Correlation between chest computed tomography findings and pulmonary function test results in the post-recovery phase of COVID-19.

OBJECTIVE: The radiological and functional lung sequelae in COVID-19 survivors remain unclear. We compared the chest computed tomography findings of COVID-19 patients with normal and abnormal pulmonary function test results in the post-recovery phase. METHODS: The data of consecutive patients who underwent pulmonary function tests and chest computed tomography within 14 days after recovery from COVID-19 at two medical centers between May and October 2020 were collected retrospectively. Two thoracic radiologists who were blinded to the clinical information and pulmonary function test results classified the patients according to the computed tomography features, evidence of fibrotic-like changes, and semi-quantitative quantification of the extent of pulmonary abnormalities. The clinical characteristics and computed tomography findings of patients with normal pulmonary function test results were compared with those of patients with abnormal results. RESULTS: A total of 101 COVID-19 survivors, comprising 48 ambulatory and 53 hospitalized patients, were included at a median of 95 days from initial symptom onset. Computed tomography revealed fibrotic-like changes in 10.9% of patients. A reduction in the diffusion capacity of carbon monoxide was the most common lung function abnormality (19.8%). Abnormal diffusion capacity of carbon monoxide was associated with the presence and extension of lung opacities on chest computed tomography scans and fibrotic pulmonary abnormalities. The sensitivity, specificity, and accuracy of reduced diffusion capacity of carbon monoxide for detecting fibrotic-like pulmonary changes on chest computed tomography scans were 72.7%, 87.8%, and 86.1%, respectively. CONCLUSION: Our study suggests that the presence of an abnormal diffusion capacity of carbon monoxide in the post-recovery phase of COVID-19 is associated with a greater risk of long-term parenchymal lung disease, as evidenced by the presence of fibrotic-like changes on chest computed tomography scans, such as traction bronchiectasis and architectural distortion.

Correlation between chest computed tomography findings and pulmonary function test results in the post-recovery phase of COVID-19

ABSTRACT Objective The radiological and functional lung sequelae in COVID-19 survivors remain unclear. We compared the chest computed tomography findings of COVID-19 patients with normal and abnormal pulmonary function test results in the post-recovery phase. Methods The data of consecutive patients who underwent pulmonary function tests and chest computed tomography within 14 days after recovery from COVID-19 at two medical centers between May and October 2020 were collected retrospectively. Two thoracic radiologists who were blinded to the clinical information and pulmonary function test results classified the patients according to the computed tomography features, evidence of fibrotic-like changes, and semi-quantitative quantification of the extent of pulmonary abnormalities. The clinical characteristics and computed tomography findings of patients with normal pulmonary function test results were compared with those of patients with abnormal results. Results A total of 101 COVID-19 survivors, comprising 48 ambulatory and 53 hospitalized patients, were included at a median of 95 days from initial symptom onset. Computed tomography revealed fibrotic-like changes in 10.9% of patients. A reduction in the diffusion capacity of carbon monoxide was the most common lung function abnormality (19.8%). Abnormal diffusion capacity of carbon monoxide was associated with the presence and extension of lung opacities on chest computed tomography scans and fibrotic pulmonary abnormalities. The sensitivity, specificity, and accuracy of reduced diffusion capacity of carbon monoxide for detecting fibrotic-like pulmonary changes on chest computed tomography scans were 72.7%, 87.8%, and 86.1%, respectively. Conclusion Our study suggests that the presence of an abnormal diffusion capacity of carbon monoxide in the post-recovery phase of COVID-19 is associated with a greater risk of long-term parenchymal lung disease, as evidenced by the presence of fibrotic-like changes on chest computed tomography scans, such as traction bronchiectasis and architectural distortion.

Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal.

Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.

Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal / Consenso de terminologia em radiologia torácica em português do Brasil e de Portugal

ABSTRACT Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.

RESUMO A comunicação eficiente entre a equipe médica é um fator importante no diagnóstico e tratamento precoce e adequado dos pacientes. A terminologia utilizada em relatórios de exames radiológicos aparece nesse contexto como um elo importante entre radiologistas e os demais integrantes da equipe médica. Portanto, a heterogeneidade no uso de termos em relatórios é importante mas ainda pouco discutida. Este artigo é resultado de uma extensa revisão da nomenclatura radiológica em radiologia torácica, englobando pela primeira vez termos utilizados em vários métodos (radiografia, TC e RM), desenvolvida por radiologistas brasileiros e portugueses. O objetivo desta revisão da terminologia médica foi criar uma linguagem padronizada para os profissionais médicos e as equipes multidisciplinares.

Pictorial Review of Thoracic Parasitic Diseases: A Radiologic Guide.

Parasitoses are infectious diseases of global distribution, with predominance in areas of poor sanitation. Parasites cause damage through direct tissue injury and the inflammatory response generated by their migration and establishment in various organs. Thoracic involvement by parasitic disease can generate both specific and nonspecific clinical, laboratorial, and radiologic manifestations, which often makes their diagnosis challenging. The correct diagnosis is crucial for definition of treatment, which sometimes requires rapid intervention. Based on a literature review of the last few decades, this article aimed to characterize the main radiologic findings related to thoracic manifestations of parasitic diseases, correlating them with radiographic and tomographic images of patients with confirmed diagnosis of such pathologies. The included parasitic diseases are malaria, Chagas disease, toxoplasmosis, amoebiasis, ascariasis, toxocariasis, strongyloidiasis, dirofilariasis, cysticercosis, echinococcosis, schistosomiasis, and paragonimiasis.

Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest.

PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of 18F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation.

PET/CT é amplamente utilizada para avaliação de pacientes com neoplasias torácicas. Altos níveis de captação de 18F-fluordesoxiglicose (FDG) são geralmente vistos em neoplasias, mas também podem ser fisiológicos, decorrentes de artefatos ou ocorrerem em condições benignas, como lesões infecciosas, inflamatórias e iatrogênicas. Por outro lado, alguns tumores malignos podem não captar FDG, como o adenocarcinoma in situ (anteriormente denominado de carcinoma bronquioloalveolar) e tumores carcinoides. Os autores ilustram as principais armadilhas e artefatos na interpretação dos exames torácicos de PET/CT oncológicos, com estratégias para evitar erros de interpretação.

Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest / Armadilhas e artefatos na interpretação de PET/CT na oncologia torácica

Abstract PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of 18F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation.

Resumo PET/CT é amplamente utilizada para avaliação de pacientes com neoplasias torácicas. Altos níveis de captação de 18F-fluordesoxiglicose (FDG) são geralmente vistos em neoplasias, mas também podem ser fisiológicos, decorrentes de artefatos ou ocorrerem em condições benignas, como lesões infecciosas, inflamatórias e iatrogênicas. Por outro lado, alguns tumores malignos podem não captar FDG, como o adenocarcinoma in situ (anteriormente denominado de carcinoma bronquioloalveolar) e tumores carcinoides. Os autores ilustram as principais armadilhas e artefatos na interpretação dos exames torácicos de PET/CT oncológicos, com estratégias para evitar erros de interpretação.

Aspects of bronchioloalveolar carcinoma and of adenocarcinoma with a bronchioloalveolar component: CT findings.

Bronchioloalveolar carcinoma has various presentations and a wide spectrum of imaging patterns, as does adenocarcinoma with a bronchioloalveolar component. The objective of this essay was to describe and illustrate the CT findings that are most characteristic of these tumors. Three presentations are described: solitary pulmonary nodule, consolidation, and diffuse pattern. The last two should be included in the differential diagnosis, together with infectious diseases. Knowledge of the various presentations and the use of proper diagnostic procedures are crucial to early diagnosis and to improving survival.

Treadmill exercise inducing mild to moderate ischemia has no significant effect on skeletal muscle or cardiac 18F-FDG uptake and image quality on subsequent whole-body PET scan.

We report the effects of treadmill exercise on (18)F-FDG uptake in skeletal muscles and image quality of torso PET and compare stress myocardial perfusion imaging patterns with myocardial (18)F-FDG uptake. There were 3 groups of patients: 48 patients underwent PET within 8 h after a treadmill test (Ex 8), 45 patients within 48 h after a treadmill test (Ex 48), and 34 patients without prior exercise. Mean workload (8.4 ± 2.3 [Ex 8] vs. 8.9 ± 2.6 metabolic equivalents [Ex 48]) was similar in both exercise groups. Muscle uptake was assessed by standardized uptake value. Myocardial uptake patterns were compared visually. Minor differences between patient groups were noted only for maximum standardized uptake value in quadriceps muscles. There was no correlation between perfusion defects and myocardial (18)F-FDG uptake patterns. Thus, treadmill exercise does not affect muscle (18)F-FDG uptake or image quality on subsequent PET. Cardiac (18)F-FDG uptake on torso PET scans is unrelated to myocardial perfusion status.

Aspectos tomográficos do carcinoma bronquíolo-alveolar e dos adenocarcinomas mistos com componente bronquíolo-alveolar / Aspects of bronchioloalveolar carcinoma and of adenocarcinoma with a bronchioloalveolar component: CT findings

O carcinoma bronquíolo-alveolar e os adenocarcinomas mistos com componente bronquíolo-alveolar têm apresentações variadas e múltiplos padrões por imagem. O objetivo deste ensaio foi descrever e ilustrar os achados mais característicos desses tumores em TC. São descritas três apresentações: nódulo pulmonar solitário, consolidação e apresentação difusa, sendo que as duas últimas são importantes no diagnóstico diferencial com acometimento infeccioso. O conhecimento das diversas apresentações e a utilização de propedêutica diagnóstica adequada são definitivos para o diagnóstico precoce e o aumento na sobrevida.

Bronchioloalveolar carcinoma has various presentations and a wide spectrum of imaging patterns, as does adenocarcinoma with a bronchioloalveolar component. The objective of this essay was to describe and illustrate the CT findings that are most characteristic of these tumors. Three presentations are described: solitary pulmonary nodule, consolidation, and diffuse pattern. The last two should be included in the differential diagnosis, together with infectious diseases. Knowledge of the various presentations and the use of proper diagnostic procedures are crucial to early diagnosis and to improving survival.

Thoracic manifestations of collagen vascular diseases.

Collagen vascular diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. The collagen vascular diseases that most commonly involve the lung are rheumatoid arthritis, progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and dermatomyositis, mixed connective tissue disease, and Sjögren syndrome. Interstitial lung disease and pulmonary arterial hypertension are the main causes of mortality and morbidity among patients with collagen vascular diseases. Given the broad spectrum of possible thoracic manifestations and the varying frequency with which different interstitial lung diseases occur, the interpretation of thoracic images obtained in patients with collagen vascular diseases can be challenging. The task may be more difficult in the presence of treatment-related complications such as drug toxicity and infections, which are common in this group of patients. Although chest radiography is most often used for screening and monitoring of thoracic alterations, high-resolution computed tomography can provide additional information about lung involvement in collagen vascular diseases and may be especially helpful for differentiating specific disease patterns in the lung. General knowledge about the manifestations of thoracic involvement in collagen vascular diseases allows radiologists to provide better guidance for treatment and follow-up of these patients.

Comparative study of clinical, pathological and HRCT findings of primary alveolar proteinosis and silicoproteinosis.

OBJECTIVE: To compare the clinical, high-resolution computed tomography (HRCT) and pathological findings of primary alveolar proteinosis (PAP) and silicoproteinosis. MATERIAL AND METHODS: The study included 15 patients with PAP (6 women, 9 men, mean age 31 years) and 13 with silicoproteinosis (13 men, mean age 29.5 years). PAP was diagnosed by lung biopsy in 13 and bronchoalveolar lavage in two patients and silicoproteinosis by bronchoalveolar lavage in 10 and autopsy in three cases. HRCT images were reviewed by two chest radiologists with consensus for the presence, extent and distribution of ground-glass opacities, septal thickening, consolidation and nodules. Radiological-pathological correlation was performed by one radiologist and one chest pathologist. RESULTS: Seven (46%) patients with PAP were asymptomatic; the remainder presented slowly progressive dyspnea and dry cough. All silicoproteinosis patients had dry cough and rapidly progressive dyspnea. The most common HRCT finding on PAP was the crazy-paving pattern (93%). All cases had areas of geographic sparing in the affected lung. The most common finding in silicoproteinosis (92%) was dependent consolidation with calcification in 83%. Centrilobular nodules were common (85%). On pathology, both diseases demonstrated intra-alveolar accumulation of PAS material, thickening of interlobular septae and alveolar walls and no evidence of fibrosis. A few silica particles were seen in silicoproteinosis. CONCLUSION: Despite the pathological similarities, PAP and silicoproteinosis have distinct clinical and imaging features and prognosis. Bilateral crazy-paving pattern with areas of geographic sparing is characteristic for PAP. Silicoproteinosis presents with bilateral dependent consolidation often with areas of calcification. The crazy-paving pattern is not seen in silicoproteinosis.

Swine-origin influenza A (H1N1) viral infection: thoracic findings on CT.

OBJECTIVE: The purpose of this article is to illustrate and describe various CT manifestations of swine-origin influenza A (H1N1) viral infection. CONCLUSION: The imaging findings seen in patients with H1N1 infection include consolidations, ground-glass opacities, interlobular septal thickening, small nodules, and findings suggestive of small airways disease, among others. Definitive diagnosis is based on correlation of the CT findings with the clinical symptoms and laboratory test results.

Interobserver variability of ultrasound parameters in portal hypertension.

The aim of this study was to assess interobserver agreement of ultrasound parameters for portal hypertension in hepatosplenic mansonic schistosomiasis. Spleen size, diameter of the portal, splenic and superior mesenteric veins and presence of thrombosis and cavernous transformation were determined by three radiologists in blinded and independent fashion in 30 patients. Interobserver agreement was measured by the kappa index and intraclass correlation coefficient. Interobserver agreement was considered substantial (kappa = 0.714-0.795) for portal vein thrombosis and perfect (kappa = 1) for cavernous transformation. Interobserver agreement measured by the intraclass correlation coefficient was excellent for longitudinal diameter of the spleen (r = 0.828-0.869) and splenic index (r = 0.816-0.905) and varied from fair to almost perfect for diameter of the portal (r = 0.622-0.675), splenic (r = 0.573-0.913) and superior mesenteric (r = 0.525-0.607) veins. According to the results, ultrasound is a highly reproducible method for the main morphological parameters of portal hypertension in schistosomiasis patients.

Interobserver variability of ultrasound parameters in portal hypertension

The aim of this study was to assess interobserver agreement of ultrasound parameters for portal hypertension in hepatosplenic mansonic schistosomiasis. Spleen size, diameter of the portal, splenic and superior mesenteric veins and presence of thrombosis and cavernous transformation were determined by three radiologists in blinded and independent fashion in 30 patients. Interobserver agreement was measured by the kappa index and intraclass correlation coefficient. Interobserver agreement was considered substantial (ê = 0.714-0.795) for portal vein thrombosis and perfect (ê = 1) for cavernous transformation. Interobserver agreement measured by the intraclass correlation coefficient was excellent for longitudinal diameter of the spleen (r = 0.828-0.869) and splenic index (r = 0.816-0.905) and varied from fair to almost perfect for diameter of the portal (r = 0.622-0.675), splenic (r = 0.573-0.913) and superior mesenteric (r = 0.525-0.607) veins. According to the results, ultrasound is a highly reproducible method for the main morphological parameters of portal hypertension in schistosomiasis patients.

Avaliação ultra-sonográfica de nódulos sideróticos esplênicos em pacientes esquistossomóticos com hipertensão portal / Ultrasonographic assessment of splenic siderotic nodules in schistosomal patients with portal hypertension", "_i": "en

OBJETIVO: Medir a sensibilidade e a reprodutibilidade da ultra-sonografia na detecção de nódulos sideróticos esplênicos em pacientes esquistossomóticos, tendo a ressonância magnética como padrão de referência. MATERIAIS E MÉTODOS: Na primeira fase do trabalho, 21 pacientes portadores de esquistossomose na forma hepatoesplênica com diagnóstico de nódulos sideróticos à ressonância magnética foram submetidos a avaliação ultra-sonográfica para a determinação da sensibilidade do método. Na segunda fase, com o objetivo de avaliar a reprodutibilidade da ultra-sonografia na detecção e na quantificação de nódulos sideróticos (A: 1-5 nódulos; B: 6-20 nódulos; C: mais de 20 nódulos), outros 30 pacientes esquistossomóticos foram submetidos a avaliação ultra-sonográfica de forma cega e independente por dois observadores. A reprodutibilidade foi medida por meio da concordância entre os observadores e do teste kappa. RESULTADOS: A sensibilidade da ultra-sonografia foi de 95,2 por cento (intervalo de confiança a 95 por cento [77,3 por cento; 99,2 por cento]). A concordância entre ultra-sonografia e ressonância magnética para a detecção de nódulos sideróticos foi de 96,7 por cento (intervalo de confiança a 95 por cento [82,8 por cento; 99,9 por cento]). Para a classificação dos nódulos conforme a sua quantificação, o índice kappa demonstrou concordância interobservador substancial (kappa = 0,67). CONCLUSÃO: A ultra-sonografia é um método que apresenta elevada sensibilidade e boa precisão para a avaliação de nódulos sideróticos esplênicos.

OBJECTIVE: To evaluate ultrasound sensitivity and reproducibility as compared with magnetic resonance imaging as the gold standard in the detection of splenic siderotic nodules in schistosomal patients. MATERIALS AND METHODS: Initially, 21 patients with hepatosplenic schistosomiasis and diagnosed with splenic siderotic nodules by magnetic resonance imaging were ultrasonographically evaluated for determining the method sensitivity. In a second phase, the method reproducibility in the detection and quantification of siderotic nodules (A: 1-5 nodules; B: 6-20 nodules; C: > 20 nodules) was evaluated in 30 patients who were submitted to ultrasonography blindly and independently assessed by two observers. Interobserver agreement was measured by kappa statistics. RESULTS: Ultrasound sensitivity was 95.2 percent (95 percent confidence interval [77.3 percent; 99.2 percent]). Intermethod agreement in the detection of siderotic nodules was 96.7 percent (95 percent confidence interval [82.8 percent; 99.9 percent]). For classification of nodules according to their quantification, the kappa test demonstrated a statistically significant interobserver agreement (kappa = 0.67). CONCLUSION: Ultrasonography is highly sensitive and accurate in the assessment of splenic siderotic nodules in schistosomal patients.

[Detection of pulmonary nodules by computer-aided diagnosis in multidetector computed tomography: preliminary study of 24 cases]. / Diagnóstico auxiliado por computador na detecção de nódulos pulmonares pela tomografia computadorizada com múltiplos detectores: estudo preliminar de 24 casos.

OBJECTIVES: To evaluate the performance of a computer program designed to facilitate the detection of pulmonary nodules using multidetector computed tomography (MDCT) scans of the chest. METHODS: We evaluated 24 consecutive MDCT scans of the chest at the Fleury Diagnostic Imaging Center during the period from October 7 to October 19 of 2006, using a 64-channel CT scanner. The study comprised 12 females and 12 males, ranging from 35 to 77 years of age (mean, 57.9 years). Double reading and a computer-aided diagnosis (CAD) system were used in order to perform two independent analyses of the data. The nodules found using both methods were recorded, and the data were compared. RESULTS: The total sensitivity of CAD for the detection of nodules was 16.5%, increasing to 55% when nodules <4 mm in diameter were excluded. Sensitivity by diameter was 6.5% for nodules <4 mm, 45% for nodules of 4-6 mm, 100% for nodules of 6 mm-10 cm, and 0% for nodules >1 cm. More than 99% of true nodules detected by CAD were registered in the image double reading process. CONCLUSIONS: In this preliminary 24-case study, the sensitivity of computer program tested was not significantly greater than that of the double-reading process that is routinely performed in this facility.

Diagnóstico auxiliado por computador na detecção de nódulos pulmonares pela tomografia computadorizada com múltiplos detectores: estudo preliminar de 24 casos / Detection of pulmonary nodules by computer-aided diagnosis in multidetector computed tomography: preliminary study of 24 cases

OBJETIVOS: Avaliar o desempenho de um programa para auxílio na detecção de nódulos pulmonares em tomografia computadorizada com múltiplos detectores (TCMD). MÉTODOS: Foram avaliadas 24 tomografias computadorizadas de tórax consecutivas realizadas no Centro de Medicina Diagnóstica Fleury no período de 07/10/2006 a 19/10/2006 usando um tomógrafo helicoidal multidetectores de 64 canais. O estudo compreendeu 12 pacientes do sexo feminino e 12 do sexo masculino, com idades variando entre 35 e 77 anos, idade média de 57,9. As imagens foram analisadas independentemente pelo método da dupla leitura e pelo programa diagnóstico auxiliado por computador (DAC). Os nódulos encontrados nos diferentes processos foram registrados e os dados comparados. RESULTADOS: A sensibilidade total da detecção de nódulos pelo DAC nesse trabalho foi de 16,5 por cento, 55 por cento excluindo os nódulos medindo <4 mm. A sensibilidade separada por tamanho foi de 6,5 por cento para nódulos <4 mm, 45 por cento para nódulos de 4 a 6 mm, 100 por cento para nódulos de 6 mm a 1 cm, e 0 por cento para nódulos >1 cm. Menos de 1 por cento dos nódulos verdadeiros destacados pelo DAC não haviam sido registrados no processo de dupla leitura. CONCLUSÕES: Neste trabalho preliminar de 24 casos, o programa testado não conseguiu superar de forma significativa a sensibilidade da dupla leitura realizada de rotina neste serviço.

OBJECTIVES: To evaluate the performance of a computer program designed to facilitate the detection of pulmonary nodules using multidetector computed tomography (MDCT) scans of the chest. METHODS: We evaluated 24 consecutive MDCT scans of the chest at the Fleury Diagnostic Imaging Center during the period from October 7 to October 19 of 2006, using a 64-channel CT scanner. The study comprised 12 females and 12 males, ranging from 35 to 77 years of age (mean, 57.9 years). Double reading and a computer-aided diagnosis (CAD) system were used in order to perform two independent analyses of the data. The nodules found using both methods were recorded, and the data were compared. RESULTS: The total sensitivity of CAD for the detection of nodules was 16.5 percent, increasing to 55 percent when nodules <4 mm in diameter were excluded. Sensitivity by diameter was 6.5 percent for nodules <4 mm, 45 percent for nodules of 4-6 mm, 100 percent for nodules of 6 mm-10 cm, and 0 percent for nodules >1 cm. More than 99 percent of true nodules detected by CAD were registered in the image double reading process. CONCLUSIONS: In this preliminary 24-case study, the sensitivity of computer program tested was not significantly greater than that of the double-reading process that is routinely performed in this facility.

Definição do nível da junção ureterovesical pela tomografia computadorizada / Definition of ureterovesical junction level by computed tomography

OBJETIVO: Definir o nível da implantação ureteral na bexiga através da tomografia computadorizada. MATERIAIS E MÉTODOS: Através de tomografia computadorizada da pelve com contraste endovenoso de 46 pacientes (31 homens e 15 mulheres) com idade entre 18 e 45 anos, com pelo menos um dos ureteres contrastado pelo contraste excretado, medimos as distâncias do meato ureteral até o teto acetabular e a borda superior da sínfise púbica, além do volume da bexiga. Utilizamos o teste t de Student para avaliar se houve diferenças estatísticas entre grupos. RESULTADOS: O nível da implantação ureteral na bexiga foi, em média, 10,6 ± 8,1 mm abaixo do teto acetabular e, em média, 29,7 ± 9,5 mm acima da borda superior da sínfise púbica. Nos pacientes com volume de repleção vesical menor que 200 ml e maior ou igual a 200 ml os níveis da implantação ureteral na bexiga foram, em média, 11,6 ± 7,3 mm e 10,2 ± 8,4 mm abaixo do teto acetabular (p = 0,61) e, em média, 28,3 ± 7,3 mm e 30,3 ± 10,2 mm acima da borda superior da sínfise púbica (p = 0,52), respectivamente, e nos pacientes do sexo masculino e feminino foram, em média, 11,8 ± 8,0 mm e 8,3 ± 8,0 mm abaixo do teto acetabular (p = 0,17) e, em média, 27,7 ± 9,2 mm e 33,9 ± 8,8 mm acima da borda superior da sínfise púbica (p = 0,34), respectivamente. CONCLUSÃO: Calcificações localizadas abaixo de 3 cm do teto acetabular e abaixo de 1,5 cm acima da borda superior da sínfise púbica provavelmente não representam cálculos ureterais. O grau de repleção vesical e o sexo não interferem significativamente na posição do meato ureteral.