Radiologia Brasileira最新文献

{"title":"Predicting uninformative prostate magnetic resonance imaging sequences: a hypothesis-generating pilot study.","authors":"Negar Firoozeh, Spencer C Behr, Antonio C Westphalen","doi":"10.1590/0100-3984.2025.0007","DOIUrl":"10.1590/0100-3984.2025.0007","url":null,"abstract":"<p><strong>Objective: </strong>To determine the proportion of men with completely negative multiparametric magnetic resonance imaging (MRI) scans and which individual sequence-T2-weighted imaging (T2WI) or diffusion-weighted imaging (DWI)-best predicts an overall negative examination result.</p><p><strong>Materials and methods: </strong>This was a single-center retrospective study evaluating 492 MRI scans compliant with Prostate Imaging Reporting and Data System (PI-RADS), version 2.1. Radiology reports described the absence of lesions or suspicious lesions with PI-RADS scores of 3-5, signifying positive T2WI or DWI results. Positivity on a dynamic contrast-enhanced (DCE) study was determined by early or simultaneous focal enhancement consistent with lesions on T2WI or DWI. All scans reported as negative were prospectively reviewed to ensure that each sequence truly met the criteria for negativity according to the PI-RADS guidelines. Descriptive statistics were employed to summarize the data, and the chi-square test was employed to assess the relationship between a negative T2WI result and a negative DWI/DCE result, as well as that between a negative DWI result and a negative DWI/DCE result, with logistic regression models identifying predictors of such combined results.</p><p><strong>Results: </strong>Among the patients evaluated, approximately one-third of those with suspected prostate cancer and 10% of those with known cancer could have concluded their examination after a single negative sequence. A negative T2WI result predicted negative DWI/DCE findings in 62.4% of scans (95% CI: 55.3-68.9), with an odds ratio of 245.3 (<i>p</i> < 0.001). Similarly, a negative DWI result predicted negative T2WI/DCE findings in 88.9% of scans (95% CI: 83.1-92.7) with an odds ratio of 76.4 (<i>p</i> < 0.001). These associations remained robust after adjustment for age, prostate-specific antigen level, prostate-specific antigen density, cancer status, and radiologist.</p><p><strong>Conclusion: </strong>Findings from T2WI or DWI may serve as preliminary indicators for the subsequent diagnostic yield of other sequences, with DWI appearing to hold a slight advantage. Although the accuracy of this approach is not yet sufficient for clinical implementation, these results are promising and merit further investigation.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20250007"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversed halo sign on chest computed tomography: a retrospective analysis of 286 cases.","authors":"Camila Soares Franco, Paula Terra Martins Almeida Amaral, Eduardo Kaiser Ururahy Nunes Fonseca, Tassia Regina Yamanari, Paulo Esrom Moreira Catarina, Alessandra de Pinho Pimenta Borges, Luiz Augusto de Moraes Pinheiro Filho, Felipe Freitas Camara, Márcio Valente Yamada Sawamura","doi":"10.1590/0100-3984.2025.0014-en","DOIUrl":"10.1590/0100-3984.2025.0014-en","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the main causes of the reversed halo sign (RHS) on computed tomography (CT) of the chest and its imaging features.</p><p><strong>Materials and methods: </strong>This was a retrospective study reviewing all chest CT scans for which the report contained the term \"reversed halo sign\" among those performed between 2015 and 2020 at a tertiary care hospital.</p><p><strong>Results: </strong>A total of 286 cases were identified, and the corresponding CT images and clinical data were reviewed. In this population, the most common cause of an RHS was pulmonary infarction (in 42%), followed by cryptogenic organizing pneumonia (in 17%) and bacterial pneumonia (in 16%). In addition, the CT characteristics of the RHS were identified in various conditions, such as pulmonary thromboembolism with pulmonary infarction, in which the RHS was typically smooth-walled and solitary with a peripheral distribution.</p><p><strong>Conclusion: </strong>The RHS can be observed in many contexts, and its CT characteristics, in combination with the clinical picture, can help narrow the differential diagnosis.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20250014"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between the computed tomography pattern and vaccination status in individuals with COVID-19.","authors":"Laís Rodrigues Bertoche, Waldinei Mercês Rodrigues, Caroline von Abel de Sousa, Vitor Maltoni Damasio, Hélder Jorge Andrade Gomes, Eduardo Vieira Ponte","doi":"10.1590/0100-3984.2025.0004","DOIUrl":"10.1590/0100-3984.2025.0004","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the frequency of the typical computed tomography (CT) pattern in individuals with coronavirus 2019 (COVID-19), comparing those who were vaccinated with those who were unvaccinated.</p><p><strong>Materials and methods: </strong>This was a retrospective study of the medical records of patients with clinical suspicion of COVID-19 between August 2021 and February 2022. The vaccination status was classified as absent/incomplete (0 or 1 dose) or complete (2 or more doses). The pattern seen on the first chest CT was defined as typical, atypical, indeterminate, or normal, the last three patterns being combined to form what was designated the non-typical group.</p><p><strong>Results: </strong>Binary logistic regression analysis showed that individuals with a complete vaccination status were less likely to present with the typical CT pattern than were those with an absent/incomplete vaccination status (adjusted OR = 0.19, 95% CI: 0.06-0.60).</p><p><strong>Conclusion: </strong>This information is important because it demonstrates that the frequency of the CT pattern considered typical of COVID-19 is currently lower than it was before the vaccines became available. Therefore, the typical CT pattern is no longer expected.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20250004"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic aspects of sural nerve anatomy.","authors":"Márcio Luís Duarte, Ocacir de Souza Reis Soares, Jean-Louis Brasseur","doi":"10.1590/0100-3984.2024.0120","DOIUrl":"10.1590/0100-3984.2024.0120","url":null,"abstract":"<p><p>The anatomy of the sural nerve is highly variable, and the nerve can present injuries of various etiologies, including iatrogenic injury during surgery. Precise knowledge of the course and morphology of the sural nerve is valuable, and the ability to assess the nerve properly before surgery increases the postoperative success rate, as well as facilitating the execution of nerve conduction studies and biopsies. The purpose of this article is to describe and illustrate the anatomy of the sural nerve, as seen on ultrasonography, which is a practical and economical imaging method.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20240120"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of infantile hemangiomas: a pictorial essay.","authors":"Laura Bosi Gil, Carlos Eduardo Nedel, Juliana Gonçalves Silveira, Ana Paula Vfb Sperb, Mariane Cibelle Barreto da Silva Barros, Bárbara Limberger Nedel","doi":"10.1590/0100-3984.2025.0041-en","DOIUrl":"10.1590/0100-3984.2025.0041-en","url":null,"abstract":"<p><p>Infantile hemangioma (IH) is a common benign vascular neoplasm with a characteristic pattern of progression: at birth, it is not fully developed; in the first days or weeks of life, it grows; and its growth peaks at around one year of age, after which there is spontaneous regression. Although most IHs are superficial and therefore obvious on physical examination, they can also affect deeper planes or other organs, in which case they are best assessed with imaging examinations. Methods such as ultrasound and magnetic resonance imaging can help differentiate IHs from vascular malformations, other benign tumors, and malignant tumors. The aim of this pictorial essay is to demonstrate the various presentations of IHs through illustrative cases, with an emphasis on imaging findings.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20250041"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12251563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography findings of pneumonia resistant to empirical therapy in patients with hematologic diseases.","authors":"Luca Giuliani, Nicholas Landini, Giorgio Maria Masci, Silvia Palladino, Valeria Panebianco, Giammarco Raponi, Alice Di Rocco, Giuseppe Gentile, Carlo Catalano","doi":"10.1590/0100-3984.2024.0118","DOIUrl":"10.1590/0100-3984.2024.0118","url":null,"abstract":"<p><strong>Objective: </strong>To investigate computed tomography (CT) features of pneumonia that does not respond to empirical therapy in patients with hematologic diseases.</p><p><strong>Materials and methods: </strong>This was a retrospective analysis of all patients with hematologic disease who were diagnosed with pneumonia between 2017 and 2023, did not respond to empirical therapy for the infection, and underwent bronchoalveolar lavage and CT within a week of each other. The distribution and CT pattern of pulmonary abnormalities were assessed, as was the presence of lymphadenopathy, pleural effusion, and pericardial effusion.</p><p><strong>Results: </strong>Forty-nine patients (30 males; mean age, 61 years) were included. We identified Gram-negative bacteria in 45 patients, Gram-positive bacteria in 13, and fungi in three. Pulmonary abnormalities were bilateral in 73% of the patients in the sample, and there was no difference in prevalence between the upper and lower lung fields in 53%. Common alterations were consolidation, in 73% of the patients, bronchial wall thickening, in 71%, bronchiectasis, in 55%, and nodules, in 53%; extrapulmonary findings were less common, being identified in ≤ 27%. Pulmonary findings were typically bilateral and without a predominance between the upper and lower lung fields (<i>p</i> < 0.05). Common associations were between consolidation and bronchiectasis, between nodules and bronchial wall thickening, and between bronchiectasis and bronchial wall thickening (<i>p</i> < 0.05 for all).</p><p><strong>Conclusion: </strong>The CT manifestations of pneumonia in patients with hematologic diseases not responding to empirical therapy can resemble those of lobular pneumonia with airway inflammation. For that reason, as well as because multiple pathogens can be present in the same patient, examination of bronchoalveolar lavage fluid can be necessary.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20240118"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing renal biopsy: efficacy and safety of the ultrasound-guided tangential approach.","authors":"Rogério Augusto Pinto-Silva, Marcell de Barros Duarte Pereira, Milton Domingos Panzi Neto, Otton Lourenço de Lima Reis, Raquel Sadala Mendes, Gessilane Martins da Silva, David Campos Wanderley, Stanley de Almeida Araújo","doi":"10.1590/0100-3984.2024.0132-en","DOIUrl":"10.1590/0100-3984.2024.0132-en","url":null,"abstract":"<p><strong>Objective: </strong>To present the results of a series of outpatient renal biopsies performed with a tangential approach, as well as to conduct an analysis focusing on patient safety and the frequency with which sufficient material was obtained.</p><p><strong>Materials and methods: </strong>This retrospective observational study examined the pathology results and evolution of 244 patients referred for ultrasound-guided renal biopsy at a single center. In each biopsy, the needle was advanced in the cortex just below the renal capsule. The pathologist examined the fragments, counting the viable glomeruli obtained; additional punctures were performed if necessary, as long as Doppler ultrasound showed no bleeding. The patients remained at rest at the clinic, being discharged after a follow-up ultrasound evaluation and contacted one week later to investigate late adverse events.</p><p><strong>Results: </strong>Ten patients were excluded from the analysis, leaving a sample of 234 patients. The material obtained for diagnosis was considered sufficient in 95.73% of the procedures, partially adequate in 3.42%, and not very representative in 0.85%. Two patients (0.85%) had bleeding greater than 50 cm³ and were referred to the hospital emergency department. Both of those patients had a favorable evolution: one required only a period at rest, and the other required a blood transfusion, being discharged 48 h after the procedure.</p><p><strong>Conclusion: </strong>The tangential approach to renal biopsy, with its high rates of safety and efficacy, representing a reliable diagnostic tool for renal and systemic diseases, should be the method of choice for obtaining adequate pathological specimens.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20240132"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sternum in detail: a review of the anatomy and pathologies of the sternum.","authors":"Margrit Elis Müller, Lara Carolina Peixoto Quiche, Lucas Daniel Pereira Lopes, Adham do Amaral E Castro, Eduardo Kaiser Ururahy Nunes Fonseca","doi":"10.1590/0100-3984.2024.0128-en","DOIUrl":"10.1590/0100-3984.2024.0128-en","url":null,"abstract":"<p><p>The sternum and the sternoclavicular joints can exhibit a wide range of anatomical variations and serve as sites for numerous diseases, many of which are diagnosed solely through imaging studies. Recognizing these variations and differentiating them from pathological conditions is essential for radiologists, because accurate identification helps prevent misdiagnoses and treatment delays. This study provides a comprehensive review of the sternal anatomy, addressing anatomical variations, as well as mechanical, inflammatory, and traumatic pathologies, discussing their radiographic characteristics across different imaging modalities. Thus, it provides an overview of the key radiological findings.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20240128"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver stiffness assessed by elastography for the evaluation of hepatocellular carcinoma risk in patients with fibrosis: a systematic review and meta-analysis.","authors":"Marielle Malucelli Mallmann, Fernando Linhares Pereira, Maria Cristina Chammas, Márcio Luís Duarte, Ana Maria Andrade, Emilton Lima Júnior, Odery Ramos Júnior","doi":"10.1590/0100-3984.2024.0108","DOIUrl":"10.1590/0100-3984.2024.0108","url":null,"abstract":"<p><p>This study aimed to systematically review the highest-quality evidence regarding the cutoff value in kPa for the diagnostic accuracy of ultrasound-based liver elastography in comparison with reference standards, including magnetic resonance imaging (MRI), computed tomography, and liver biopsy. In addition, we assessed the presence of hepatocellular carcinoma (HCC) and its associated implications in clinical and diagnostic contexts. We conducted a search using Medical Subject Headings across PubMed, Embase, Cochrane Library, Web of Science, Scopus, and Lilacs for articles published up to June 6, 2024. Of 1,131 studies identified, 33 were eligible and 8 met the quality criteria, as evaluated with the \"RTI Item Bank\" and \"QUADAS-2\" tools, following the PICO strategy. The mean elasticity of the liver parenchyma among patients with confirmed HCC was 18.77 kPa (95% CI: 16.28-21.27), making ultrasound liver elastography useful as a predictor of the diagnosis by gold-standard methods such as MRI. Ultrasound elastography is a low-cost, accessible, and noninvasive diagnostic tool capable of estimating liver elasticity in patients with HCC. However, due to the heterogeneity of the articles included in this review, further prospective studies are needed in order to confirm and standardize a cutoff stiffness value for early HCC screening, which could improve patient outcomes, particularly in resource-limited settings.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20240108"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12157276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical comparison of American and European classifications of müllerian anomalies: pros and cons.","authors":"Luís Ronan Marquez Ferreira de Souza, Cinthia Callegari Barbisan, Cecília Vidal de Souza Torres, Isadora Balderama Canedo","doi":"10.1590/0100-3984.2024.0096-en","DOIUrl":"10.1590/0100-3984.2024.0096-en","url":null,"abstract":"<p><p>Müllerian anomalies represent a spectrum of congenital malformations of the female reproductive tract. Over the decades, various classifications have been developed to categorize these anomalies. Based on a classification proposed by Kaufmann and Jarcho in 1946, the classification devised by the American Fertility Society in 1988 was considered simple and practical; although it faced criticism for its subjectivity and limitations in classifying complex anomalies, it was widely adopted. In 2013, the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy introduced a more detailed classification, which, albeit more complex and with a risk of overdiagnosis, also included cervical and vaginal anomalies. In 2021, the American Society for Reproductive Medicine updated the classification with the aim of simplifying and improving diagnostic accuracy, expanding the categories, and defining more objective criteria. This new classification seeks to facilitate communication among professionals and enhance clinical management, emphasizing the importance of continuous updates to improve reproductive outcomes and the quality of life for patients affected by these anomalies. This article aims to discuss the strengths and limitations of each of these classifications, offering a critical analysis of their impact on the diagnosis and treatment of müllerian anomalies. It also seeks to highlight aspects that may be refined in future revisions to achieve greater diagnostic precision and clinical applicability.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":"58 ","pages":"e20240096"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}