Ana Cláudia Ferreira Rosa

Hemangiomas hepáticos: aspectos ultra-sonográficos e clínicos

Hemangiomas are the most common benign tumors of the liver, occurring in all age groups, and more frequently in adults. The vast majority of hemangiomas are small, asymptomatic, and are incidentally discovered. Larger lesions may eventually produce symptoms. The sonographic aspect of these tumors varies, the lesions being typically small, well defined and hyperechoic. In this study the authors review clinical and sonographic features of hemangiomas, highlighting the clinical significance of such features to be taken into consideration in the treatment of affected patients.

Aspectos ultra-sonográficos da trombose da veia porta

Portal vein thrombosis may be associated with many alterations, such as the presence of tumors (for example, hepatocellular carcinoma, metastatic liver disease and carcinoma of the pancreas) as well as pancreatitis, hepatitis, septicemia, trauma, splenectomy, portacaval shunts, hypercoagulable conditions (for example, pregnancy), in neonates (for example, omphalitis and umbilical vein catheterization) and in acute dehydration. The authors discuss herein the sonographic features of portal vein thrombosis as well as some aspects of clinical relevance.

Avaliação dos tumores hepáticos ao Doppler

Os avancos recentes na ultra-sonografia tem ampliado a possibilidade de deteccao de tumores hepaticos. Isto tem auxiliado na perspectiva de melhora do prognostico destes pacientes, a medida que novas tecnicas terapeuticas tem surgido. Neste artigo os autores relatam achados ao Doppler que podem auxiliar na identificacao e caracterizacao dos tumores hepaticos, avaliando dados do Doppler colorido, pulsado e do Doppler de amplitude (power Doppler). Fazem, tambem, referencia a novas modalidades de imagem, como o uso da harmonica.

História da ultra-sonografia intra-operatória

A ultra-sonografia intra-operatoria foi realizada especialmente a partir de 1960, com alguns relatos de experiencias iniciais nos anos 50. Inicialmente foram avaliados tumores cerebrais, posteriormente estudando-se tambem calculos de vias biliares e calculos renais. Entretanto, a ultra-sonografia intra-operatoria em modo A ou modo B estatico nao adquiriu grande aceitacao no meio medico. Nao obstante, os primeiros estudos forneceram as bases para o desenvolvimento da moderna ultra-sonografia intra-operatoria, com a utilizacao dos equipamentos ultra-sonograficos em modo B em tempo real. Os autores discorrem sobre a utilizacao da ultra-sonografia intra-operatoria desde o seu inicio ate os dias atuais.

Ultra-sonografia endoscópica (USE) do esôfago, estômago, cólons e reto

The authors review the main applications of endoscopic ultrasonography in the management of diseases of the esophagus, stomach, colon and rectum. The methodology and the main findings at endoscopic ultrasonography are discussed as well as ultrasound findings of malignant and benign diseases of the esophagus, stomach, colon and rectum.

Avaliação dos insulinomas pela ultra-sonografia intra-operatória: estado atual do tema

Os autores fazem uma revisao da literatura sobre a utilizacao da ultra-sonografia intra-operatoria para a avaliacao dos insulinomas pancreaticos. Sao referidos os resultados da ultra-sonografia intra-operatoria, ultra-sonografia e tomografia computadorizada realizadas no pre-operatorio, e os resultados da inspecao e palpacao do pâncreas realizadas durante procedimentos cirurgicos referidos na literatura.

PANCREATITE AGUDA LEVE: AVALIAÇÃO PELA ULTRA-SONOGRAFIA. ESTUDO PROSPECTIVO*

We analyzed the ultrasonographic findings of 21 patients with mild acute pancreatitis. The presence or absence of pancreatic hypoechogenicity and peripancreatic fluid collection was assessed. Pancreatic hypoechogenicity was identified in 19 patients (90.5%) whereas small sac fluid collection was identified in 3 (15.8%) of these patients. No abnormality was seen in 2 patients (9.5%). Regarding the etiology of acute pancreatitis, cholelithiasis was identified in 15 patients (71.5%), alcohol abuse was identified in 4 patients (19.0%), and in 2 patients (9.5%) no probable etiology could be found. The authors conclude that ultrasonography may identify abnormalities in the majority of patients with mild acute pancreatitis and can be used to assess patients with peripancreatic fluid collections.

Envolvimento hepático na sarcoidose: relato de caso

Sarcoidosis is an inflammatory disease whose etiology remains unknown. It is characterized by the formation of non-caseating granulomas and adenopathy, mainly in the pulmonary interstice. This is a systemic disease that may affect any organ or system and should be included in the differential diagnosis of infectious, neoplastic or autoimmune diseases as a correct diagnosis avoids unnecessary surgeries or administration of drugs. The authors report a case of pulmonary sarcoidosis with hepatic involvement in which the patient has developed cirrhosis and portal vein thrombosis.

Avaliação ultra-sonográfica e ao Doppler dos TIPS (anastomose portossistêmica intra-hepática transjugular)

Transjugular intrahepatic portosystemic shunts (TIPS) are the most recent and popular technique for the relief of symptomatic portal hypertension, particularly in patients with varices and gastrointestinal bleeding and less often in patients with refractory ascites. TIPS may be complicated by stenosis or occlusion of the stent. Sonography with Doppler provides a noninvasive method for monitoring patients with TIPS. The authors report the recent sonographic and Doppler findings in patients with normal functioning TIPS and patients with stenosis or occlusion of TIPS.

Coleção líquida adjacente ao ligamento falciforme em pacientes no pós-operatório imediato de transplante de fígado: achado ultra sonográfico normal ou anormal? Estudo prospectivo

Liver transplantations are increasingly being performed, thus requiring accurate evaluation of related complications. Ultrasonography is the first screening technique for the detection of complications of liver transplantation. The authors report the finding of fluid collection around the falciform ligament in the immediate postoperative period of liver transplantation in patients with no signs of intraabdominal sepsis. This finding was observed in 33 (94.3%) of the 35 patients evaluated. The authors consider this finding to be a normal occurrence in the immediate postoperative period of liver transplantation.