Radiologia Brasileira最新文献

{"title":"Vacuum-assisted excision of breast lesions in surgical de-escalation: where are we?","authors":"Beatriz Medicis Maranhão Miranda, Almir Galvão Vieira Bitencourt","doi":"10.1590/0100-3984.2022.0078-en","DOIUrl":"10.1590/0100-3984.2022.0078-en","url":null,"abstract":"<p><p>Vacuum-assisted excision of breast lesions has come to be widely used in clinical practice. Increased acceptance and availability of the procedure, together with the use of larger needles, has allowed the removal of a greater amount of sample, substantially reducing the surgical upgrade rate and thus increasing the reliability of the results of the procedure. These characteristics result in the potential for surgical de-escalation in selected cases and gain strength in a scenario in which the aim is to reduce costs, as well as the rates of underestimation and overtreatment, without compromising the quality of patient care. The objective of this article is to review the technical parameters and current clinical indications for performing vacuum-assisted excision of breast lesions.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981092","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":"Deep infiltrating endometriosis: cine magnetic resonance imaging in the evaluation of uterine contractility.","authors":"Deborah Monteiro Soares,&nbsp;Leonardo Kayat Bittencourt,&nbsp;Flavia Paiva Proença Lobo Lopes,&nbsp;Marco Aurelio Pinho de Oliveira","doi":"10.1590/0100-3984.2022.0069","DOIUrl":"10.1590/0100-3984.2022.0069","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate uterine function by using cine magnetic resonance imaging to visualize the contractile movements of the uterus in patients with and without deep infiltrating endometriosis (with or without associated adenomyosis).</p><p><strong>Materials and methods: </strong>This was a prospective case-control study. The study sample comprised 43 women: 18 in the case group and 25 in the control group. We performed cine magnetic resonance imaging in a 3.0 T scanner, focusing on the presence, direction, and frequency of uterine peristalsis.</p><p><strong>Results: </strong>The frequency of uterine peristalsis was higher in the case group than in the control group, in the periovulatory phase (3.83 vs. 2.44 peristaltic waves in two minutes) and luteal phase (1.20 vs. 0.91 peristaltic waves in two minutes). However, those differences were not statistically significant. There was a significant difference between the patients with adenomyosis and those without in terms of the frequency of peristalsis during the late follicular/periovulatory phase (0.8 vs. 3.18 peristaltic waves in two minutes; <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The frequency of uterine peristalsis appears to be higher during the periovulatory and luteal phases in patients with deep infiltrating endometriosis, whereas it appears to be significantly lower during the late follicular/periovulatory phase in patients with adenomyosis. Both of those effects could have a negative impact on sperm transport and on the early stages of fertilization.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9976147","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 pulmonary histoplasmosis: pictorial essay.","authors":"Ana Luiza Di Mango,&nbsp;Antônio Carlos Portugal Gomes,&nbsp;Bruno Hochhegger,&nbsp;Gláucia Zanetti,&nbsp;Edson Marchiori","doi":"10.1590/0100-3984.2022.0106-en","DOIUrl":"https://doi.org/10.1590/0100-3984.2022.0106-en","url":null,"abstract":"<p><p>Endemic systemic mycoses are prevalent in specific geographic areas of the world and are responsible for high rates of morbidity and mortality in the populations of such areas, as well as in immigrants and travelers returning from endemic regions. Pulmonary histoplasmosis is an infection caused by <i>Histoplasma capsulatum</i>, a dimorphic fungus. This infection has a worldwide distribution, being endemic in Brazil. Histoplasmosis can affect the lungs, and its diagnosis and management remain challenging, especially in non-endemic areas. Therefore, recognition of the various radiological manifestations of pulmonary histoplasmosis, together with the clinical and epidemiological history of the patient, is essential to narrowing the differential diagnosis. This essay discusses the main computed tomography findings of pulmonary histoplasmosis.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981086","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":"Where is tibial edema located in cases of osteomeniscal impingement?","authors":"Camilo Partezani Helito,&nbsp;Livia Dau Videira,&nbsp;Henrique Augusto Lino,&nbsp;Paulo Victor Partezani Helito,&nbsp;Marcelo Bordalo-Rodrigues","doi":"10.1590/0100-3984.2022.0115","DOIUrl":"https://doi.org/10.1590/0100-3984.2022.0115","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the location of tibial edema related to meniscal degeneration with a flap displaced into the meniscotibial recess (osteomeniscal impingement) on magnetic resonance imaging (MRI).</p><p><strong>Materials and methods: </strong>We evaluated 40 MRI examinations of patients submitted to surgery due to inferior displacement of a meniscal flap tear into the meniscotibial recess and peripheral bone edema. Tibial edema was quantified in the coronal and axial planes.</p><p><strong>Results: </strong>On coronal MRI sequences, edema started in the tibial periphery and extended for a mean of 5.6 ± 1.4 mm, or 7.4 ± 2.1% of the tibial plateau. In the craniocaudal direction, the mean extension was 8.8 ± 2.9 mm. The mean ratio between the extent of craniocaudal and mediolateral edema was 1.6 ± 0.6. In the axial plane, the edema started in the medial periphery and extended for a mean of 6.2 ± 2.0 mm, or 8.2 ± 2.9% of the tibial plateau. In the anteroposterior measurement, the mean start and end of the edema was 21.4 ± 5.4 mm and 35.7 ± 5.7 mm, respectively, or 43.4 ± 10.2% and 72.8 ± 11.1% of the tibial plateau.</p><p><strong>Conclusion: </strong>Apparently, tibial edema resulting from osteomeniscal impingement always starts in the periphery of the meniscus. In the coronal plane, it appears to be more extensive in the craniocaudal direction than in the mediolateral direction. In the axial plane, we found it to extend, on average, approximately 6.2 mm in the mediolateral direction and to be most commonly located from the center to the posterior region of the medial tibial plateau.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981099","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":"Risk estimates for ionizing radiation.","authors":"Renato Dimenstein","doi":"10.1590/0100-3984.2023.56.3e5-en","DOIUrl":"https://doi.org/10.1590/0100-3984.2023.56.3e5-en","url":null,"abstract":"1. Medical physicist, specialist certified by the Associação Brasileira de Física Médica, radiation safety supervisor at the Comissão Nacional de Energia Nuclear. Email: renato.dimenstein@gmail.com. https://orcid.org/0000-0003-2014-061X. According to the literature, cumulative (stochastic) effects of radiation exposure, including cancer and hereditary effects, are caused by a mutation or other permanent changes in which the cell remains viable. Although the severity of the response observed in the stochastic effect does not depend on the minimum threshold, the probability of a stochastic effect increases in parallel with an increase in the radiation dose(1). Despite the fact that the use of radiation has proven safe for medical purposes, health professionals still have many questions about the risks of exposure, especially those related to nuclear medicine patients. To answer those questions about radiological safety, Willegaignon et al.(2) conducted a study, published in a recent issue of Radiologia Brasileira, on radiation safety measures in diagnostic nuclear medicine. Their simple yet robust methodology allowed the quantification of radiation exposure of patients injected with radioisotopes. The experimental work employed a precalibrated Geiger-Müller detector to estimate patient radiation dose rates. An external dosimetry study evaluated, separately, exposure to different radioisotope energies, levels of radioactivity, radiopharmaceuticals, and clearance times. Measurements with the radiation detector estimated the dose rate (in μSv/h) of individuals occupationally exposed in settings of radioisotope administration, image acquisition, and patient release from the nuclear medicine unit. On the basis of the data collected, the authors estimated the radiation exposure of the patient after leaving the radioisotope sector, as a function of time. What is important in their article is the discrimination of radiation dose values, which showed that individuals in the general population and hospital workers received equivalent dose values lower than the limits established by international radiation safety standards(3). The methodological limitations of the external dosimetry of the study in question are related to the response times of the detector systems and the Geiger calibration curves for the different radioisotope energies. Despite the uncertainties, the results and conclusion of the Willegaignon et al.(2) study do not change. Therefore, the relevance of their work lies in ensuring the safe use of radioisotopes for occupationally exposed individuals and individuals in the general population, in accordance with radiation safety guidelines(4,5). The Willegaignon et al.(2) article allows us to conclude that the equivalent doses for individuals in the general population do not exceed the limit of 1 mSv/year established for such individuals(6). In most cases, dose limits are incomprehensible to the public. Therefore, to facilitate communication betwe","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981087","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":"Tibial edema in osteomeniscal impingement: how can we contribute?","authors":"Carolina Freitas Lins, Marcello Henrique Nogueira-Barbosa","doi":"10.1590/0100-3984.2023.56.3e3-en","DOIUrl":"10.1590/0100-3984.2023.56.3e3-en","url":null,"abstract":"","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981095","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 role of cine magnetic resonance imaging in the evaluation of uterine contractility in patients with deep infiltrating endometriosis.","authors":"Luís Ronan Marquez Ferreira de Souza, Patricia Prando Cardia","doi":"10.1590/0100-3984.2023.56.3e1-en","DOIUrl":"10.1590/0100-3984.2023.56.3e1-en","url":null,"abstract":"","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981100","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":"Achados radiográficos da acromegalia: ensaio iconográfico","authors":"Luisa Couto Baptista, Marcelo Mantiolhe Martins, Vinícius Neves Marcos","doi":"10.1590/0100-3984.2022.0083","DOIUrl":"https://doi.org/10.1590/0100-3984.2022.0083","url":null,"abstract":"Resumo A acromegalia é um distúrbio metabólico pouco frequente, muitas vezes apresentando grande atraso diagnóstico. A artralgia é um dos sintomas mais comumente encontrados nos pacientes acromegálicos, motivando a realização de radiografias convencionais, as quais podem apresentar achados sutis que podem passar despercebidos. O objetivo deste ensaio é retratar os achados radiográficos da acromegalia, buscando demonstrar a importância deste método que, apesar de simples, pode sugerir o diagnóstico, mesmo em fases iniciais, alterando assim o curso clínico da doença.","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44348273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amorphous breast calcifications: is BI-RADS 4a appropriate?","authors":"Tatiane Mendes Gonçalves de Oliveira,&nbsp;Rafael Melo Seksenian,&nbsp;José Galdino Souza Santana,&nbsp;Bárbara Nogueira Caracas de Souza,&nbsp;Felipe Alves de Jesus,&nbsp;Francesca Maia Faria,&nbsp;Larissa Raquel Mouro Mandarano","doi":"10.1590/0100-3984.2022.0085-en","DOIUrl":"10.1590/0100-3984.2022.0085-en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the positive predictive value (PPV) of amorphous calcifications and to analyze the imaging variables that could alter the risk of malignancy associated with this finding.</p><p><strong>Materials and methods: </strong>This was a retrospective study of 138 stereotactically guided percutaneous vacuum-assisted biopsies of amorphous calcifications, performed between January 2012 and December 2017. All of the patients included were referred for radiological follow-up for a minimum of one year (if the histopathology showed a benign lesion) or for surgical treatment (if the histopathology showed malignancy or a lesion of uncertain malignant potential).</p><p><strong>Results: </strong>We found that the PPV of amorphous calcifications was 9.42%. However, most of the malignant amorphous calcifications were in cases of invasive carcinoma or high-grade ductal carcinoma in situ, indicating clinically relevant disease. The relative risk of malignancy associated with amorphous calcifications was 6.15 times higher in patients with a family or personal history of breast or ovarian cancer. Neither being postmenopausal nor having dense breasts was found to be predictive of malignancy in patients with amorphous calcifications.</p><p><strong>Conclusion: </strong>Amorphous calcifications in the breast had a PPV for malignancy of 9.42%, indicating the possibility of placing the finding in subcategory 4a, which requires histopathological analysis. Our finding that the risk of malignancy associated with this subtype of calcifications is up to 6.15 times higher in patients with a family or personal history of breast cancer warrants greater concern regarding the clinical, radiologic, and histopathologic correlations after biopsy.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507146","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":"Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles.","authors":"Felipe Constanzo,&nbsp;Bernardo Corrêa de Almeida Teixeira,&nbsp;Patricia Sens,&nbsp;Hamzah Smaili,&nbsp;Dante Luiz Escuissato,&nbsp;Ricardo Ramina","doi":"10.1590/0100-3984.2022.0035","DOIUrl":"10.1590/0100-3984.2022.0035","url":null,"abstract":"<p><strong>Objective: </strong>The perfusion profile of vestibular schwannomas (VSs) and the factors that influence it have yet to be determined.</p><p><strong>Materials and methods: </strong>Twenty patients with sporadic VS were analyzed by calculating parameters related to the extravascular extracellular space (EES)-the volume transfer constant between a vessel and the EES (Ktrans); the EES volume per unit of tissue volume (Ve); and the rate transfer constant between EES and blood plasma (Kep)-as well as the relative cerebral blood volume (rCBV), and by correlating those parameters with the size of the tumor and its structure (solid, cystic, or heterogeneous).</p><p><strong>Results: </strong>Although Ktrans, Ve, and Kep were measurable in all tumors, rCBV was measurable only in large tumors. We detected a positive correlation between Ktrans and rCBV (r = 0.62, <i>p</i> = 0.031), a negative correlation between Ve and Kep (r = -0.51, <i>p</i> = 0.021), and a positive correlation between Ktrans and Ve only in solid VSs (r = 0.64, <i>p</i> = 0.048). Comparing the means for small and large VSs, we found that the former showed lower Ktrans (0.13 vs. 0.029, <i>p</i> < 0.001), higher Kep (0.68 vs. 0.46, <i>p</i> = 0.037), and lower Ve (0.45 vs. 0.83, <i>p</i> < 0.001). The mean Ktrans was lower in the cystic portions of cystic VSs than in their solid portions (0.14 vs. 0.32, <i>p</i> < 0.001), as was the mean Ve (0.37 vs. 0.78, <i>p</i> < 0.001). There were positive correlations between the solid and cystic portions for Ktrans (r = 0.71, <i>p</i> = 0.048) and Kep (r = 0.74, <i>p</i> = 0.037).</p><p><strong>Conclusion: </strong>In VS, tumor size appears to be consistently associated with perfusion values. In cystic VS, the cystic portions seem to have lower Ktrans and Ve than do the solid portions.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507153","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}