Oesophageal dysmotility in systemic sclerosis: comparison of HRCT and scintigraphy.

The aim of this study was to compare oesophageal abnormalities observed in high-resolution CT with radionuclide transit in patients with systemic sclerosis. 76 patients with systemic sclerosis were evaluated by high-resolution CT and oesophageal transit scintigraphy. Residual activity > or =20% (in relation to peak activity) at 15 s after the beginning of the swallow of the labelled liquid (in supine position) was considered indicative of oesophageal dysfunction. Supra-aortic and infra-aortic oesophageal coronal diameters were measured in high-resolution CT. Oesophageal dilatation was deemed present when the diameters exceeded 10 mm. 19 patients (25%) had supra-aortic oesophageal dilatation and 48 patients (63.1%) had infra-aortic dilatation. The prevalence of radionuclide transit delay was 77.6%. All patients (19/19) with supra-aortic dilatation had oesophageal dysfunction, compared with 70.2% (40/57) of the patients with no supra-aortic dilatation (p = 0.004). Oesophageal dysfunction was present in 97.9% (47/48) of patients with infra-aortic dilatation, compared with 42.9% (12/28) in patients without it (p < 0.001). Receiver operating characteristic (ROC) curves have demonstrated that the supra-aortic and infra-aortic diameters had good discriminatory capacity for oesophageal dysfunction in systemic sclerosis (area under the curve, 95% confidence interval: 0.80, 0.70-0.89 and 0.92, 0.86-0.98, respectively). There is a clinically significant association between oesophageal dysmotility and high-resolution CT findings of oesophageal coronal dilatation. The evaluation of infra-aortic oesophageal coronal diameter can provide additional useful information about the functional and anatomic conditions of the oesophagus in systemic sclerosis.

Ultrasonography: is it useful in the diagnosis of cancer in thyroid nodules?

The role of ultrasonography (US) in the diagnosis of cancer in thyroid nodules is not well-established. The aim of the present study was to evaluate US performance in predicting cancer in thyroid nodules using a novel approach. Two hundred and eighty-nine patients with thyroid nodular disease were evaluated with clinical, biochemical and cytopathological examinations. Eighty patients with palpable solitary thyroid nodules or multinodular goiters who were to undergo surgery were included, and had a US exam performed by one of us. Some US characteristics of thyroid nodules were associated to cancer: absent halo, hypoechogenicity and microcalcifications, with sensitivity, respectively, of 56, 44 and 56%, and specificity of, respectively, 80, 83 and 94%. These findings were considered positive and were studied in two different combinations: simultaneous, when two or more were positive, and parallel, when any positive finding was present. When positive findings were studied simultaneously, sensitivity ranged 25 to 38% and specificity ranged 89 to 97%. Microcalcifications, associated or not to other findings, were highly specific for thyroid cancer, but they were only present in half of the malignancies. When positive findings were studied in parallel, sensitivity ranged 69 to 81% and specificity ranged 70 to 81%. The parallel combination of hypoechogenicity or microcalcifications or absent halo improved US sensitivity to 81% with an acceptable specificity (70%). This method is potentially useful to help us select patients for surgery when fine-needle aspiration biopsy is repetitively non-diagnostic or select for biopsy incidentally discovered non-palpable nodules.

Utilizaçäo da sensitometria no controle de qualidade de imagens radiográficas / Utilization of sensitometry in quality control of radiographic images

Utilizando o método sensitométrico analisou-se a resposta característica de filmes radiográficos e a qualidade das imagens neles geradas. A sensitometria consistiu em sensibilizações e avaliações sistemáticas dos filmes após o seu processamento. A coleta de dados foi realizada diariamente, durante o período de três meses. Os resultados desta pesquisa demostraram que 100 por cento dos filmes apresentam uma resposta característica em desacordo com a sensitometria utilizada como referência. Os resultados podem acrescentar pontos desfavoráveis na decisão de utilizar essa marca e tipo de filme no Serviço de Radiologia em questão.

Using a sensitometric method, the characteristic answer of radiographic films and the quality of the produced images were analized. Sensitometry was a sistematic sensibilization and evaluation of the films after they were processed. Data was collected daily in a period of three months. Results from this research show a desagreement in 100% from the pattern of the sensitometric characteristics to the analized films. This conclusion may add negative points in decision on using this or that fabricant and type of film at the Radiologic Service in question.

Atuaçäo do físico médico nos serviços de radiologia, hemodinâmica e unidade de bloco cirúrgico no Hospital de Clínicas de Porto Alegre / Actuation of physical medical in ridiology, hemodinamic services and surgical unit in Hospital de Clinica de Porto Alegre

Atualmente, os hospitais tem demonstrado maior interesse no Programa de Garantia de Qualidade, bem como, na Radioproteção, no que tange a serviços que envolvam radiações ionizantes. Faz-se necessário, perante a esta tendência, a presença do Físico Médico, que irá elaborar plano de Proteção Radiológica, Programa de Garantia da Qualidade informar mensalmente as doses individuais, acompanhar inspeções sanitárias, treinar e orientar os profissionais envolvidos nessa área. Portanto, o presente trabalho tem o objetivo de relatar as atividades desempenhadas por este profissional nos Serviço de Radiologia, Hemodinâmica e unidade de Bloco Cirúrgico, assim como, a metodologia e os resultados obtidos.

At present, the hospitals have showed more interest in the Quality Assurance Program, also, in Radioprotection, about the services that involve ionization radiation. This is necessery, because a treemd, the presence of the Medical Physics, that will organize a Radiologic Protection project, Quality Assurance Program, inform monthly the individual doses, accompany sanitary inspection, train and orientale the profissionals involve in this area. Consequently, the present paper has the; objective to give an account of the activities executed for this profissional in the Radiologic, Hemodinamic and Surgery Unit, also, the metodology and the results obteined with it.

Ecobiometria do olho fetal / Fetal eye ultrasonic measurement

Foram realizadas mediçöes do diâmetro transversal equatorial ocular em 224 fetos de gestantes normais utilizando-se um ecógrafo Toshiba equipado com transdutor de 2,4 MHz. A idade gestacional dos fetos oscilou entre 12 e 19 semanas. O diâmetro ocular médio variou de 3,3 mm na 12ª semana até 18,9 mm na 39ª. O crescimento ocular mostrou-se mais rápido na primeira metade da gestaçäo diminuindo paulatinamente até chegar a um mínimo nas últimas semanas. Com os dados obtidos foi posssivel construir nomogramas aplicáveis ao nosso meio, que poderäo auxiliar na detecçäo intra-uterina de diversas patologias