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1.
Cardiology ; 110(4): 241-8, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18073479

RESUMO

OBJECTIVES: The purpose of this study was to assess whether different coronary plaque types as classified by multislice computed tomography (CT) are retrospectively correlated with acute coronary syndromes (ACS) in an unselected study population. METHODS: Sixty-three consecutive patients were examined with 16-slice CT coronary angiography. Coronary plaque types were classified as calcifying type 1, mixed (calcifying > non-calcifying) type 2, mixed (non-calcifying > calcifying) type 3, and non-calcifying type 4. Patients who had an ACS within 17 days were included. All patients underwent invasive coronary angiography. RESULTS: Fifty-eight patients (92%) had coronary plaques evaluated by CT: 18 type 1 (31%), 10 type 2 (17%), 16 type 3 (28%) and 14 type 4 (24%). The presence of a non-calcifying plaque component (types 2-4; 40 of 63 patients, 63%) was correlated with ACS (n = 15; 24%) (p < 0.001). Only type 3 was significantly correlated with ACS (p = 0.01), but plaque types 2 and 4 were not. The diagnostic accuracy of CT for detection of stenosis >50% in proximal segments was: sensitivity 98%, specificity 90%, negative predictive value 97%, positive predictive value 97% per patient. CONCLUSIONS: Mixed calcifying/non-calcifying plaques with a predominantly non-calcifying component (type 3) as classified by multislice CT are retrospectively correlated with ACS.


Assuntos
Síndrome Coronariana Aguda/etiologia , Doença da Artéria Coronariana/complicações , Adulto , Idoso , Calcinose/complicações , Calcinose/diagnóstico por imagem , Angiografia Coronária/métodos , Doença da Artéria Coronariana/classificação , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos
2.
Eur Radiol ; 18(4): 707-15, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17938936

RESUMO

Prostate cancer is the most common cancer in men. In the future, a significant further increase in the incidence of prostate cancer is expected. Therefore, improvement of prostate cancer diagnosis is a main topic of diagnostic imaging. The systematic prostate biopsy ("ten-core biopsy") is now the "gold standard" of prostate cancer diagnosis but may miss prostate cancer. Contrast-enhanced colour Doppler ultrasound (US) and elastography are evolving methods that may dramatically change the role of US for prostate cancer diagnosis. Contrast-enhanced colour Doppler US allows for investigations of the prostate blood flow and consequently for prostate cancer visualization and therefore for targeted biopsies. Comparisons between systematic and contrast-enhanced targeted biopsies have shown that the targeted approach detects more cancers and cancers with higher Gleason scores with a reduced number of biopsy cores. Furthermore, elastography, a new US technique for the assessment of tissue elasticity has been demonstrated to be useful for the detection of prostate cancer, and may further improve prostate cancer staging. Therefore, contrast-enhanced colour Doppler US and elastography may have the potential to improve prostate cancer detection, grading and staging. However, further clinical trials will be needed to determine the promise of these new US advances.


Assuntos
Neoplasias da Próstata/diagnóstico por imagem , Biópsia , Meios de Contraste , Elasticidade , Humanos , Masculino , Estadiamento de Neoplasias , Próstata/irrigação sanguínea , Próstata/patologia , Neoplasias da Próstata/patologia , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores
3.
Eur J Radiol ; 68(3): 456-64, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17913424

RESUMO

PURPOSE: To assess whether fusion of multislice computed tomography (CT) images with electroanatomical (EA)-mapping data using a new image integration module (CartoMerge) is feasible and accurate to navigate ablation catheters in right and left atrial catheter ablation. MATERIAL AND METHODS: Twenty-four patients were examined with ECG-gated cardiac multislice CT (64 mm x 0.6mm, 0.33 s) 1 day before left atrial (LA) (15 patients) radiofrequency or right atrial cavotricuspid isthmus ablation (9 patients). CT data were fused with the non-fluoroscopic EA-mapping data by using dedicated software (CartoMerge) and the value of CT was analysed. RESULTS: In 23/24 (96%) patients, CT images could be fused with the EA-map. The alignment error was 2.16+/-0.35 mm. In 15/15 (100%) patients, CT added relevant anatomical information regarding the course of the esophagus or the pulmonary veins before LA-ablation. CT added useful information in only 3/8 (37.5%) of patients undergoing right atrial cavotricuspid isthmus ablation. CONCLUSION: 3D-navigation of RF-ablation catheters in the atria assisted by image fusion of multislice CT with EA-mapping data is feasible and accurate. CT added relevant anatomical information about the left atrium and the pulmonary veins before LA-ablation, CT also provided information about the course of the esophagus which might help to avoid thermal injury. CT image fusion might be of minor value before right atrial cavotricuspid isthmus catheter ablation.


Assuntos
Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/cirurgia , Mapeamento Potencial de Superfície Corporal/métodos , Ablação por Cateter/métodos , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Imageamento Tridimensional/métodos , Cirurgia Assistida por Computador/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Técnica de Subtração , Resultado do Tratamento
4.
AJR Am J Roentgenol ; 189(3): 574-80, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17715103

RESUMO

OBJECTIVE: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of greater than 50% graft stenosis within 2 weeks of coronary artery bypass grafting and to investigate the clinical value of 64-slice CT. SUBJECTS AND METHODS: Forty-one patients (70 grafts, 46 arterial and 24 venous) underwent 64-slice CT a mean of 2.6 years after minimally invasive or conventional coronary artery bypass surgery. RESULTS: All 70 grafts were assessable, and none of the grafts was excluded from analysis. For the detection of 50-90% graft stenosis, the sensitivity of CT was 75%, the specificity was 95%, the positive predictive value was 67%, and the negative predictive value was 97% (true disease prevalence, 8/70 grafts; 11%). Greater than 50% graft stenosis and occlusion pooled together (prevalence, 14/70; 20%) were detected with a sensitivity of 85%, specificity of 95%, positive predictive value of 80%, and negative predictive value of 96%. Vein graft disease was found in eight (42%) of 19 patent vein grafts (graft age, 15.6 +/- 2.3 years). The disease was nonobstructive in three (16%) of the 19 grafts. The course of the left internal mammary artery was median retrosternal (< 1 cm deep) in 33.3% of conventionally sutured grafts. CONCLUSION: Sixty-four-slice CT angiography can be used for accurate exclusion of greater than 50% graft stenosis, but detection of distal anastomotic stenosis is limited, and the degree of stenosis can be overestimated. The advantages of CT, however, are that it is noninvasive, vein graft disease can be diagnosed at an early stage, and complementary evaluation of extracardiac anatomic features provides useful information before coronary artery bypass grafting is redone.


Assuntos
Angiografia Coronária/métodos , Ponte de Artéria Coronária/efeitos adversos , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/etiologia , Sobrevivência de Enxerto , Tomografia Computadorizada por Raios X/métodos , Grau de Desobstrução Vascular , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resultado do Tratamento
5.
Curr Opin Urol ; 17(1): 39-47, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17143110

RESUMO

PURPOSE OF REVIEW: Prostate cancer is the most commonly diagnosed malignancy in men. Gray-scale ultrasound-guided systematic biopsy is the standard of care for prostate cancer detection in men with an elevated prostate-specific antigen or an abnormal digital rectal examination. Systematic biopsy may miss up to 35% of clinically relevant cancers. Color and power Doppler ultrasound, ultrasound contrast agents, and elastography have and will dramatically change the role of ultrasound in prostate cancer diagnosis. RECENT FINDINGS: Several reports have demonstrated that contrast-enhanced ultrasound investigations of the blood flow of the prostate allow for prostate cancer visualization and therefore, for targeted biopsies. Comparisons between systematic and contrast-enhanced ultrasound-targeted biopsies have shown that the targeted approach detects more cancers with a lower number of biopsy cores. Furthermore, contrast-enhanced ultrasound has been shown to detect cancers with higher Gleason scores compared with the systematic approach, which seems to improve prostate cancer grading. In addition, elastography is a new ultrasound technique that allows for the assessment of tissue elasticity. SUMMARY: Contrast-enhanced ultrasound and elastography improve prostate cancer detection and may be useful for prostate cancer grading and staging. Future clinical trials will be needed to determine the promise of these new advances for ultrasound of the prostate evolving into clinical applications.


Assuntos
Próstata/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Humanos , Masculino , Ultrassonografia
6.
J Heart Valve Dis ; 15(4): 494-8, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16901041

RESUMO

BACKGROUND AND AIM OF THE STUDY: Aortic valve calcification may be an independent risk factor for adverse clinical outcome. The study aim was to assess the predictive value of possible risk factors, including the severity of aortic valve calcification as quantified with 16-multislice computed tomography (MSCT) for adverse short-term clinical outcome in patients with asymptomatic, degenerative aortic stenosis (AS). METHODS: Possible risk factors for adverse short-term clinical outcome were prospectively tested in 34 consecutive patients with asymptomatic AS as follows: (i) aortic valve calcium (AVC) score as quantified with MSCT; (ii) echocardiographic parameters--aortic valve area (AVA) calculated with continuity equation, mean and maximal transvalvular pressure gradients, end-diastolic septal wall diameter; and (iii) laboratory tests (brain natriuretic peptide (BNP), C-reactive protein (CRP)). RESULTS: Within 18-24 months of follow up, 11 of 34 patients developed a major adverse clinical outcome. Ten patients suffered from onset of symptoms accompanied by hemodynamic progression, and one patient died from sudden cardiac death. Six of these 10 patients underwent aortic valve replacement, one patient declined surgery, and three patients were not accepted for surgery (one of these died suddenly shortly afterwards). The aortic valve calcium score was the strongest predictor of a major adverse clinical event (p < 0.001) among all parameters assessed (1,928 +/- 789 versus 5,111 +/- 2,409 Agatston units). The plasma level of BNP (p = 0.003), mean transvalvular pressure gradient (p = 0.002) and AVA (p = 0.003) were also risk factors for adverse clinical outcome. CONCLUSION: The AVC score as quantified with MSCT predicted adverse short-term clinical outcome in patients with asymptomatic AS. In patients with severe aortic valve calcification, close follow up examinations are mandatory, and early elective surgery may be considered even in the absence of symptoms. MSCT provides a comprehensive non-invasive imaging approach for risk stratification in patients with asymptomatic AS.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/patologia , Tomografia Computadorizada por Raios X , Valva Aórtica/química , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/patologia , Calcinose/patologia , Ecocardiografia , Seguimentos , Humanos , Modelos Lineares , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
7.
Heart Surg Forum ; 9(5): E754-8, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16809129

RESUMO

BACKGROUND: The purpose of this study was to investigate the assessment of ascending aortic atherosclerosis with 16-multidetector computed tomography (16-MDCT) angiography prior to total endoscopic coronary artery bypass (TECAB) surgery. METHODS: Forty-five patients were examined with electrocardiogram-gated, 16-MDCT angiography. The presence of atherosclerosis at the ascending aorta was graduated as severe (>50% of circumference) or as mild (<50% of circumference). Ascending aortic plaque composition was evaluated based on CT densities expressed as Hounsfield units (HU). TECABs using the Da Vinci telemanipulator were performed either on the arrested heart (n = 39) with an intra-aortic cardiopulmonary bypass (CPB) perfusion device or on the beating heart (n = 6) in patients with severe atherosclerosis. RESULTS: The presence of mild atherosclerosis at the ascending aorta (11/39) was associated with intra-aortic CPB perfusion device-related difficulties such as intra-aortic balloon migration (BM) or balloon rupture (P = .007) in arrested heart TECABs. The CT density of atherosclerotic plaque in patients with BM was mean 58 HU +/- 51 standard deviation (SD), suggesting noncalcifying plaque. In patients without BM, CT density of plaque was mean 526 HU +/- 306 SD corresponding to calcifying plaque (P < .001). Balloon rupture occurred in 2 patients who had calcifying plaque at the ascending aorta. CONCLUSION: Evaluation of ascending aortic atherosclerosis with 16-MDCT angiography is useful prior to TECAB surgery. Even mild atherosclerosis of the ascending aorta is associated with intraoperative difficulties regarding the remote-access perfusion system that is used for arrested heart TECAB surgery.


Assuntos
Doenças da Aorta/diagnóstico por imagem , Aterosclerose/diagnóstico por imagem , Ponte de Artéria Coronária/métodos , Tomografia Computadorizada por Raios X , Aorta , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Robótica
8.
J Am Coll Cardiol ; 47(7): 1410-7, 2006 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-16580530

RESUMO

OBJECTIVES: The purpose of this study was to evaluate whether multislice computed tomography (MSCT) provides a reliable, noninvasive imaging modality for identification of patients with degenerative aortic valve stenosis (AS) by quantifying the aortic valve area (AVA) in comparison to the accepted diagnostic standard transthoracic echocardiography (TTE). BACKGROUND: Management of patients with degenerative AS is based on the severity of disease. The severity of AS in clinical practice is assessed by TTE and classified as mild, moderate, or severe according to the AVA. METHODS: Forty-six patients were examined with contrast-enhanced, electrocardiogram-gated, 16-row MSCT for the evaluation of the diagnostic accuracy. In 30 patients, quantification of the AVA with MSCT was compared to TTE using the continuity equation with Doppler velocity-time integral for calculation of the AVA. RESULTS: Sensitivity of MSCT for the identification of patients with degenerative AS was 100%, and the specificity was 93.7%. Thirty of 46 patients had AS determined by TTE. Quantification of AVA by MSCT (mean AVA = 0.94 cm2) in patients with AS showed a good correlation to TTE (r = 0.89; p < 0.001). Bland-Altman plot illustrated good intermodality agreement between the two methods (limits of agreement, 0.20; 0.29). CONCLUSIONS: Multislice computed tomography may provide an accurate, noninvasive imaging technique for detection of patients with AS and quantification of AVA.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Idoso , Valva Aórtica/diagnóstico por imagem , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/normas
9.
J Hum Evol ; 51(1): 91-101, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16549104

RESUMO

Body mass and structural properties of the femoral and tibial midshafts of the "Iceman," a late Neolithic (5,200 BP) mummy found in the Tyrolean Alps, are determined from computed tomographic scans of his body, and compared with those of a sample of 139 males spanning the European early Upper Paleolithic through the Bronze Age. Two methods, based on femoral head breadth and estimated stature/bi-iliac (pelvic) breath, yield identical body-mass estimates of 61 kg for the Iceman. In combination with his estimated stature of 158 cm, this indicates a short but relatively wide or stocky body compared to our total sample. His femur is about average in strength compared to our late Neolithic (Eneolithic) males, but his tibia is well above average. His femur also shows adaptations for his relatively broad body (mediolateral strengthening), while his tibia shows adaptations for high mobility over rough terrain (anteroposterior strengthening). In many respects, his tibia more closely resembles those of European Mesolithic rather than Neolithic males, which may reflect a more mobile lifestyle than was characteristic of most Neolithic males, perhaps related to a pastoral subsistence strategy. There are indications that mobility in general declined between the European Mesolithic and late Neolithic, and that body size and shape may have become more variable throughout the continent following the Upper Paleolithic.


Assuntos
Fêmur/anatomia & histologia , Múmias , Tíbia/anatomia & histologia , Adulto , Constituição Corporal , Tamanho Corporal , Fêmur/diagnóstico por imagem , Humanos , Itália , Locomoção , Masculino , Múmias/diagnóstico por imagem , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios X
10.
AJR Am J Roentgenol ; 185(5): 1289-93, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16247151

RESUMO

OBJECTIVE: The objective of our study was to assess the feasibility of using 16-MDCT angiography for the preoperative assessment of the radial and ulnar arteries and the palmar arches in patients scheduled for radial artery harvesting for coronary artery bypass graft (CABG) surgery. CONCLUSION: Sixteen-MDCT angiography shows promise for the noninvasive preoperative assessment of the radial artery as a CABG donor site.


Assuntos
Ponte de Artéria Coronária , Artéria Radial/transplante , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Angiografia , Meios de Contraste/administração & dosagem , Estudos de Viabilidade , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Iohexol/administração & dosagem , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Artéria Radial/fisiologia , Grau de Desobstrução Vascular
13.
Ultrasound Med Biol ; 30(10): 1379-84, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15582238

RESUMO

This study was designed to evaluate power Doppler imaging for assessment of urinary bladder neck blood flow in comparison with laser Doppler flowmetry (LDF) in an animal model. Transrectal power Doppler ultrasound (US) and LDF of the urinary bladder neck were performed in three anesthetized pigs during comparative cystometry. Normal saline (NaCl) was used for the first run, followed by a second run with 0.2 mol/L potassium chloride (KCl). Standardized sonographic equipment settings (Acuson Sequoia 512); MountainView, CA) were used for power Doppler imaging. Computer-assisted calculation of color pixel density (CPD) of power Doppler images was performed using Scion Image) software image analysis. Tissue perfusion units (TPU) were measured using a BLF21 laser Doppler flowmeter (Transonic Systems Inc., Ithaca, NY, USA). The power Doppler results were compared with the findings obtained by LDF. NaCl filling resulted in a mean CPD increase at the bladder neck from 18.65 (+/- 1.78) at empty bladder to 37.8 (+/- 1.84) at 100 mL and to 88.32 (+/- 1.35) at full bladder capacity (C(max)) of 270 mL, respectively. With KCl filling, a mean CPD increase from 18.65 (+/- 1.78) to 59.63 (+/- 0.5) at 100 mL and 110.82 (+/- 2.98) at full bladder capacity (270 mL) was observed. The CPD increase was significantly higher for KCl than with NaCl (p < 0.001). With NaCl filling, bladder neck blood flow increased from 22 TPU (empty) to 46 TPU (100 mL) and 62.5 TPU at C(max), compared to 22 TPU, 50 TPU and 102.5 TPU with KCl. CPD and TPU measurements showed a strong correlation at p = 0.01. In conclusion, transrectal power Doppler US image quantification is a feasible and accurate method for assessing blood flow changes in the urinary bladder neck.


Assuntos
Ultrassonografia Doppler em Cores/métodos , Bexiga Urinária/irrigação sanguínea , Animais , Pressão Sanguínea/fisiologia , Dilatação , Feminino , Processamento de Imagem Assistida por Computador/métodos , Fluxometria por Laser-Doppler/métodos , Modelos Animais , Cloreto de Potássio , Fluxo Sanguíneo Regional , Cloreto de Sódio , Suínos , Bexiga Urinária/diagnóstico por imagem , Urodinâmica
15.
J Ultrasound Med ; 23(5): 595-601, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15154525

RESUMO

OBJECTIVE: To evaluate the impact of left renal vein entrapment on outcome after surgical varicocele repair using color Doppler sonography. METHODS: Eighty-four men had varicoceles on color Doppler sonography (2 right sided, 74 left sided, and 8 bilateral), which were diagnosed on the basis of a venous diameter of 3 mm or greater and venous retrograde flow in the pampiniform plexus of veins during the Valsalva maneuver or when changing from a supine to an upright position. Diagnosis of the left renal vein entrapment was based on the following criteria: antero-posterior diameter of greater than 1 cm and peak velocity of less than 15 cm/s for the left renal vein at the mid portion and anteroposterior diameter of less than 0.2 cm and peak velocity of greater than 110 cm/s (or, alternatively, a diameter ratio and peak velocity ratio of >5) for the left renal vein between the aorta and superior mesenteric artery. All patients underwent surgical varicocele repair. In postoperative follow-up, we compared the presence of left renal vein entrapment with the frequency of varicocele recurrence. RESULTS: Sixteen (19%) of 84 patients had left renal vein entrapment with a left-sided varicocele. Postoperatively (mean follow-up +/- SD, 19.3 +/- 11.7 months), 27 (32.2%) of 84 had varicocele recurrence, including all 16 patients with left renal vein entrapment and 11 (20.1%) of 68 patients without left renal vein entrapment. The varicocele recurrence rate was significantly greater in patients with left renal vein entrapment (P < .001, Fisher exact test). CONCLUSIONS: The presence of left renal vein entrapment resulted in a significantly higher varicocele recurrence rate. Patients with varicoceles should routinely be evaluated for the presence of left renal vein entrapment before surgical repair.


Assuntos
Veias Renais , Varicocele/cirurgia , Adulto , Constrição Patológica/diagnóstico por imagem , Humanos , Masculino , Estudos Prospectivos , Recidiva , Veias Renais/diagnóstico por imagem , Ultrassonografia Doppler em Cores
16.
J Ultrasound Med ; 23(5): 631-7; quiz 638-9, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15154529

RESUMO

OBJECTIVE: To assess dynamic intraurethral sonography in the diagnostic evaluation of the function of the rhabdosphincter in female patients with urinary stress incontinence in relation to patient age. METHODS: Sixty-two patients with clinically proved urinary stress incontinence were investigated by means of intraurethral sonography with a 12.5-MHz endoluminal 9F catheter. The omega-shaped rhabdosphincter was visualized at rest and during voluntary contractions. Changes of muscle thickness and transducer-sphincter distance were measured and considered as parameters of muscle function. The intraurethral sonographic data were compared with results of standard urodynamic tests. RESULTS: Transducer-sphincter distance and sphincter muscle thickness showed a significant decrease with positive linear dependency on patient age (P < .001). Patients with grade III urinary stress incontinence had complete loss of sphincter contractility. A negative correlation was revealed between urethral closure pressure and patient age. CONCLUSIONS: We found an age-related decrease in rhabdosphincter function. Our results suggest that the rhabdosphincter is a substantial component of the continence mechanism in female urinary stress incontinence. Unlike urethral pressure profiles, which can only reveal zones of higher intraluminal pressure, transurethral sonography is highly specific for measurement of the function of the rhabdosphincter.


Assuntos
Uretra/fisiopatologia , Incontinência Urinária por Estresse/fisiopatologia , Adulto , Fatores Etários , Idoso , Envelhecimento/fisiologia , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Diafragma da Pelve/fisiologia , Pressão , Ultrassonografia , Uretra/diagnóstico por imagem , Cateterismo Urinário , Incontinência Urinária por Estresse/diagnóstico por imagem , Urodinâmica
17.
J Ultrasound Med ; 23(3): 331-7, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15055779

RESUMO

OBJECTIVE: To assess the value of 2 transducer positions for measurement of finger flexor tendon thickness by sonography. METHODS: Flexor tendon thickness of the third finger was measured sonographically by 2 independent investigators in 20 healthy volunteers (n = 40 fingers) and in 4 cadaveric specimens (n = 4 fingers). Flexor tendon thickness was measured at histologic examination in the cadaveric specimens. We defined the area of the A1 annular pulley as position I and the area of the A2 annular pulley as position II. Sonographic measurements were performed in transverse (dorsovolar and radioulnar) and longitudinal planes. Interobserver and intraobserver variabilities were evaluated by each investigator performing 3 measurements at each position. RESULTS: In position I, volunteers had flexor tendon thickness of 2.7 to 4.0 mm (mean +/- SD, 3.28 +/- 0.26 mm) longitudinally; transversally the thickness was 2.5 to 4.0 mm (mean, 3.34 +/- 0.29 mm) dorsovolar and 5.5 to 8.9 mm (mean, 7.34 +/- 0.71) radioulnar in position I. Position II revealed thickness of 3.2 to 4.2 mm (mean, 3.6 +/- 0.23 mm) longitudinally; transversally the thickness was 2.7 to 4.1 mm (mean, 3.4 +/- 0.27) dorsovolar and 4.3 to 6.8 mm (mean, 5.27 +/- 0.65) radioulnar. Interobserver and intraobserver variability for position I was better than for position II (P < .01 versus P < .05). Sonographic findings correlated excellently with histologic findings (r2 = 0.94). CONCLUSIONS: Standardized transducer positions for sonographic measurements of finger flexor tendon thickness showed good interobserver and intraobserver variability. Position I was found to be more reliable than position II.


Assuntos
Dedos/diagnóstico por imagem , Tendões/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Transdutores , Ultrassonografia
19.
Crit Rev Comput Tomogr ; 44(5): 263-78, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14669846

RESUMO

OBJECTIVE: The aim of this study was to identify recognizable landmarks on coronal CT (CCT) scans for the localization of the anterior and posterior ethmoid arteries, which are important anatomic structures and surgical landmarks within the ethmoid sinuses. MATERIALS AND METHODS: Four series of plastinated cadaver specimens and 80 CCT examinations were evaluated to identify the anatomical landmarks that define the course of the anterior and posterior ethmoid arteries within the ethmoid sinuses. RESULTS: The following anatomic landmarks: the indentations into the medial orbital wall, the relationship between the superior oblique and medial rectus orbital muscles, and the lateral ethmoid fovea wall thinning proved to be useful CCT landmarks for the localization of the anterior and posterior ethmoid arteries. CONCLUSION: The results of this study suggest that familiarity with the above-mentioned landmarks on routine CCT images facilitates the localization of the anterior and posterior ethmoid arteries as they enter the ethmoid sinus.


Assuntos
Seio Etmoidal/irrigação sanguínea , Órbita/irrigação sanguínea , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia , Artérias/anatomia & histologia , Criança , Seio Frontal/irrigação sanguínea , Humanos , Pessoa de Meia-Idade
20.
Eur Radiol ; 13(8): 1872-5, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12942287

RESUMO

Primary brachial plexus tumors are rare, usually benign, and in general have a good prognosis after surgical excision. We present a case of a schwannoma in which sonography enabled the correct diagnosis of a probably benign brachial plexus tumor. Key to the diagnosis was the demonstration of a smooth-bordered, longish, and well-defined nodule along a brachial plexus nerve root. Cross-sectional imaging modalities that provide a high degree of soft tissue contrast and spatial resolution, such as sonography and MR imaging, were suitable methods to establish the correct preoperative diagnosis. Findings at CT, sonography, MR imaging, and surgery are discussed.


Assuntos
Plexo Braquial , Neurilemoma/diagnóstico , Neoplasias do Sistema Nervoso Periférico/diagnóstico , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Neurilemoma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia
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