Arthur Soares Souza Junior

Consenso brasileiro ilustrado sobre a terminologia dos descritores e padrões fundamentais da TC de tórax

The objective of this new Brazilian consensus is to update and to continue the standardization of the principal terms and fundamental patterns in chest CT scans in Portuguese. There is a succinct definition of the principal terms used to describe chest CT findings, as well as illustrations of classic examples. The group of authors comprised radiologists specializing in chest radiology and holding membership in the Brazilian College of Radiology and Diagnostic Imaging, as well as pulmonologists having a special interest in diagnostic imaging and holding membership in the Brazilian Thoracic Association.

Consenso Brasileiro sobre a Terminologia dos Descritores de Tomografia Computadorizada do Tórax

JORGE L PEREIRA-SILVA PRESIDENTE Faculdade de Medicina da Universidade Federal da Bahia. JORGE KAVAKAMA VICE-PRESIDENTE Faculdade de Medicina da Universidade de São Paulo. MÁRIO TERRA FILHO SECRETÁRIO Faculdade de Medicina da Universidade de São Paulo. NELSON DA S. PORTO PRESIDENTE DE HONRA Universidade Federal do Rio Grande do Sul. ARTHUR SOARES SOUZA JÚNIOR Faculdade de Medicina de São José do Rio Preto. EDSON MARCHIORI Universidade Federal Fluminense. CÉSAR DE ARAÚJO NETO Faculdade de Medicina da Universidade Federal da Bahia. MARCELO CHAVES Faculdade de Medicina da Universidade de São Paulo. KLAUS L. IRION Universidade Federal do Rio Grande do Sul. DANY JASINOVODOLINSK Universidade Federal de São Paulo. PEDRO DALTRO Clínica de Diagnóstico por Imagem do Centro Médico Barrashopping. LUIZ FELIPE NOBRE Faculdade de Medicina de Santa Catarina. MARCELO FUNARI Faculdade de Medicina da Universidade de São Paulo. DANTE L. ESCUISSATO Universidade Federal do Paraná.

Edema pulmonar hidrostático: aspectos na tomografia computadorizada de alta resolução

Objective: This study aimed to use high-resolution computed tomography scans of the chest to characterize the principal alterations occurring in cases of hydrostatic pulmonary edema. Methods: A retrospective analysis was made of the tomography scans of 15 patients presenting clinical profiles of hydrostatic pulmonary edema. The cases were divided into five groups by etiology: congestive heart failure (n = 7); acute mitral valve disease (n = 2); acute myocardial infarction (n = 2); myocarditis (n = 2); and fibrosing mediastinitis (n = 2). Results: The principal findings in the cases of hydrostatic pulmonary edema were ground-glass opacities (in 100%), interlobular septal thickening (in 100%), pleural effusion (in 87%) and peribronchovascular interstitial thickening (in 80%). Other, less common, findings were increased blood vessel diameter, consolidations and air-space nodules. Conclusion: The predominant pattern found in the patients studied was that of ground-glass opacities accompanied by interlobular septal thickening (mosaic attenuation pattern) and bilateral (predominantly right-sided) pleural effusion.

Alterações difusas da traquéia: aspectos na tomografia computadorizada

The aim of this pictorial essay was to present the main computed tomography findings seen in diffuse diseases of the trachea. The diseases studied included amyloidosis, tracheobronchopathia osteochondroplastica, tracheobronchomegaly, laryngotracheobronchial papillomatosis, lymphoma, neurofibromatosis, relapsing polychondritis, Wegeners granulomatosis, tuberculosis, paracoccidioidomycosis, and tracheobronchomalacia. The most common computed tomography finding was thickening of the walls of the trachea, with or without nodules, parietal calcifications, or involvement of the posterior wall. Although computed tomography allows the detection and characterization of diseases of the central airways, and the correlation with clinical data reduces the diagnostic possibilities, bronchoscopy with biopsy remains the most useful procedure for the diagnosis of diffuse lesions of the trachea.

Linfomas pulmonares: avaliação por tomografia computadorizada

This paper describes the tomographic appearance of pulmonary lymphomas. We studied the thoracic computed tomographies of ten patients with biopsy-proven diagnoses non-Hodgkins and Hodgkins disease. The most common radiologic findings in this series are the alveolar opacities with air bronchograms (n=8). Other manifestations include multiple pulmonary nodules (n=4), thickening of broncho-vascular bundles (n=3) and foci of ground-glass attenuation (n=2). The present series confirms the results published in available literature about the radiographic appearance of the disease.

Curso de diagnóstico por imagem do tórax Capítulo VI - Diagnóstico por imagem na bronquiectasia

bronquiectasia, e importante o conhecimento dos achadosque podem levar a suspeita desta doenca.Como os trajetos dos bronquios e dos ramos da arteriapulmonar sao contiguos e paralelos, a inflamacao peribron-quica torna os contornos dos vasos menos nitidos, particu-larmente nas bases. Pode ocorrer associacao com reducaovolumetrica. Quando a inflamacao se agrava e ocorre fibro-se, as paredes bronquicas se tornam visiveis, formando li-nhas paralelas (trilhos de trem), que podem ser melhor apre-ciadas nas regioes basais na radiografia do torax em

Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

OBJECTIVE: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). METHODS: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Students t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. RESULTS: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively) CONCLUSIONS: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy.

Curso de diagnóstico por imagem do tórax: Capítulo II - Imagenologia da pleura

mento for curto e largo, o derrame sera subpulmonar, pois opulmao flutuara livremente na superficie do liquido.A radiografia em decubito lateral com raios horizontais(fig. 1) e mais sensivel do que a em posicao ortostatica parao diagnostico de derrame pleural e pode demonstrar colecaopleural de 5ml. Com o paciente em posicao supina (fig. 1)Os diferentes metodos de imagem tem papel importanteno diagnostico e na conduta nas doencas da pleura. A radio-grafia do torax continua sendo o primeiro metodo para ava-liacao das anormalidades da pleura e, dependendo da evolu-cao clinica, podemos lancar mao da tomografia computado-rizada

Curso de diagnóstico por imagem do tórax: capítulo V - imagem da embolia pulmonar

. Em cada episodioe comum a liberacao de multiplos embolos, que geralmentese alojam em ramos da arteria pulmonar, sendo mais co-muns a direita. Raramente, o embolo cavalga a bifurcacaodo tronco da arteria pulmonar (embolo em sela) ou tem ori-gem em câmaras cardiacas direitas (Figura 1) e cerca de 15%dos pacientes com embolia pulmonar apresentam infarto ver-dadeiro