Imagiologia
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- Induced pneumoperitoneum in CT evaluation of peritoneal carcinomatosisPublication . Caseiro-Alves, F; Gonçalo, Manuela; Abraúl, E; Pinto, E; Oliveira, CF; Vilaça-Ramos, HBACKGROUND: Imaging of peritoneal carcinomatosis is a well-known problem even for technologies as recent as computed tomography (CT). The purpose of this study was to evaluate whether CT performed after induced pneumoperitoneum (CT-PP) could have a higher sensitivity in the detection of peritoneal implants over conventional CT. METHODS: Five patients with known ovarian malignancies underwent standard CT and CT-PP. Exploratory laparotomy was performed with a maximum interval of 7 days from the last imaging procedure. Results were prospectively compared with surgical findings on a compartment to compartment basis. RESULTS: CT-PP was well-tolerated with no serious adverse reactions registered. The anterior and visceral peritoneum, the paracolic gutters and subphrenic areas were particularly well depicted but not the pelvis which was poorly evaluated in all cases. CT-PP detected all the three cases where peritoneal carcinomatosis was present even when metastatic nodules were smaller than 2 mm; it also showed intraabdominal adhesions in two patients, an important finding that precludes the use of intraperitoneal chemotherapy. CONCLUSIONS: With CT-PP there seems to be a reduction in the threshold of detectability of peritoneal implants. The direct demonstration of intraperitoneal adhesions is an important secondary finding. Disadvantages of CT-PP are (1) it is a time-consuming method and (2) it does not evaluate all the peritoneal recesses potentially involved in peritoneal carcinomatosis.
- Produits de contraste en imagerie par résonance magnétique du foiePublication . Alexandre, M; Coffin, C; Caseiro-Alves, F; Mathieu, D
- Umbilical hernia of stomachPublication . Sampaio, R; Ferreira, MHerniation of the stomach through the umbilicus is exceedingly rare with only one case reported in the international literature in the past 40 years. One case of a reducible gastric umbilical hernia, not diagnosed by endoscopy, is reported. Diagnosis was made by double-contrast barium examination after 5 years of symptoms and ineffective treatment. Herniation of the stomach is difficult to diagnose by endoscopy and radiological studies can be more sensitive and allow a more specific diagnosis.
- Water enema computed tomography (WE-CT) in the local staging of low colorectal neoplasms: comparison with transrectal ultrasoundPublication . Caseiro-Alves, F; Gonçalo, Manuela; Ilharco, J; Agostinho, A; Castro e Sousa, F; Vilaça-Ramos, HBACKGROUND: To determine the accuracy of computed tomography performed with a water enema application (WE-CT) in the local staging of low colorectal neoplasms and to compare the results with those of transrectal ultrasonography (TRUS). METHODS: Forty patients with low colorectal tumors were evaluated prospectively by CT with the simultaneous administration of a lukewarm rectal enema (0.5-1.5 L). Thin slices (5 mm) and intravenous application of iodinated contrast media were routinely used. TRUS was performed in 18 patients. Tumor size, location, and staging according to the TNM classification of the UICC were registered. Tumors were classified as < T3 (T1 or T2) or as T3 or T4. For staging peritumoral lymph node metastases on WE-CT, two criteria of positivity were tested: N+ if at least one peritumoral node > or 5 mm in diameter was seen (reading A); N+ if at least one peritumoral node > or = 5 mm or three peritumoral nodes < 5 mm were identified (reading B). RESULTS: For the tumor staging, WE-CT showed a sensitivity of 90%, a specificity of 73%, a positive predictive value (PPV) of 90%, a negative predictive value (NPV) of 73%, and an accuracy of 85%. For TRUS, the results were sensitivity of 73%, specificity of 29%, PPV of 62%, NPV of 40%, and an accuracy of 39%. Concerning nodal staging with WE-CT, results were superior when reading A was used: sensitivity = 84%, specificity = 83%, PPV = 73%, NPV = 91%, and accuracy = 84%. TRUS showed a sensitivity of 29%, specificity of 100%, PPV of 100%, NPV of 67%, and an accuracy of 71%. CONCLUSION: WE-CT is a reliable technique for the local staging of low colorectal tumors that can be superior to TRUS. For diagnosis of peritumoral metastatic lymph nodes on WE-CT, the 5-mm diameter cutoff value is the most appropriate size criterion.
- Diagnostic value of ultrasound and color doppler in identifying axillary lymph node metastases in patients with breast cancer: preliminary resultsPublication . Couto, D; Dias, M; Gonçalo, Manuela; Oliveira, CF
- Two Cases of Bronchopulmonary Sequestration in Adult Life: Cross-sectional Imaging with Emphasis on Angio-CTPublication . Donato, P; Teixeira, L; Melo, TB; Maravilha, S; Ilharco, J; Caseiro-Alves, F
- Sclerosis of gross cysts of the breast: a three-year studyPublication . Gomes, C; Amaral, N; Marques, C; Borralho, R; Oliveira, CFBreast cysts can be separated into two types: Type I cyst with a lining epithelium which shows apocrine metaplasia, and Type II cyst with an epithelium which is markedly attenuated or absent. The risk of subsequent breast cancer among patients with Type I cysts can be up to 4. The standard treatment is fine needle aspiration, but 20% of the cysts recur. Pharmacological treatment has been tried, which reduces size and volume, but has side-effects and a high recurrence rate post-treatment occurs. The objectives of this prospective study were to sclerose the cyst, induce its regression and prevent or reduce recurrence rate, with the administration of a sclerosing solution (Sclerovein) within the cyst post-aspiration. Fifty-seven patients were followed in the study, 37 with Type I cysts and 20 with Type II cysts. At the end of six months all patients with Type II cysts had no detectable cyst. On the other hand, two patients still had a residual Type I cyst. At the end of three years our recurrence rate appears to be less than 2%, with one patient with a possible recurrence. No significant side-effects were observed. The use of Sclerovein is a simple and safe alternative in the treatment of recurring cysts.
- Contrast-enhanced MR angiography of thoracic vascular malformations in a pediatric population.Publication . Caseiro-Alves, F; Gil-Agostinho, P; Ramalheiro, G; Gil-Agostinho, P
- Fusão lunato-triquetral sintomática: caso clínicoPublication . Teixeira, L; Quental, J; Brito, J; Néri, A; Teixeira, J; Caseiro-Alves, F; Nascimento, A
- Imaging of benign liver lesionsPublication . Mathieu, D; Caseiro-Alves, F