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1.
Radiol Bras ; 54(3): 198-203, 2021.
Article in English | MEDLINE | ID: mdl-34108768

ABSTRACT

Fungal infections of the central nervous system (CNS) are rare. However, because of the increase in the number of immunocompromised individuals, they have been gaining prominence in the differential diagnosis of CNS infections. Imaging techniques are sensitive for detecting and localizing an abnormality, in many cases allowing the origin of a lesion to be categorized as infectious, inflammatory, neoplastic, or vascular. This essay illustrates the magnetic resonance imaging and computed tomography findings of the most common fungal infections of the CNS, based on the experience of the Radiology Department of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, RS, Brazil.


As infecções fúngicas do sistema nervoso central (SNC) são raras, entretanto, com o aumento no número de indivíduos imunocomprometidos elas têm ganhado destaque no diagnóstico diferencial de infecções no SNC. As atuais técnicas de imagem são sensíveis para detectar uma anormalidade, localizá-la, e em muitos casos categorizar a lesão como de origem infecciosa e/ou inflamatória, neoplásica ou vascular. Este ensaio ilustra os achados de ressonância magnética e tomografia computadorizada mais comuns nas infecções fúngicas do SNC baseadas na experiência do Serviço de Radiologia do Hospital de Clínicas de Porto Alegre.

2.
Radiol. bras ; 54(3): 198-203, May-June 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1250662

ABSTRACT

Abstract Fungal infections of the central nervous system (CNS) are rare. However, because of the increase in the number of immunocompromised individuals, they have been gaining prominence in the differential diagnosis of CNS infections. Imaging techniques are sensitive for detecting and localizing an abnormality, in many cases allowing the origin of a lesion to be categorized as infectious, inflammatory, neoplastic, or vascular. This essay illustrates the magnetic resonance imaging and computed tomography findings of the most common fungal infections of the CNS, based on the experience of the Radiology Department of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, RS, Brazil.


Resumo As infecções fúngicas do sistema nervoso central (SNC) são raras, entretanto, com o aumento no número de indivíduos imunocomprometidos elas têm ganhado destaque no diagnóstico diferencial de infecções no SNC. As atuais técnicas de imagem são sensíveis para detectar uma anormalidade, localizá-la, e em muitos casos categorizar a lesão como de origem infecciosa e/ou inflamatória, neoplásica ou vascular. Este ensaio ilustra os achados de ressonância magnética e tomografia computadorizada mais comuns nas infecções fúngicas do SNC baseadas na experiência do Serviço de Radiologia do Hospital de Clínicas de Porto Alegre.

5.
J Craniofac Surg ; 28(7): e697-e700, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28891901

ABSTRACT

Maxillary hypoplasia (MH) is a rare cause of respiratory dysfunction in infants and may occur in association with genetic abnormalities or as an isolated condition. It is included in the differential diagnosis of congenital nasal obstruction. This paper seeks to report a case series of infants with MH, discuss methods for its diagnosis, and compare computed tomography (CT) measurements of nasal cavities of infants with MH and without craniomaxillofacial abnormalities. The therapeutic approach in each patient is also described. All infants with MH admitted to a tertiary hospital between 2012 and 2015 were included. Baseline nasal endoscopy was performed at bedside. The width of the infants' nasal cavities was measured by a radiologist with experience in CT scanning of facial bones. Control patients were infants of matched sex and similar age who underwent head CT scanning for various reasons. Overall, 8 infants with MH and 8 controls were assessed. All nasal cavity dimensions of infants with MH were significantly smaller than those of control subjects. The authors conclude that the diagnosis of MH should be considered in infants with nasal obstruction and nasal cavity narrowing at nasal endoscopy.


Subject(s)
Micrognathism/diagnostic imaging , Nasal Cavity/diagnostic imaging , Nasal Obstruction/diagnostic imaging , Diagnosis, Differential , Female , Humans , Infant , Male , Tomography, X-Ray Computed
6.
Appetite ; 116: 21-28, 2017 09 01.
Article in English | MEDLINE | ID: mdl-28400302

ABSTRACT

BACKGROUND: The A3669G single nucleotide polymorphism (SNP) of the glucocorticoid receptor (GR) gene NR3C1 is associated with altered tissue sensitivity to glucocorticoids (GCs). GCs modulate the food reward circuitry and are implicated in increased intake of palatable foods, which can lead to the metabolic syndrome and obesity. We hypothesized that presence of the G variant of the A3669G SNP would affect preferences for palatable foods and alter metabolic, behavioural, and neural outcomes. METHODS: One hundred thirty-one adolescents were genotyped for the A3669G polymorphism, underwent anthropometric assessment and nutritional evaluations, and completed behavioural measures. A subsample of 74 subjects was followed for 5 years and performed a brain functional magnetic resonance imaging (fMRI) paradigm to verify brain activity in response to food cues. RESULTS: Sugar and total energy consumption were lower in A3669G G allele variant carriers. On follow-up, this group also had reduced serum insulin concentrations, increased insulin sensitivity, and lower anxiety scores. Because of our unbalanced sample sizes (31/37 participants non-G allele carriers/total), our imaging data analysis failed to find whole brain-corrected significant results in between-group t-tests. CONCLUSION: These results highlight that a genetic variation in the GR gene is associated, at the cellular level, with significant reduction in GC sensitivity, which, at cognitive and behavioural levels, translates to altered food intake and emotional stress response. This genetic variant might play a major role in decreasing risk for metabolic and psychiatric diseases.


Subject(s)
Allostasis , Appetite Regulation , Energy Intake , Food Preferences , Polymorphism, Single Nucleotide , Adolescent , Adolescent Nutritional Physiological Phenomena , Alleles , Anxiety/genetics , Anxiety/metabolism , Anxiety/psychology , Brazil , Child , Child Nutritional Physiological Phenomena , Cohort Studies , Female , Genetic Association Studies , Humans , Insulin Resistance , Longitudinal Studies , Male , Prospective Studies , Stress, Psychological/genetics , Stress, Psychological/metabolism , Stress, Psychological/psychology
7.
Radiol Bras ; 49(5): 329-336, 2016.
Article in English | MEDLINE | ID: mdl-27818548

ABSTRACT

The term rhombencephalitis refers to inflammatory diseases affecting the hindbrain (brainstem and cerebellum). Rhombencephalitis has a wide variety of etiologies, including infections, autoimmune diseases, and paraneoplastic syndromes. Infection with bacteria of the genus Listeria is the most common cause of rhombencephalitis. Primary rhombencephalitis caused by infection with Listeria spp. occurs in healthy young adults. It usually has a biphasic time course with a flu-like syndrome, followed by brainstem dysfunction; 75% of patients have cerebrospinal fluid pleocytosis, and nearly 100% have an abnormal brain magnetic resonance imaging scan. However, other possible causes of rhombencephalitis must be borne in mind. In addition to the clinical aspects, the patterns seen in magnetic resonance imaging can be helpful in defining the possible cause. Some of the reported causes of rhombencephalitis are potentially severe and life threatening; therefore, an accurate initial diagnostic approach is important to establishing a proper early treatment regimen. This pictorial essay reviews the various causes of rhombencephalitis and the corresponding magnetic resonance imaging findings, by describing illustrative confirmed cases.


O termo rombencefalite se refere a doenças inflamatórias que afetam o rombencéfalo (tronco cerebral e cerebelo). Rombencefalites possuem grande variedade de causas, incluindo infecciosas, autoimunes e síndromes paraneoplásicas. Listeria é a causa mais comum das rombencefalites infecciosas. A rombencefalite primária por Listeria ocorre em adultos jovens e saudáveis, com um curso de tempo bifásico, como uma síndrome gripal acompanhada de disfunção do tronco cerebral. Em 75% dos pacientes manifesta-se pleiocitose no líquido cefalorraquidiano e em quase 100% a ressonância magnética cerebral é anormal. Mas há outras causas possíveis para rombencefalites que devem ser lembradas. Além de aspectos clínicos, os padrões de imagem encontrados na ressonância magnética podem ser úteis na definição da possível causa. Algumas das causas descritas de rombencefalites são potencialmente graves e fatais; assim, uma abordagem diagnóstica inicial precisa é importante para estabelecer um tratamento precoce adequado. Este ensaio iconográfico revisa as diversas causas de rombencefalites e os seus achados de ressonância magnética, por meio de casos ilustrativos confirmados.

8.
Radiol. bras ; 49(5): 329-336, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-829391

ABSTRACT

Abstract The term rhombencephalitis refers to inflammatory diseases affecting the hindbrain (brainstem and cerebellum). Rhombencephalitis has a wide variety of etiologies, including infections, autoimmune diseases, and paraneoplastic syndromes. Infection with bacteria of the genus Listeria is the most common cause of rhombencephalitis. Primary rhombencephalitis caused by infection with Listeria spp. occurs in healthy young adults. It usually has a biphasic time course with a flu-like syndrome, followed by brainstem dysfunction; 75% of patients have cerebrospinal fluid pleocytosis, and nearly 100% have an abnormal brain magnetic resonance imaging scan. However, other possible causes of rhombencephalitis must be borne in mind. In addition to the clinical aspects, the patterns seen in magnetic resonance imaging can be helpful in defining the possible cause. Some of the reported causes of rhombencephalitis are potentially severe and life threatening; therefore, an accurate initial diagnostic approach is important to establishing a proper early treatment regimen. This pictorial essay reviews the various causes of rhombencephalitis and the corresponding magnetic resonance imaging findings, by describing illustrative confirmed cases.


Resumo O termo rombencefalite se refere a doenças inflamatórias que afetam o rombencéfalo (tronco cerebral e cerebelo). Rombencefalites possuem grande variedade de causas, incluindo infecciosas, autoimunes e síndromes paraneoplásicas. Listeria é a causa mais comum das rombencefalites infecciosas. A rombencefalite primária por Listeria ocorre em adultos jovens e saudáveis, com um curso de tempo bifásico, como uma síndrome gripal acompanhada de disfunção do tronco cerebral. Em 75% dos pacientes manifesta-se pleiocitose no líquido cefalorraquidiano e em quase 100% a ressonância magnética cerebral é anormal. Mas há outras causas possíveis para rombencefalites que devem ser lembradas. Além de aspectos clínicos, os padrões de imagem encontrados na ressonância magnética podem ser úteis na definição da possível causa. Algumas das causas descritas de rombencefalites são potencialmente graves e fatais; assim, uma abordagem diagnóstica inicial precisa é importante para estabelecer um tratamento precoce adequado. Este ensaio iconográfico revisa as diversas causas de rombencefalites e os seus achados de ressonância magnética, por meio de casos ilustrativos confirmados.

9.
Radiographics ; 36(5): 1448-62, 2016.
Article in English | MEDLINE | ID: mdl-27618324

ABSTRACT

Mucopolysaccharidosis (MPS) is an inherited metabolic disease and a member of the group of lysosomal storage disorders. Its hallmark is a deficiency of lysosomal enzymes involved in the degradation of mucopolysaccharides, also known as glycosaminoglycans (GAGs). The products of GAG degradation accumulate within lysosomes and in the extracellular space, thereby interfering with the degradation of other macromolecules. This process leads to chronic degeneration of cells, which in turn affects multiple organs and systems. There are seven distinct types of MPS (I, II, III, IV, VI, VII, and IX), which are divided into subtypes according to the deficient enzyme and the severity of the clinical picture. Although clinical manifestations vary considerably among the different types of MPS, the central nervous system (CNS) is characteristically affected, and magnetic resonance (MR) imaging is the method of choice to evaluate brain and spinal cord abnormalities. Enlarged perivascular spaces, white matter lesions, hydrocephalus, brain atrophy, cervical spinal canal stenosis with or without spinal cord compression and myelopathy, and bone abnormalities in the skull and spine (dysostosis multiplex) are typical imaging findings described in the literature and reviewed in this article. The differential diagnosis of MPS is limited because the constellation of imaging findings is highly suggestive. Thus, radiologists should be aware of its typical neuroimaging findings so they can recognize cases not yet diagnosed, exclude other metabolic diseases, monitor CNS findings over time, and assess treatment response. (©)RSNA, 2016.


Subject(s)
Magnetic Resonance Imaging/methods , Mucopolysaccharidoses/diagnostic imaging , Neuroimaging/methods , Humans , Mucopolysaccharidoses/physiopathology
10.
Am J Med Genet A ; 167(6): 1323-9, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25913727

ABSTRACT

In some cases Neu-Laxova syndrome (NLS) is linked to serine deficiency due to mutations in the phosphoglycerate dehydrogenase (PHGDH) gene. We describe the prenatal and postnatal findings in a fetus with one of the most severe NLS phenotypes described so far, caused by a homozygous nonsense mutation of PHGDH. Serial ultrasound (US) and pre- and postnatal magnetic resonance imaging (MRI) evaluations were performed. Prenatally, serial US evaluations suggested symmetric growth restriction, microcephaly, hypoplasia of the cerebellar vermis, micrognathia, hydrops, shortened limbs, arthrogryposis, and talipes equinovarus. The prenatal MRI confirmed these findings prompting a diagnosis of NLS. After birth, radiological imaging did not detect any gross bone abnormalities. DNA was extracted from fetal and parental peripheral blood, all coding exons of PHGDH were PCR-amplified and subjected to Sanger sequencing. Sequencing of PHGDH identified a homozygous premature stop codon mutation (c.1297C>T; p.Gln433*) in fetal DNA, both parents (first-cousins) being heterozygotes. Based on previous associations of mutations in this gene with a milder NLS phenotype, as well as cases of serine deficiency, these observations lend further support to a genotype-phenotype correlation between the degree of PHGDH inactivation and disease severity.


Subject(s)
Abnormalities, Multiple/genetics , Brain Diseases/genetics , Carbohydrate Metabolism, Inborn Errors/genetics , Codon, Nonsense , Fetal Growth Retardation/genetics , Ichthyosis/genetics , Limb Deformities, Congenital/genetics , Microcephaly/genetics , Phenotype , Phosphoglycerate Dehydrogenase/deficiency , Phosphoglycerate Dehydrogenase/genetics , Psychomotor Disorders/genetics , Seizures/genetics , Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/pathology , Base Sequence , Brain Diseases/diagnosis , Brain Diseases/pathology , Carbohydrate Metabolism, Inborn Errors/diagnosis , Carbohydrate Metabolism, Inborn Errors/pathology , Consanguinity , Female , Fetal Growth Retardation/diagnosis , Fetal Growth Retardation/pathology , Fetus , Gene Expression , Genes, Lethal , Genetic Variation , Genotype , Homozygote , Humans , Ichthyosis/diagnosis , Ichthyosis/pathology , Infant, Newborn , Limb Deformities, Congenital/diagnosis , Limb Deformities, Congenital/pathology , Male , Microcephaly/diagnosis , Microcephaly/pathology , Molecular Sequence Data , Pedigree , Psychomotor Disorders/diagnosis , Psychomotor Disorders/pathology , Seizures/diagnosis , Seizures/pathology , Sequence Analysis, DNA , Severity of Illness Index , Ultrasonography, Prenatal
11.
Article in Portuguese | LILACS | ID: biblio-879619

ABSTRACT

A dor abdominal em quadrante inferior direito (QID) é uma queixa freqüente nos pronto-atendimentos médicos. A apendicite e alguns dos seus diagnósticos diferenciais (gastrointestinais) mais prevalentes serão abordados neste artigo, com destaque ao manejo e investigação associando clínica e imagem à Tomografia Computadorizada (TC).


The right low quadrant abdominal pain is a frequent cause of emergency care. Appendicitis and some of its main differential diagnoses (gastrointestinal) will be addressed in this article, especially the management and investigation associating clinic and image at computed tomography (CT).


Subject(s)
Abdominal Pain , Tomography, X-Ray Computed
12.
Article in Portuguese | LILACS | ID: biblio-879776

ABSTRACT

O objetivo deste capítulo é auxiliar o médico emergencista a identificar alterações em Tomografias de Crânio nas patologias neurorradiológicas mais prevalentes nesse tipo de serviço. Será realizada breve explicação sobre a definição, epidemiologia, aspectos clínicos e achados de imagem acerca de cada patologia.


The purpose of this chapter is to help the emergency physician to identify changes in skull CT scans of the most prevalent neuroradiological pathologies in this type of service. A brief explanation of the definition, epidemiology, clinical and imaging findings about each pathology will be presented.


Subject(s)
Skull , Emergencies , Neuroimaging , Tomography
13.
Clin. biomed. res ; 34(1): 80-83, 2014. ilus
Article in English | LILACS | ID: biblio-834445

ABSTRACT

Transrectal ultrasound-guided prostate needle biopsy is the ideal method of obtaining prostate specimens for histological analysis and is therefore often used in clinical practice. In most studies, prostate biopsy is considered a safe procedure with few major complications. In the present report, we describe a case of endocarditis with spondylodiscitis, two very rare complications associated with prostate biopsy. In the present report, we describe a case of infective endocarditis (IE) with spondylodiscitis (SD), two very rare complications of prostate biopsy. Only a few cases have been described in the literature reporting IE or SD as complications of prostate biopsy.


Subject(s)
Humans , Male , Aged , Discitis/diagnosis , Discitis/therapy , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/etiology , Biopsy/adverse effects , Prostate
14.
Article in Portuguese | LILACS | ID: biblio-882682

ABSTRACT

O objetivo deste capítulo é ajudar o médico que trabalha em um serviço de emergência a interpretar uma radiografia de tórax. Será revisada a anatomia básica e exemplificadas as principais doenças não traumáticas mais frequentemente observadas.


The objective of this chapter is to help the emergencist physician to read chest radiographies. It will be rewiewed the basic anatomy of the chest and the main nontraumatic diseases most frequently observed.


Subject(s)
Diagnostic Imaging , Radiography, Thoracic , Emergency Medical Services
15.
Acta méd. (Porto Alegre) ; 34: [6], 20130.
Article in Portuguese | LILACS | ID: biblio-879909

ABSTRACT

A ressonância magnética (RM) é um exame não invasivo que, através de interações magnéticas com núcleos de átomos de hidrogênio, produz imagens de segmentos do corpo humano com grande acurácia diagnóstica. Seu potencial de delineamento anatômico, associado com ausência de efeitos deletérios, o torna peça importante para avaliação de mal formações fetais.


Magnetic resonance imaging (MRI) is a non-invasive test that produces images of body parts through interactions with hydrogen atoms core, which present high diagnostic accuray. Its potential capability of anatomical delineation and the lack of biological proven effects turns MRI an option of great potential for the fetal assessment.


Subject(s)
Magnetic Resonance Imaging , Ultrasonography, Prenatal/methods , Pregnancy
16.
Acta méd. (Porto Alegre) ; 33(1): [6], 21 dez. 2012.
Article in Portuguese | LILACS | ID: biblio-881489

ABSTRACT

O tromboembolismo pulmonar (TEP) é um tipo de tromboembolismo venoso que ocorre na circulação arterial pulmonar. É uma patologia que cursa com morbidade e mortalidade elevadas, uma vez que os pacientes costumam apresentar doenças graves subjacentes e que complicam também devido a instabilidade hemodinâmica secundária ao TEP. O diagnóstico desta condição depende da combinação de uma série de fatores clínicos, que definem a probabilidade pré-teste associados a exames de imagem, sendo a angiotomografia computadorizada (angioTC) o método de escolha.


Pulmonary embolism is a class of venous embolism that occurs in pulmonary arterial circulation. It curses with high morbity and mortality, since patients often have severe underlying diseases and may progress inadequately due to secondary hemodynamic instability. The diagnosis of this condition depends on the match of a series of clinical factors that defines probability plus image exams, being angioCT the main diagnostic tool.


Subject(s)
Pulmonary Embolism/diagnostic imaging , Radiology/methods
17.
Acta méd. (Porto Alegre) ; 33(1): [7], 21 dez. 2012.
Article in Portuguese | LILACS | ID: biblio-881495

ABSTRACT

O fígado é um órgão em que, muito frequentemente, se verificam lesões focais de natureza neoplásica primária. A avaliação correta destas lesões é fundamental, uma vez que sua etiologia pode ser desde lesões inocentes sem qualquer significado clínico até processos malignos ou com potencial maligno, cujo tratamento precoce pode determinar a cura do paciente. Os exames de imagem cumprem um papel de relevo na detecção e caracterização destas lesões. Este artigo tem como objetivo descrever as características radiológicas das principais lesões hepáticas focais, descrevendo os principais achados nos exames de ultrassonografia, tomografia computadorizada e ressonância magnética.


The liver is an organ in which, very often, occurs focal lesion of primary neoplasic nature. The correct evaluation of these lesions is essential, since its etiology may be innocent, without any clinical significance, to malignant processes or malignant potential, which may provide early treatment to cure the patient. Imaging studies play an important role in the detection and characterization of these lesions. This article aims to describe the radiological characteristics of the main focal hepatic lesions, describing the main finding on ultrasound examination, computed tomography and magnetic resonance imaging.


Subject(s)
Liver Neoplasms/classification , Liver Neoplasms/diagnostic imaging , Diagnostic Imaging
18.
Acta méd. (Porto Alegre) ; 33(1): [6], 21 dez. 2012.
Article in Portuguese | LILACS | ID: biblio-882375

ABSTRACT

Neste trabalho objetivamos esclarecer quais as principais indicações, contra-indicações, vantagens e desvantagens, de acordo com a faixa etária, de cada exame nas diversas condições patológicas do cérebro em pediatria.


In this work we aimed to clarify the main indications, contraindications, advantages anddisadvantages, according to the age, of each examination in various pathological conditions of the brain in pediatrics.


Subject(s)
Brain Diseases/diagnostic imaging , Pediatrics , Magnetic Resonance Spectroscopy , Radiography , Tomography, Emission-Computed , Ultrasonography
19.
Radiol. bras ; 34(2): 79-81, mar.-abr. 2001. ilus, tab
Article in Portuguese | LILACS | ID: lil-309840

ABSTRACT

A histerossalpingografia é um exame realizado para avaliação da anatomia uterina e da permeabilidade tubária, característica esta que torna a pesquisa de causa de infertilidade primária ou secundária sua principal indicação. Este trabalho se propôs a estudar a prevalência de alterações na histerossalpingografia em pacientes com infertilidade. Para tal, foram alocadas todas as pacientes que se submeteram ao exame, num período de quatro meses. Entre as 48 pacientes estudadas, 36 apresentavam infertilidade primária e 12, infertilidade secundária. As pacientes com infertilidade primária apresentaram maior índice de malformações uterinas, enquanto as pacientes com infertilidade secundária apresentaram obstrução tubária como alteração mais frequënte. Não ocorreu nenhuma intercorrência significativa durante a realização dos exames. O trabalho permite afirmar que este exame é muito útil na pesquisa de infertilidade, uma vez que, freqüentemente, diagnostica alterações importantes, sendo um exame barato e de raras complicações.


Subject(s)
Humans , Female , Hysterosalpingography , Infertility, Female , Prevalence
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