Resumo A ultrassonografia pulmonar é uma modalidade diagnóstica bem estabelecida no conceito point of care da medicina de emergência. No contexto da pandemia pela doença do coronavírus 2019 (COVID-19), a ultrassonografia assumiu um papel importante, apresentando boa correlação dos seus achados com a tomografia computadorizada. Conhecer as possibilidades diagnósticas da ultrassonografia é fundamental na abordagem da COVID-19 e seus diagnósticos diferenciais.

Abstract Lung ultrasound is a well-defined diagnostic modality in the point of care emergency medicine concept. In the context of the coronavirus disease 2019 (COVID-19) pandemic, the lung ultrasound assumed an essential role in this disease, with a valid correlation of the imaging results with computed tomography. Recognize how the diagnostic possibilities of ultrasound in the approach of COVID-19 and its differential diagnoses are fundamental.

ResumoObjetivo:Estudo longitudinal, ultrassonográfico com modo B e Doppler, dos rins e fígado maternos na gravidez de baixo risco, para estabelecer, quantificar parâmetros de normalidade e correlacioná-los com as modificações fisiológicas.Materiais e Métodos:Foram examinadas 25 gestantes, realizando-se quatro exames em cada paciente no primeiro, segundo e terceiro trimestres de gravidez e no pós-parto.Resultados:Na gravidez houve aumento do volume renal, dilatação pielocalicinal em 45,4% no rim direito e 9% no rim esquerdo, incidência de litíase renal em 18,1% no rim direito e 13,6% no rim esquerdo. Com dilatação pielocalicinal, o valor médio dos índices de resistividade nas artérias renais foi 0,68; nas segmentares, 0,66; nas interlobares, 0,64; e nas arqueadas, 0,64. Sem dilatação pielocalicinal, o valor nas artérias renais foi 0,67; nas segmentares, 0,64; nas interlobares, 0,63; e nas arqueadas, 0,61. As velocidades de fluxo da veia porta apresentaram valores maiores na gravidez, com valor médio da velocidade máxima de 28,9 cm/s e no pós-parto de 22,6 cm/s. O padrão da onda da veia hepática direita apresentou modificações que persistiram no pós-parto em 31,8%. Colelitíase foi observada em 18,1%.Conclusão:Mostraram-se significantes as alterações do volume renal, dilatações pielocalicinais, litíase renal, colelitíase, mudanças nas velocidades de fluxo da veia porta e alterações no padrão da onda da veia hepática direita.

AbstractObjective:Longitudinal study with B-mode ultrasonography and Doppler ultrasonography of maternal kidneys and liver in low-risk pregnancy, to establish and quantify normality parameters, correlating them with physiological changes.Materials and Methods:Twenty-five pregnant women were assessed and selected to participate in the study, each of them undergoing four examinations at the first, second, third trimesters and postpartum.Results:Findings during pregnancy were the following: increased renal volume, pyelocaliceal dilatation with incidence of 45.4% in the right kidney, and 9% in the left kidney; nephrolithiasis, 18.1% in the right kidney, 13.6% in the left kidney. With pyelocaliceal dilatation, mean values for resistivity index were: 0.68 for renal arteries; 0.66 for segmental arteries; 0.64 for interlobar arteries; 0.64 for arcuate arteries. Without pyelocaliceal dilatation, 0.67 for renal arteries; 0.64 for segmental arteries; 0.63 for interlobar arteries; and 0.61 for arcuate arteries. Portal vein flow velocities presented higher values in pregnancy, with mean value for maximum velocity of 28.9 cm/s, and 22.6 cm/s postpartum. The waveform pattern of the right hepatic vein presented changes persisting in the postpartum period in 31.8% of the patients. Cholelithiasis was observed in 18.1% of the patients.Conclusion:Alterations in renal volume, pyelocaliceal dilatation, nephrolithiasis, cholelithiasis, changes in portal vein flow velocity, alterations in waveform pattern of the right hepatic vein, proved to be significant.

PurposeWe developed a stereotactic device to guide the puncture for percutaneous nephrolithotripsy, which uses the distance from the target calyx to its perpendicular point on skin (SCD) to calculate the needle´s entry angle. This study seeks to validate the use of measurements obtained by ultrasound (US) and computerized tomography (CT) for needle´s entry angle calculation and to study factors that may interfere in this procedure.Materials and MethodsHeight, weight, abdominal circumference, CT of the urinary tract in dorsal decubitus (DD) and ventral decubitus (VD), and US of the kidneys in VD were obtained from thirty-five renal calculi patients. SCD obtained were compared and correlated with body-mass index (BMI).ResultsBMI was 28.66 ± 4.6 Kg/m2. SCD on CT in DD was 8.40 ± 2.06cm, in VD was 8.32 ± 1.95cm, in US was 6.74 ± 1.68cm. SCD measured by US and CT were statistically different (p < 0.001), whereas between CT in DD and VD were not. SCD of the lower calyx presented moderate correlation with BMI.ConclusionSCD obtained by CT in ventral and dorsal decubitus may be used for calculation of the needle´s entry angle. SCD obtained by US cannot be used. A rule for the correlation between BMI and the SCD could not be determined.