Marcio Ricardo Taveira Garcia

Aneurisma da artéria carótida interna extracraniana: relato de caso

Os aneurismas verdadeiros da arteria carotida interna extracraniana sao raros, ao contrario dos supraclinoideos, somando menos de 4% dos aneurismas perifericos. Eles se apresentam clinicamente como massas palpaveis cervicais, junto a margem inferior do ângulo da mandibula, causando rouquidao, disfagia e dor por compressao nervosa. Ha frequente associacao desta doenca com outros aneurismas perifericos devido a sua etiologia principal (aterosclerose). Os aneurismas perifericos sao comumente identificados a ultra-sonografia Doppler, quando na vigencia de janela acustica adequada. Nesta situacao, os aneurismas podem ser avaliados tanto morfologica como hemodinamicamente. Sua identificacao e estudo sao importantes para prevenir graves complicacoes, como tromboses, infartos macicos ou embolicos da area correspondente no sistema nervoso central, ruptura e disseccao, alem de auxiliar na indicacao da melhor conduta terapeutica.

Timo: caracterização ultra-sonográfica

O timo e uma pequena glândula responsavel pela producao de linfocitos T, importante na resposta imunitaria do organismo. E orgao relativamente grande no periodo perinatal e pode estender-se superiormente, atingindo o pescoco, com variantes anatomicas. E possivel identificar o timo normal, por meio da ultra-sonografia, pelo acesso supra-esternal, paraesternal e esternal e tambem na regiao cervical quando em localizacao atipica. A partir do inicio da puberdade, devido a sua involucao com diminuicao progressiva do seu tamanho e porque o pulmao aerado se interpoe entre o timo e o feixe sonoro, a sua visualizacao e mais dificil. O padrao da ecotextura normal timica e caracteristica: hipoecogenico em relacao ao parenquima normal da tireoide e apresenta multiplas estruturas ecogenicas lineares e focais, dispersas pelo parenquima, que correspondem aos septos e vasos sanguineos. O reconhecimento pela ultra-sonografia de tecido timico pode ser importante para evitar investigacoes desnecessarias ou cirurgias num timo normal que mimetiza massa patologica.

Aspectos de imagem na tendinite calcária pré-vertebral

Acute calcific prevertebral tendinitis is a benign and rare condition that presents calcification of the superior oblique fibers of longus colli muscle with local inflammatory reaction. Such condition is one of the less common presentations of calcium hydroxyapatite deposition disease. Clinical signs are usually acute neck pain and odynophagia, and it may be misdiagnosed as retropharyngeal abscess, spondylodiscitis or traumatic injury. The imaging findings in calcific prevertebral tendinitis are pathognomonic. The knowledge of such findings is extremely important to avoid unnecessary interventions in a patient presenting a condition with a good response to conservative treatment.

Postsurgical Imaging of the Oral Cavity and Oropharynx: What Radiologists Need to Know-Erratum.

Radiologists’ understanding of the postsurgical findings and complex techniques of reconstruction of the oral cavity and oropharynx allows early diagnosis of tumor recurrence or typical postsurgical complications.

Lesões expansivas do plexo coróide

As lesoes expansivas do plexo coroide constituem um grupo bastante amplo e heterogeneo de doencas e seus simuladores. Tumores, infeccoes, anomalias congenitas, hemorragias, cistos e fenomenos degenerativos sao alguns dos exemplos de causas de lesoes expansivas do plexo coroide. No presente trabalho fizemos revisao da literatura pertinente, descrevendo os achados de imagem e ilustrando-os com alguns casos do nosso servico. Apesar de nao existir na literatura descricao de sinais patognomonicos, a avaliacao criteriosa e sistematica das caracteristicas das lesoes pode sugerir determinada etiologia.

Analysis of the blood supply to the post-fracture edentulous mandible: study by colour Doppler sonography

PurposeThis study assessed the arterial blood supply to the mandible of edentulous patients treated for mandibular fractures using colour Doppler ultrasound.MethodsThe blood supply of edentulous patients surgically treated for mandibular fractures (group A) and edentulous fracture-free individuals (group B) was assessed. Only the fractured sides were evaluated in the first group (N = 17), whereas each side was evaluated in the second group (N = 20). The arterial flow of six sites was assessed. The systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI), acceleration and flow direction of each artery were obtained. Additionally, the presence of local vascular obstructive factors was evaluated. The differences between groups were analysed using the Kruskal-Wallis test, which was complemented by the Mann-Whitney test, for correlations between the degree of alveolar atrophy and the study factors (p < 0.050).ResultsThere was a significant decrease in the flow of certain arteries, especially the submental (SPV, p = 0.007, PI, p = 0.022, and acceleration, p = 0.015), in the fracture group. The facial artery in both groups showed lower values related to local obstructive factors (SPV, p = 0.001, FDV, p = 0.040, and PI, p = 0.030). The submental artery flow was higher (SPV, p = 0.006, and FDV, p = 0.009) in non-atrophic individuals.ConclusionsThere was a decreased flow mainly in the submental artery, but there were no cases of major vascular injury in edentulous patients treated for mandibular fractures.

Eosinophilic Solid and Cystic Renal Cell Carcinoma: Imaging Features of a Novel Neoplasm

Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) is a recently described entity with distinct clinical, pathologic, and molecular features. However, the radiological aspects of ESC RCC have not been characterized. In this report, we describe the imaging findings of 2 ESC RCCs. We found 2 distinct imaging patterns that varied depending on histopathologic features (solid or cystic predominance). In conclusion, it is important to know the imaging characteristics and pathologic correlation of this novel neoplasm to increase its recognition and to improve the decision-making process.