Radiologia Brasileira最新文献

A typical approach for many cardiovascular surgical procedures is median sternotomy. Despite advances in surgical techniques and postoperative care, complications still occur in 0.5-5.0% of cases. Radiological assessment of the chest after sternotomy is a challenge, because normal findings resulting from surgical trauma can resemble complications. This pictorial essay aims to provide an overview of normal postoperative imaging findings and the spectrum of complications that can arise, including surgical material-related issues, hematomas, bone complications, and infections. Diagnosis and management require careful interpretation of imaging studies, considering the recovery timeline and clinical status of the patient. With the increasing number of cardiothoracic surgical procedures, this is essential knowledge for radiologists, allowing them to contribute to an accurate diagnosis and the appropriate management of patients.

Objective: To investigate the accuracy of magnetic resonance imaging (MRI) in classifying sonographically indeterminate ovarian and adnexal masses.

Materials and methods: This was a retrospective cross-sectional study of the unenhanced pelvic MRI scans of 243 patients with a collective total of 336 adnexal and ovarian masses.

Results: Unenhanced MRI showed a sensitivity of 97.7%, a specificity of 86.4%, and an accuracy of 93.8%. The area under the ROC curve was 0.944 (95% CI: 0.913-0.974).

Conclusion: Our results show that an unenhanced MRI protocol can be used to classify adnexal masses, especially in clinical settings in which the intravenous administration of gadolinium-based contrast is not safe and should be avoided.

The middle cerebellar peduncle (MCP) is the largest afferent system of the cerebellum and consists of fibres from the cortico-ponto-cerebellar tract. Specifically, several relevant diseases can present with hyperintensity in the MCP on T2-weighted/fluid-attenuated inversion recovery (T2/FLAIR) magnetic resonance imaging sequences, including multiple sclerosis; acute disseminated encephalomyelitis; neuromyelitis optica spectrum disorder; progressive multifocal leucoencephalopathy; hepatic encephalopathy; osmotic demyelination syndrome; multiple system atrophy; fragile X-associated tremor/ataxia syndrome; megalencephalic leucoencephalopathy with subcortical cysts; spinocerebellar ataxias; hemi-pontine infarct with trans-axonal degeneration; and diffuse midline glioma with the histone H3K27M mutation. The aim of this pictorial review is to discuss the imaging findings that are relevant for the differential diagnosis of diseases presenting with MCP hyperintensity on T2/FLAIR sequences. Such knowledge is of utmost importance for the practicing radiologist.

Objective: To identify and analyze the main findings on computed tomography (CT) scans ordered in the emergency department of a tertiary care hospital.

Materials and methods: This was a cross-sectional observational study conducted through analysis of CT scans of the head, chest, and abdomen of all patients admitted to the emergency department of a tertiary care hospital over a period of four months.

Results: Among a sample of 331 patients, pathological radiological findings were observed in 59.2%, with the highest number of alterations being observed on abdominal CT, followed by chest CT. The most prevalent findings were as follows: in the abdomen-obstructive uropathy (in 12.2%), pyelonephritis (in 6.4%), cholecystitis (in 5.8%), and enterocolitis (in 5.8%); in the chest-pneumonia (in 23.7%), pleural effusion (in 12.9%), and pulmonary contusion (in 5.4%); and in the head-extracranial soft tissue edema (in 11.9%), stroke (in 10.7%), and brain contusion (in 7.9%).

Conclusion: Our findings demonstrate the importance of using CT for proper diagnosis and clinical management in emergency departments. Our data also contribute to establishing the most prevalent radiological findings in each anatomical region, thus promoting rapid, efficient clinical practice in emergency settings.

Sclerosing bone dysplasias encompass abnormalities in bone density, divided into hereditary and nonhereditary forms. Primarily diagnosed through radiography, they are often incidental findings. Among the hereditary forms, the following stand out: osteopetrosis, osteopoikilosis, multiple diaphyseal sclerosis (ribbing disease), osteopathia striata, and Camurati-Engelmann disease. Among the nonhereditary forms, intramedullary osteosclerosis and melorheostosis present specific radiographic characteristics. The main differential diagnoses include osteoblastic metastases, tuberous sclerosis, and renal osteodystrophy, requiring careful differentiation because of their similarities.

Magnetic resonance imaging is an essential tool for the assessment of the scrotum, particularly in cases with inconclusive ultrasound findings. It has a great capacity to differentiate between intratesticular and extratesticular lesions, as well as between neoplastic and non-neoplastic lesions. By providing an accurate characterization of lesions, magnetic resonance imaging plays a crucial role in preoperative tumor staging and decision-making. This pictorial essay highlights the key non-neoplastic and neoplastic testicular pathologies, as evaluated by magnetic resonance imaging. The recognition of these pathologies underscores the role the radiologists play in the care of patients with scrotal lesions, by providing an appropriate evaluation of the relevant imaging characteristics.

Objective: To assess the prevalence of changes on computed tomography (CT) in Graves' orbitopathy (GO) and to correlate those changes with disease activity, as well as with clinical and biochemical variables.

Materials and methods: This was a retrospective study, conducted at a tertiary hospital, of clinical, biochemical, and imaging data from consecutive patients with GO who underwent at least one orbital CT scan between July 2012 and December 2020. A single observer quantified the thickness of the extraocular muscles and the degree of proptosis. Clinical and biochemical variables were analyzed to determine whether they correlated with CT changes, GO activity, and GO severity.

Results: Our sample included data from 67 patients with GO (134 orbits), 50 (74.6%) of whom were female. There were positive correlations between the clinical activity score and increase in thyroid-stimulating factor/free thyroxine, between the severity of GO and the increase in the thickness of the extraocular muscles, and between the degree of proptosis and muscle thickness.

Conclusion: Orbital CT proved effective in detecting thickening of the extraocular muscles and proptosis in patients with GO, changes that correlated significantly with clinical and biochemical variables. Muscle thickening was associated with the severity of GO and could be a biomarker of the risk of vision loss.