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Perez De Isla L.,Cardiologia Hospital Clinico San Carlos | Perez De Isla L.,Charles III University of Madrid | Feltes G.,Cardiologia Hospital Clinico San Carlos | Moreno J.,Cardiologia Hospital Clinico San Carlos | And 9 more authors.
European Heart Journal Cardiovascular Imaging | Year: 2014

Background Left atrium (LA) size assessment is clinically relevant, but the accuracy of two-dimensional echocardiographic (2D-echo) methods is limited. Three-dimensional (3D) echocardiography is an excellent alternative but is far frombeing used in daily clinical practice. Three-dimensional-wall motion tracking (3D-WMT) allows us to obtain volumes in a very simple and rapid manner. The aims of this study were to evaluate the accuracy of 3D-WMT technology to assess LA volume using cardiac magnetic resonance (CMR) as a reference method, to evaluate its reproducibility, and to determine its added clinical value to classify the LA enlargement severity. Methods and results Seventy consecutive patients referred for aCMR study were prospectively enrolled. They under went LA volume assessment by means of 2D-echo,3D-WMT, and CMR. Inter-methods agreement was assessed. The mean age was 56±18 years and 42 patients (60%) were males. Average maximal LA volume obtained by 2D-echo, 3D-WMT, and CMR were 63.33±26.82, 79.80±29.0, and 79.80±28.99 mL, respectively.Univariate linear regression analysis showed a good correlation between 3D-WMT and CMR (r = 0.83; P < 0.001). The agreement analysis showed a similar result (ICC = 0.83; 95% CI = 0.74-0.89; P < 0.001). Furthermore, the LA enlargement degree was better evaluated with 3D-WMT than with 2D-echo. Conclusion This study validates LA volume measurements obtained using the new and fast 3D-WMT technology, compared with CMR. This method is fast, accurate, and reproducible, and it allows a better classification of left LA enlargement severity compared with 2D-echo. © The Author 2014. Source


Scheeren B.,Grande Rio University | Maciel A.C.,Radiologia | de Barros S.G.S.,Grande Rio University
Arquivos de Gastroenterologia | Year: 2014

Context: Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives: The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods: Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid) contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results: Three hundred and thirty-three (n = 333) consecutive patients were studied - 213 (64%) in Group I and 120 (36%) in Group II. Esophageal alterations were found in 104 (31%) patients, with a higher prevalence in Group I (36.2%), especially on the items esophageal clearance (16.9%) and tertiary contractions (16.4%). It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion: Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis. © 2014, IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent. All rights reserved. Source


Vervloet L.A.,University of Campinas | Camargos P.A.M.,Federal University of Minas Gerais | Soares D.R.F.,Radiologia | De Oliveira G.A.,Colegio Brasileiro de Radiologia | De Oliveira J.N.,Colegio Brasileiro de Radiologia
Jornal de Pediatria | Year: 2010

Objective: To describe the clinical, hematological and radiographic characteristics of children hospitalized for Mycoplasma pneumoniae pneumonia. Method: The study population consisted of 190 children between 3 months and 16 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups, to wit: 95 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the enzyme-linked immunosorbent assay (ELISA) method; and 95 children with pneumonia caused by other etiologic agents. Using a validated scoring system, the clinical, hematological and radiographic findings of both groups were compared to differentiate Mycoplasma pneumoniae pneumonia (group 1) from pneumonia caused by other etiologic agents (group 2), itself divided into two groups, bacterial (n = 75) and viral (n = 20). Results: Mycoplasma pneumoniae pneumonia was found most often in girls (p < 0.01), older children (p < 0.01), and patients with dry cough (p < 0.01) and extrapulmonary manifestations (p < 0.01). The clinical, hematological and radiographic variables of Mycoplasma pneumoniae pneumonia (mean score = 6.95) scored between those found in bacterial (mean score = 8.27) and viral pneumonia (mean score = 0.90). Conclusion: Results suggest that the scoring system can contribute to the presumptive diagnosis of Mycoplasma pneumoniae pneumonia and help differentiate pneumonic status caused by other etiologic agents. Copyright © 2010 by Sociedade Brasileira de Pediatria. Source


Monaco D.,Radiologia | Franco F.,Radiologia e Diagnostica per Immagini | Marcato C.,Radiologia e Diagnostica per Immagini | Larini P.,Radiologia e Diagnostica per Immagini | And 2 more authors.
Radiologia Medica | Year: 2011

Purpose: The aim of study was to evaluate the results of our experience with transarterial embolization based on a modified algorithm in patients with splenic injury. Materials and methods: We collected data of patients admitted to our hospital from January 2006 to August 2008 for blunt splenic injury. During this period, 46 patients were admitted for splenic trauma, of whom 17 were treated surgically, 15 conservatively and 14 with percutaneous embolisation (13 men, mean age 44.8, mean injury severity score 18.5, six with grade IV and eight with contrast blush). Patients in shock were referred for laparotomy and splenectomy, whereas those who were haemodynamically stable or responsive to fluid resuscitation were further evaluated with computed tomography (CT). In the presence of imaging evidence of splenic injury ranging from grade I to grade III (n=15) a conservative approach was adopted, whereas haemodynamically unstable patients with grade V injury (n=17) were treated with splenectomy. Embolisation was performed in 14 patients with grade IV injury or in the event of contrast extravasation, regardless of injury grade. In patients with diffuse organ damage, we embolised the main splenic artery, whereas in the case of localised injury, embolisation was selective. Results: Proximal embolization was required in eight cases and distal coil embolization in six. In 13 cases, we placed magnetic-resonance-compatible coils 4-6 mm in diameter; only one patient was treated with gel-foam injection. Immediate technical success was achieved in all cases. In 13/14 patients (92.9%), no periprocedural complications were observed, whereas the remaining patient underwent splenectomy within 24 h due to recurrent bleeding. Conclusions: On the basis of our algorithm, it is possible to reach a quick decision on the most appropriate treatment for patients presenting with blunt abdominal trauma, and splenic artery embolization seems to offer a reliable option in those with high-grade splenic injury or active bleeding. © 2011 Springer-Verlag Italia Riassunto: Obiettivo: Scopo del nostro lavoro è stato valutare i risultati della nostra esperienza sull'embolizzazione percutanea in pazienti con trauma splenico, sulla base di un algoritmo modificato. Materiali e metodi: Abbiamo raccolto i dati dei pazienti con trauma della milza ammessi nel nostro centro da gennaio 2006 ad agosto 2008. In questo periodo sono stati ammessi 46 pazienti con lesione splenica posttraumatica, di cui 17 sono stati trattati chirurgicamente, 15 con trattamento conservativo e 14 con embolizzazione percutanea (13 maschi, età media 44,8, injury severity score [ISS] 18,5 circa, 6 con grado IV e 8 con stravaso di mezzo di contrasto). I pazienti in stato di shock sono stati immediatamente sottoposti a laparotomia e splenectomia, mentre quelli emodinamicamente stabili o responsivi alla somministrazione di fluidi sono stati valutati con TC. In base al dato strumentale, in 15 pazienti, con lesioni spleniche di grado I, II e III è stato considerato il trattamento conservativo, mentre 17 pazienti emodinamicamente instabili, con lesioni di V grado, sono stati sottoposti a splenectomia. L'embolizzazione è stata eseguita in 14 pazienti con lesioni spleniche di IV grado o in caso di stravaso di mezzo di contrasto indipendentemente dal grado della lesione. L'embolizzazione dell'arteria splenica principale è stata effettuata nei pazienti con danno d'organo diffuso, mentre in caso di lesioni localizzate, è stata eseguita l'occlusione selettiva del solo segmento splenico interessato. Risultati: L'embolizzazione prossimale si è resa necessaria in 8 pazienti e quella distale in 6. In 13 casi sono state posizionate spirali RM compatibili con diametro variabile tra 4 e 6 mm; in un solo paziente sono state iniettate solo particelle riassorbibili. Il successo tecnico immediato è stato ottenuto in tutti i casi. In 13/14 casi (92,9%) non sono state osservate complicanze post-procedurali, mentre in un solo paziente, trattato con particelle riassorbibili, si è resa necessaria la splenectomia per recidiva di sanguinamento a 24 ore dall'embolizzazione. Conclusioni: Sulla base del nostro algoritmo, è possibile una veloce decisione sul trattamento più opportuno delle lesioni spleniche post-traumatiche e l'embolizzazione percutanea sembra offrire un'affidabile opzione in pazienti con lesioni d'organo di grado elevato o con sanguinamento attivo. © 2011 Springer-Verlag Italia. Source


Werner H.,Radiologia | Lopes J.,University of Arts | Tonni G.,Prenatal Diagnostic Center | Araujo Junior E.,Federal University of Sao Paulo
Child's Nervous System | Year: 2015

ᅟRapid prototyping is becoming a fast-growing and valuable technique for physical models in case of congenital anomalies. Manufacturing models are generally built from three-dimensional (3D) ultrasound, computed tomography, and fetal magnetic resonance imaging (MRI) scan data. Physical prototype has demonstrated to be clinically of value in case of complex fetal malformations and may improve antenatal management especially in cases of craniosynostosis, orofacial clefts, and giant epignathus. In addition, it may enhance parental bonding in visually impaired parents and have didactic value in teaching program. Hereby, the first 3D physical model from 3D ultrasound and MRI scan data reconstruction of lumbosacral myelomeningocele in a third trimester fetus affected by Chiari II malformation is reported. © 2015, Springer-Verlag Berlin Heidelberg. Source

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