM a partir de uma casuística. Destacamos o potencial desta técnica se tornar o método de imagem de escolha para doenças neurológicas e oncológicas que envolvam partes moles. Os aspectos clínicos de PET/RM e sua aplicação aos casos clínicos são ilustrados com exemplos da experiência inicial dos autores.

ABSTRACT In recent years, medical imaging with hybrid techniques has widely accepted and employed in clinical routine. PET/MRI offers significant advantages, including excellent contrast and resolution and reduced ionizing radiation, as compared to well-established PET/CT. Therefore, PET/MRI is a promising modality for oncologic imaging of some regions, such as brain, head and neck, liver and pelvis. This article set out to analyze clinical conditions that could benefit from PET/MRI imaging based on our caseload. The potential of PET/MRI to become the imaging modality of choice for assessment of neurologic and oncologic conditions associated with soft tissues is highlighted. Clinical aspects of PET/MRI and its application to clinical cases are illustrated with examples extracted from the authors’ preliminary experience.

https://doi.org/10.1590/s1679-45082017md3793 10906 downloads

ABORL-CCF and disease prevention campaigns
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Hueb, Marcelo M.

Brazilian Journal of Otorhinolaryngology

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aug 2014, Volume 80 N. 4 Pages 273 - 274

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

https://doi.org/10.1016/j.bjorl.2014.05.017 784 downloads

I Diretriz sobre Aspectos Específicos de Diabetes (tipo 2) Relacionados à Cardiologia
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Soeiro, Alexandre de Matos

; Mansur, Antonio de Pádua

; Schaan, Beatriz D.

; Caramelli, Bruno

; Rochitte, Carlos Eduardo

; Serrano Jr., Carlos Vicente

; Garzillo, Cibele Larrosa

; Calderaro, Daniela

; Gualandro, Danielle M.

; Lima, Eduardo Gomes

; Marcondes-Braga, Fabiana G.

; Lima, Felipe Gallego

; Oliveira, Felipe Martins de

; Azevedo, Fernanda Reis

; Chauhan, Hiteshi

; Salles, João Eduardo Nunes

; Soares Junior, José

; Cardoso, Juliano Novaes

; Pellanda, Lucia Campos

; Sacilotto, Luciana

; Baracioli, Luciano

; Bortolotto, Luiz A.

; César, Luiz Antonio Machado

; Ochiai, Marcelo Eidi

; Minami, Marcio H.

; Pinheiro, Martina Battistini

; Moretti, Miguel Antonio

; Oliveira, Mucio Tavares de

; Rezende, Paulo Cury

; Lemos Neto, Pedro Alves

; Admoni, Sharon Nina

; Lottenberg, Simão Augusto

; Rocha, Viviane Z.

; Hueb, Whady

; Mathias Jr., Wilson

Arquivos Brasileiros de Cardiologia

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may 2014, Volume 102 N. 5 Pages 1 - 41

Abstract: En | Text: En | PDF: En

https://doi.org/10.5935/abc.2014S002 9799 downloads

10.

Projeto: caminhos da Otorrinolaringologia
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Hueb, Marcelo

Brazilian Journal of Otorhinolaryngology

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aug 2012, Volume 78 N. 4 Pages 2 - 2

Abstract: Pt | Text: Pt | PDF: Pt

1193 downloads

11.

Iron overload in Brazilian thalassemic patients
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Assis, Reijane Alves de

; Kay, Fernando Uliana

; Rosemberg, Laércio Alberto

; Parma, Alexandre Henrique C.

; Nomura, Cesar Higa

; Loggetto, Sandra Regina

; Araujo, Aderson da Silva

; Fabron Junior, Antonio

; Veríssimo, Mônica Pinheiro de Almeida

; Baldanzi, Giorgio Roberto

; Steagal, Merula A.

; Velloso, Claudia Angela Galleni Di Sessa

; Espósito, Breno Pannia

; Nakashima, Sandra Saemi

; Diniz, Michelli da Silva

; Tricta, Fernando

; Baroni, Ronaldo Hueb

; Funari, Marcelo Buarque de Gusmão

; Wood, John C.

; Ribeiro, Andreza Alice Feitosa

; Hamerschlak, Nelson

einstein (São Paulo)

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jun 2011, Volume 9 N. 2 Pages 165 - 172

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

Objetivo: Avaliar o acúmulo de ferro em diferentes órgãos por meio da ressonância nuclear magnética T2* e correlacionar os resultados aos níveis de ferritina sérica, ferro plasmático lábil e outros órgãos envolvidos. Métodos: Foram avaliados retrospectivamente 115 pacientes talassêmicos (sendo 65 mulheres). A concentração hepática de ferro foi determinada em biópsia de 11 pacientes; os resultados foram comparados com os valores de T2* fígado. Resultados: a ferritina sérica média foi de 2.676,5 +/- 2.051,7 ng/mL. O ferro plasmático lábil foi anormal (> 0,6 Unidades/mL) em 48/83 pacientes (57%). A média dos valores de T2* no fígado foi 3,91 ± 3,95 ms, sugerindo siderose hepática em 92,1% pacientes. A média do T2* cardíaco foi de 24,96 ± 14,17 ms e 36% dos pacientes apresentavam siderose cardíaca (T2* < 20ms), dos quais 19% (22/115) já apresentavam sobrecarga cardíaca grave (T2* < 10 ms). A média de T2* no pâncreas foi de 11,12 ± 11,20 ms, perfazendo um total de 83,5% de pacientes com sobrecarga de ferro pancreático (T2* < 21 ms). Houve correlação significativa, curvilínea e inversa entre T2* fígado e a concentração de ferro hepática (r = −0,878; p <0,001) e correlação moderada entre T2* pâncreas e T2* miocárdio (r = 0,546; p <0,0001). Conclusão: Uma elevada taxa de acometimento hepático, pancreático e cardíaco por sobrecarga férrica foi demonstrada. Os níveis de ferritina não puderam prever sobrecarga de ferro hepático, cardíaco ou pancreáticos medidos por meio da ressonância nuclear magnética T2*. Não houve correlação entre a sobrecarga de ferro no fígado, pâncreas e miocárdio, nem entre a ferritina e os níveis plasmáticos de ferro sérico e os valores de T2* no fígado, coração e pâncreas.

ABSTRACT Objectives: To evaluate the use of magnetic resonance imaging in patients with β-thalassemia and to compare T2* magnetic resonance imaging results with serum ferritin levels and the redox active fraction of labile plasma iron. Methods: We have retrospectively evaluated 115 chronically transfused patients (65 women). We tested serum ferritin with chemiluminescence, fraction of labile plasma iron by cellular fluorescence and used T2* MRI to assess iron content in the heart, liver, and pancreas. Hepatic iron concentration was determined in liver biopsies of 11 patients and the results were compared with liver T2* magnetic resonance imaging. Results: The mean serum ferritin was 2,676.5 +/- 2,051.7 ng/mL. A fraction of labile plasma iron was abnormal (> 0,6 Units/mL) in 48/83 patients (57%). The mean liver T2* value was 3.91 ± 3.95 ms, suggesting liver siderosis in most patients (92.1%). The mean myocardial T2* value was 24.96 ± 14.17 ms and the incidence of cardiac siderosis (T2* < 20 ms) was 36%, of which 19% (22/115) were severe cases (T2* < 10 ms). The mean pancreas T2* value was 11.12 ± 11.20 ms, and 83.5% of patients had pancreatic iron deposition (T2* < 21 ms). There was significant curvilinear and inverse correlation between liver T2* magnetic resonance imaging and hepatic iron concentration (r= −0.878; p < 0.001) and moderate correlation between pancreas and myocardial T2* MRI (r = 0.546; p < 0.0001). Conclusion: A high rate of hepatic, pancreatic and cardiac impairment by iron overload was demonstrated. Ferritin levels could not predict liver, heart or pancreas iron overload as measured by T2* magnetic resonance imaging. There was no correlation between liver, pancreas, liver and myocardial iron overload, neither between ferritin and fraction of labile plasma iron with liver, heart and pancreas T2* values

https://doi.org/10.1590/s1679-45082011ao1897 3301 downloads

12.

Preditores de mortalidade em pacientes acima de 70 anos na revascularização miocárdica ou troca valvar com circulação extracorpórea
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Anderson, Alexander John Pessoa Grant

; Barros Neto, Francisco Xavier do Rêgo

; Costa, Marcelo de Almeida

; Dantas, Luciano Domingues

; Hueb, Alexandre Ciappina

; Prata, Marcelo Fernandes

Brazilian Journal of Cardiovascular Surgery

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mar 2011, Volume 26 N. 1 Pages 69 - 75

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

OBJETIVO: Identificar fatores de risco em septuagenários e octogenários submetidos à cirurgia cardiovascular com circulação extracorpórea (CEC). MÉTODOS: Avaliadas variáveis peri-operatórias de 265 pacientes com mais de 70 anos; desses, 248 (93,6%) eram septuagenários e 17 (6,4%) eram octogenários. RESULTADOS: Não houve diferença de mortalidade entre eles, com mortalidade global de 22 (8,3%) pacientes. Não houve diferença em relação ao tipo de procedimento (revascularização ou tratamento valvar) (P=0,545). As variáveis pré-operatórias não aumentaram o risco de morte. Enxerto arterial ou venoso (P=0,261) e número de enxertos utilizados por paciente (P=0,131) não aumentaram a mortalidade. O grupo de sobreviventes apresentou tempo médio de CEC de 70 ± 27 minutos e o grupo óbito, 88,8 ± 25,4 minutos, com significância estatística (P<0,001). O tempo de isquemia no grupo de sobreviventes foi de 55,5 ± 20 minutos e no grupo óbito, 64,9 ± 16 minutos, com significância (P=0,014). Na regressão logística multivariada, o tempo de CEC é a variável que se associa a morte, com qui-quadrado de Pearson =0,0056. Tempo de CEC > 75 minutos apresenta 3,2 vezes (IC 95%: 1,3 - 7,9), maior chance de óbito do que os pacientes com tempo de CEC < 75 minutos. Variáveis pós-operatórias: tempo de ventilação mecânica > 12 horas (P< 0,001), tempo de internação na UTI (P=0,033), reoperação (P=0,001), suporte inotrópico > 48 horas (P<0,001) e necessidade de hemoderivados (P<0,001) aumentam a mortalidade. CONCLUSÃO: A mortalidade global justifica a intervenção. CEC > 75 minutos, tempo de ventilação mecânica superior a 12 horas, de internação em UTI, reoperação, suporte inotrópico por período superior a 48 horas e uso de hemoderivados estão associados a maior mortalidade.

OBJECTIVE: To identify risk factors in septuagenarians and octogenarians submitted to cardiovascular surgery with cardiopulmonary bypass (CPB). METHODS: Per-operative variables of 265 patients over 70 years of age were analyzed. 248 (93.6%) were septuagenarians and 17 (6.4%) octogenarians. RESULTS: Overall mortality did not differ between the groups, nor did the type of procedure (CABG or valvular) (P=0.545). Pre-operative variables did not increase the death risk, nor did the use of arterial or venous grafts (P=0.261), or the number of grafts per patient (P=0.131). CPB and cross-clamp time are associated with higher mortality. The survivors' group had an average CPB time of 70 ± 27 minutes while the non-survivors group 88.8 ± 25.4 minutes (P<0.001). Cross-clamp time in the survivors was 55.5 ± 20 minutes, while 64.9 ± 16 minutes in the non-survivors (P=0.014). Using multivariate logistic regression, CPB time is associated with death (Pearson's chi square= 0.0056). CPB time over 75 minutes presents an increased risk of death of 3.2 times (CI 95%: 1.3-7.9) over those with CPB time < 75 minutes. Post-operative variables associated with increased death rates: mechanical ventilation > 12 hours (P<0.001); ICU stay (P=0.033); re-exploration (P=0.001); inotropic support > 48 hours (P<0.001); use of blood components (P<0.001). CONCLUSION: Overall mortality justifies the interventions. CPB time greater than 75 minutes, mechanical ventilation over 12 hours, length of ICU stay, need for reoperation, inotropic drug support over 48 hours, and use of blood components are associated with a higher mortality rate.

6202 downloads

13.

Acute and chronic mesenteric ischemia: MDCT findings
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Serpa, Bruna Schmitz

; Tachibana, Adriano

; Baroni, Ronaldo Hueb

; Aun, Ricardo

; Funari, Marcelo Buarque Gusmão

Jornal Vascular Brasileiro

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sep 2010, Volume 9 N. 3 Pages 156 - 163

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

A isquemia mesentérica é causada pela redução do fluxo sanguíneo mesentérico. Essa patologia pode ser dividida em aguda e crônica, baseada na rapidez e no grau em que o fluxo sanguíneo está sendo comprometido. Os autores retrospectivamente revisaram 22 casos de isquemia mesentérica, diagnosticados por tomografia computadorizada com mutidetectores (TCMD) em nosso serviço, e confirmados por cirurgia ou seguimento clínico. Os achados diagnósticos de isquemia aguda e crônica e sua frequência foram avaliados. Os avanços na TCMD 3D (tridimensional) permitiram o acesso detalhado aos vasos mesentéricos. Além disso, é possível demonstrar alterações nos segmentos intestinais, auxiliando na identificação da causa primária da doença e podendo identificar as complicações associadas a isquemia mesentérica e crônica.

Mesenteric ischemia is caused by a reduction in mesenteric blood flow. It can be divided into acute and chronic, based upon the rapidity and the degree to which the blood flow is compromised. The authors retrospectively reviewed 22 cases of mesenteric ischemia, diagnosed by multidetector computed tomography (MDCT) in our service, and confirmed by surgery or clinical follow-up. The frequency of the diagnostic findings of chronic and acute mesenteric ischemia was evaluated. The improvement of three-dimensional (3D) MDCT allows accurate assessment of mesenteric vessels. Therefore, it demonstrates changes in ischemic bowel segments helpful in determining the primary cause of the disease, and can identify the complications in patients with acute and chronic mesenteric ischemia.

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14.

Pleuropericardial cyst torsion: case report
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Kang, Davi Wen Wei

; Corpa, Maria Carolina Ercoli

; Racy, Marcelo de Castro Jorge

; Baroni, Ronaldo Hueb

; Engel, Fabiano Cataldi

; Andrade Filho, Laert de Oliveira

; Bueno, Marco Aurélio Scarpinella

einstein (São Paulo)

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jun 2010, Volume 8 N. 2 Pages 228 - 231

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

RESUMO Cistos pericárdicos constituem 12-18% de todas as massas mediastinais. Geralmente, são assintomáticos e detectados incidentalmente, podendo manifestar sintomas quando alcançam um tamanho aumentado. Na maioria das vezes, estão situados no seio cardiofrênico direito, mas podem ocupar outra localização no mediastino. Neste artigo, relatamos uma torção de cisto pleuropericárdico após esforço físico, uma complicação raríssima dessa condição, cujo diagnóstico foi realizado por meio da tomografia computadorizada do tórax e confirmado posteriormente por videotoracoscopia.

ABSTRACT Pericardial cysts account for 12-18% of all mediastinal masses. They are usually asymptomatic and incidentally detected. However, when large, they can cause symptoms. Most pericardial cysts are located in the right cardiophrenic angle, but they can be anywhere in the mediastinum. We reported a pleuropericardial cyst torsion after physical stress, a very rare complication of this condition. The diagnosis was made by computed tomography and confirmed by video-assisted thoracoscopy.

https://doi.org/10.1590/s1679-45082010rc937 2315 downloads

15.

Magnetic resonance imaging findings in adnexial torsion
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Trindade, Ronald Meira Castro

; Baroni, Ronaldo Hueb

; Rosemberg, Michelle

; Quadros, Marianne Siquara de

; Racy, Marcelo de Castro Jorge

; Tachibana, Adriano

; Funari, Marcelo Buarque de Gusmão

einstein (São Paulo)

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mar 2010, Volume 8 N. 1 Pages 92 - 96

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

RESUMO A torção anexial é um evento incomum, porém constitui importante causa de dor abdominal em mulheres. Está frequentemente associada a tumor ou cisto ovariano, mas pode ocorrer em ovários normais, principalmente em crianças. A torção de estruturas anexiais pode envolver o ovário ou a tuba, mas geralmente acomete ambos. Na maioria dos casos, é unilateral, com discreta predileção pelo lado direito. Como achados de imagem, observam-se massas ovarianas e aumento do volume ovariano, com redução ou ausência de sua vascularização. Se a torção for completa e não diagnosticada ou tratada, pode ocorrer necrose hemorrágica, evoluindo com complicações, sendo a peritonite a mais frequente. O diagnóstico precoce ajuda a prevenir danos que são irreversíveis com tratamento conservador, poupando-se o ovário. A limitação do exame físico, a possibilidade de resultados inconclusivos pela ultrassonografia e a exposição à radiação pela tomografia computadorizada fazem da ressonância magnética um complemento valioso na avaliação de emergência das doenças ginecológicas. O objetivo deste trabalho foi relatar dois casos confirmados de torção anexial, enfatizando a contribuição da ressonância magnética no diagnóstico dessa entidade.

ABSTRACT Adnexial torsion is an unusual event, but a major cause of abdominal pain in women. It is often associated with ovarian tumor or cyst, but can occur in normal ovaries, especially in children. The twisting of adnexial structures may involve the ovary or tube, but frequently affects both. In most cases, it is unilateral, with slight predilection for the right side. In imaging findings, increased ovarian volume and adnexial masses are observed, with reduced or absent vascularization. In cases of undiagnosed or untreated complete twist, hemorrhagic necrosis may occur leading to complications; in that, peritonitis is the most frequent. Early diagnosis helps preventing irreversible damage with conservative treatment, thereby saving the ovary. Limitations in performing physical examination, possible inconclusive results in ultrasound and exposure to radiation in computed tomography makes magnetic resonance imaging a valuable tool in emergency assessment of gynecological diseases. The objective of this study was to report two confirmed cases of adnexial twist, emphasizing the contribution of magnetic resonance imaging in the diagnosis of this condition.

https://doi.org/10.1590/s1679-45082010rc878 15878 downloads

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