Impact of dental cone-beam computed tomography on diagnostic evaluation and treatment plan for the maxillary sinus in dental implant planning / Impacto de la tomografía computarizada de haz cónico en el diagnóstico y plan detratamiento preimplantologico de senos maxilares

Objective: To determine the impact of CBCT on diagnostic evaluation and treatment plan for the maxillary sinus in dental implant planning. Material and Methods: Diagnostic evaluation and treatment plan for the maxillary sinus were evaluated by eight specialists experienced in dental implant placement. Eight panoramic radiographs (PAN) and CBCT examinations were obtained from five adult patients with a specific clinical need for dental implants. Evaluation was performed first on PAN then, at least 2 weeks later, on CBCT. Residual alveolar ridge height, mucosal thickening, radiographic findings and treatment plan were recorded. The confidence level was evaluated for both diagnostic evaluation and treatment plan. The kappa statistic for intra-observer reproducibility and McNemar test were performed. Results: In the diagnostic evaluation, CBCT showed significant impact on the diagnosis of radiographic findings. Availability of CBCT significantly changed the treatment plan, for less invasive treatment, or no treatment need. Observers had significantly greater confidence when using CBCT than PAN, when indicating presence of mucosal thickening and radiographic findings in the maxillary sinus. In addition, CBCT increased confidence in the treatment plan. Conclusion: The present study suggests that CBCT has an impact on the diagnostic evaluation of radiographic findings in the maxillary sinus and on the decision to place implants, owing to misdiagnosis of pathology and planning of more invasive treatments when using PAN. Availability of CBCT also improves clinician confidence. Further studies at higher levels of diagnostic efficacy should be performed, to justify the use of CBCT, by evaluating the actual treatment performed and its outcome.

Objetivo: Determinar el impacto de la tomografía computarizada de haz cónico (CBCT) en la evaluación diagnóstica y el plan de tratamiento del seno maxilar en la planificación de implantes dentales. Material y Métodos: La evaluación diagnóstica y el plan de tratamiento del seno maxilar fueron evaluados por ocho especialistas con experiencia en la colocación de implantes dentales. Se obtuvieron ocho radiografías panorámicas (PAN) y exámenes CBCT de cinco pacientes adultos con una necesidad clínica específica de implantes dentales. La evaluación se realizó primero en PAN y luego, al menos dos semanas después, en CBCT. Se registraron la altura del reborde alveolar residual, el engrosamiento de la mucosa, los hallazgos radiográficos y el plan de tratamiento. Se evaluó el nivel de confianza tanto para la evaluación diagnóstica como para el plan de tratamiento. Se realizó el estadístico kappa para la reproducibilidad intraobservador y la prueba de McNemar. Resultados: En la evaluación diagnóstica, CBCT mostró un impacto significativo en el diagnóstico de los hallazgos radiográficos. La disponibilidad de CBCT cambió significativamente el plan de tratamiento, para un tratamiento menos invasivo o sin necesidad de tratamiento. Los observadores tuvieron una confianza significativamente mayor al usar CBCT que PAN, al indicar la presencia de engrosamiento de la mucosa y hallazgos radiográficos en el seno maxilar. Además, CBCT aumentó la confianza en el plan de tratamiento. Conclusión: El presente estudio sugiere que la CBCT tiene un impacto en la evaluación diagnóstica de los hallazgos radiográficos en el seno maxilar y en la decisión de colocar implantes, debido al diagnóstico erróneo de la patología y la planificación de tratamientos más invasivos al usar PAN. La disponibilidad de CBCT también mejora la confianza del clínico. Se deben realizar más estudios a niveles más altos de eficacia diagnóstica para justificar el uso de CBCT, evaluando el tratamiento real realizado y su resultado.

Accuracy of cone-beam CT in detecting vertical root fractures in teeth with post-endodontic restorations: an in vitro study

The aim of this study was to evaluate the accuracy of cone-beam CT (CBCT) for the detection of artificially created vertical root fractures (VRF) in extracted teeth restored with metallic (MP) and fiberglass (FGP) posts. After root canal obturation, 60 extracted human premolars were scanned by using the highest-resolution settings of a CBCT unit. Theprepared roots were randomly divided into three groups: group C (control group): non-restored and non-endodontically treated teeth (n = 20); group MP (n = 20); group FGP (n = 20). In all groups, 10 teeth were artificially fractured. Two external and independent observers blindly recorded the presence or absence of VRF. Sensitivity, specificity, accuracy, intra-and interobserver agreement were calculated. Kappa value for inter-and intraobserver agreement was 0.82 and 0.84 respectively, demonstrating goodagreement. The highest values for sensitivity (0.80 -0.90), specificity (1.00) and accuracy (0.90 -0.95) were found in the control group. The teeth with FGP restoration presented the lowest sensitivity (0.30 -0.50) and accuracy (0.60 -0.65) values. Both examiners had a good performance in the diagnosis of fractures in teeth with MP, with accuracy ranging between 0.85 -0.90. The presence of MP did not influence accuracy; however, the presence of FGP reduced the diagnostic capacity of CBCT.

Reliability of Linear and Curvilinear Measurements on Cone-Beam Computed Tomography Images for the Evaluation of Implant Sites and Jaw Pathologies

ABSTRACT Objective: To evaluate the intra-examiner and inter-examiner reliability of linear and curvilinear measurements for the complete assessment of implant sites and jaw pathologies using Cone-Beam Computed Tomography (CBCT). Material and Methods: Fifty cone-beam computed tomographic images of patients were retrieved from the archives of Dentomaxillofacial Radiology. CBCT images taken for implant planning and evaluation of intrabony jaw pathologies (benign cyst/tumor) were included. Two expert oral and maxillofacial radiologists analyzed the images independently and made the measurements. The images for implant planning were analyzed for width, the height of the edentulous site, and the qualitative analysis of bone in the region. Jaw pathologies were assessed for linear dimensions and curvilinear measurements. Results: The inter-observer measurement error for implant site analysis ranged from 0.12 to 0.42 mm with almost perfect agreement (ICC: 0.94 to 1). The inter-observer measurement error for jaw pathology was 0.09 to 0.25 mm (ICC: 0.98-1). Curvilinear measurements showed perfect agreement between the observers. The intraobserver reliability for the various parameters used for the assessment of the implant site and jaw pathologies indicated almost perfect agreement. Conclusion: Reliability between the radiologists is high for various measurements on CBCT images taken for implant planning and jaw pathologies.

3D CT Soft Tissue Craniofacial Analysis and Lip Morphology

ABSTRACT Objctive: To assess the soft tissue characteristics of Bangladeshi adults to formulate soft tissue 3D CT standards using Holdaway's (HA) and lip morphology (LM) analyses. Another aim of this study was to assess the gender dimorphism of Bangladeshi population. Material and Methods: One hundred and seventeen (Eighty-five men and Thirty-two women) Bangladeshi adults have obtained their computed tomography (CT) scan at the Radiology Department for normal diagnosis. Craniofacial deformities were undetected in all cases. The CT images were prepared by a 3D imaging programming software (Mimics 11.02 Materialise). Parameters from the identified landmark points were measured in 3D through this software. Results: Upper lip thickness (ULT) (vermillion UL-A point) measurement was significant in HA and in LM analyses, upper lip protrusion (ULP) (Ls to Sn-SPog) measurement has demonstrated significant difference among both genders, where p-value was less than 0.05. Mean measurements of Bangladeshi adults were relatively comparable except the face convexity (FC) when compared with the HA cephalometric soft tissue values. Conclusion: By using HA and LM analyses, 3D CT soft tissue standards were established for Bangladeshi adults. Measurements for all parameters have remained equivalent with the HA standard data apart from the FC measurement. This consequently may demonstrate that the Bangladeshi population retains a convex shape with a slight protrusive lip or retruded chin.

Tooth Coronal Index: A Novel Tool For Age Estimation on Cone-Beam Computed Tomography

ABSTRACT Objective: To evaluate dental age assessment reliability through Tooth Coronal Index (TCI) method. Material and Methods: The cone-beam computed tomography (CBCT) scans of 160 individuals aged between 20-70 years were analyzed in the present study. The height of the crown, i.e., coronal height, and the height of the coronal pulp cavity, i.e., coronal pulp cavity height, of mandibular second premolars and first molars were calculated and then TCI was measured. The actual age of a subject was compared with TCI of tooth and the acquired data were subjected to Pearson's correlation and unpaired t-tests. Results: Negative correlation was observed between the real age and TCI of mandibular first molar (r = -0.094, p=0.382) and second premolar (r = -0.176, p=0.0961. Statistically significant difference was observed between actual age and TCI for mandibular second premolar and first molar (p<0.001). Conclusion: Tooth coronal index has the potential to estimate age of an individual on CBCT scans. It is simple, cost-effective than histological methods and can be applied to both living and unknown dead.

A Standard Method for Performance Detection of Fluorescence Imaging System / 中国医疗器械杂志

Fluorescence imaging now becomes an intraoperative navigation technique that gaining popularity in surgery and clinical research. However, at present, there is no mature and reliable method or other related guidance documents for the detection of fluorescence imaging performance. The performance analysis and quality supervision of products on the market could not be performed, which affects their clinical use and image quality. In this paper, a standard method of fluorescence imaging performance testing for fluorescence imaging system is proposed. Several kinds of fluorescence imaging performance parameters affecting fluorescence images are defined strictly. We also recommend scientific and feasible methods for their detections and analyses, which are verified by practical examples. This paper aims to provide a feasible reference standard for fluorescence performance evaluation.

Evaluation of Incidental Findings on Cone Beam Computed Tomography

Objective: To assess the prevalence of incidental findings in relation to the side of a patient's face, location, and age group on cone beam computed tomography. Material and Methods: 175 CBCT examinations were performed on patients aged between 12 and 77 years, consisting of recordings of the anatomical location and findings following each examination. For standardization of tomographic evaluations, acquired images were analyzed by two previously trained expert radiologists. After positional adjustment of the multi-dimensional images on the monitor screen, examination of each scan was conducted simultaneously on the coronal, axial, and sagittal planes. Fisher's exact tests and Chi-square tests were used to compare the frequencies of incidental findings using a significance level of 0.05. Results: The most frequent incidental finding was maxillary sinus mucosal thickening, which occurred on the right and left side in 46.3% and 46.9% of the patients, respectively. The second most frequent incidental finding was flattening of the mandibular condyle, occurring on the right and left side in 29.7% and 24% of the patients, respectively. No significant difference was observed among the individual age groups. The number of incidental findings per patient varied from 0 to 5 on the right side and left side and from 0 to 12 in total. The Kendall correlation coefficient for the number of incidental findings between the sides was 0.25 (p<0.0001), indicating a weak but significant and positive association between the sides in relation to the number of incidental findings. The mean total number of incidental findings was 4.07. Conclusion: The prevalence of the individual incidental findings and the total number of findings were not statistically different. However, some alterations were more likely to be observed bilaterally.

Evaluation of Alveolar Bone on Dental Implant Treatment using Cone Beam Computed Tomography

Objective: To observe the outcomes of dental implant treatment based on the evaluation of bone conditions using Cone Beam Computed Tomography (CBCT). Material and Methods: A total of 31 dental implants were collected for the present study. Subsequently, mesial and distal bone losses were examined, while buccal and lingual bone thickness were measured at 7 levels. Evaluation and interpretation of CBCT results was performed by 3 independent examiners. Results: The average of mesial bone loss was 1.08 mm and 1.36 mm on distal bone. Every dental implant had lingual/palatal bone on level 1 to 3, only 1 (6.5%) didn't have bone on level 4, 3 implants (9.7%) had no bone at level 5 and 6, and 22 implants (74.2%) had no bone at level 7/implant platform. There were 8 implants (25.8%) didn't have buccal bone at level 7, only 1 implant (3.2%) didn't have buccal bone at level 2,4,5 and 6, and there were 2 implants (6.5%) had no buccal bone on level 3. Dehiscence / fenestration can be seen on 90% of the implant subjects. Conclusion: These bone loss condition could be consequence of several factors such as infection, diagnosis, treatment plan, and operator's surgery skills. The implants that placed without CBCT could lead to operator miscalculation on bone condition, therefore in moderate to advanced cases, the use of CBCT should be mandatory for treatment plan.

Soft-tissue 3D Facial Imaging in Children and Adolescents: Towards the Definition of New Reference Standards

In the last decades, head and face imaging has shifted from two-dimensional (2D) representations (conventional radiography, photography) to three-dimensional (3D) techniques that can better depict the complex morphology of this part of the body, since they can provide a large number of additional anthropometric information [1-3]. 3D imaging systems can be divided into volumetric (computed tomography, cone beam computed tomography, magnetic resonance imaging) and optical surface instruments (laser scanning, moiré techniques, stereophotogrammetry, patterned light techniques) [4]. These last are safe and not invasive, and provide a 3D representation of the external (cutaneous) facial surface.

Intraoperative near-infrared fluorescent imaging during robotic operations / Sistema de imagem intraoperatória por fluorescência infravermelha durante cirurgias robóticas

ABSTRACT The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results. Disadvantages are linked to contrast distribution in certain clinical scenarios. The intraoperative near-infrared fluorescent imaging is new and promising addition to robotic surgery. Several reports show the utility of this technology in several different procedures. The ideal dose, time and site for dye injection are not well defined. No high quality evidence-based comparative studies and long-term follow-up outcomes have been published so far. Initial results, however, are good and safe.

RESUMO A identificação intraoperatória de certas estruturas anatômicas, por seu tamanho ou por elas serem ocultas à visão, pode ser desafiadora. O desenvolvimento da cirurgia minimamente invasiva trouxe dificuldades adicionais, pela falta da sensibilidade tátil completa. Diversas formas de detecção intraoperatória destas estruturas têm sido tentadas. Recentemente, a tecnologia de fluorescência infravermelha com verde de indocianina foi associada às plataformas robóticas. Além disso, essa tecnologia tem sido testada em uma variedade de cirurgias, e suas vantagens parecem estar ligadas a baixo custo, segurança e bons resultados. As desvantagens estão associadas à má distribuição do contraste em determinados cenários. A imagem intraoperatória por fluorescência infravermelha é uma nova e promissora adição à cirurgia robótica. Diversas séries mostram a utilidade da tecnologia em diferentes procedimentos. Dose ideal, local e tempo da injeção do corante ainda não estão bem estabelecidos. Estudos comparativos de alta qualidade epidemiológica baseados em evidência ainda não estão disponíveis. No entanto, os resultados iniciais são bons e seguros.

Hábitos do sono em pacientes com disfunção temporomandibular / Sleep habits in patients with temporomandibular disorders

This study aims to evaluate the association between habitual body posture during sleep, sleep disturbances, and TMD severity. One hundred and fifty patients with complaints of TMD signs and symptoms were considered for this study. However, sixty-seven patients were diagnosed with TMD through the Research Diagnostic Criteria for Temporomandibular Dysfunction (RDC-TMD) and were evaluated in the study. The sleep habits were assessed using specific questionnaires answered individually. It was use a self-report questionnaire with questions relating to different sleep habits: sleep with hand under the chin, wake up with face discomfort, read or watch TV on bed, take drug or alcohol to sleep; and questions relating to sleep disorders based on General Health Questionnaire (GHQ): difficulty to keeping sleep, wake up early and get no sleep. The level of TMD was obtained with FonsecaÆs anamnestic index. A database was created and the statistical analysis used in this study was the chi-square test, with a significance level of 95% (p < 0.05). There was a statistical association between the TMD severity and patients who sleep with hand under the chin (p=0.004), wake up with face discomfort (0=0.004), and read or watch TV on bed (p=0.009). It can be concluded that patients with TMD require special consideration with respect to usual body posture during sleep...

Este estudo tem como objetivo avaliar a associação entre a postura corporal habitual durante o sono, distúrbios do sono e severidade da DTM. Cento e cinquenta pacientes com queixas de sinais e sintomas de DTM foram considerados para este estudo. Sessenta e sete pacientes foram diagnosticados com DTM através dos critérios diagnósticos de pesquisa em disfunção temporomandibular (RDC - TMD) e incluídos neste trabalho. Os hábitos de sono foram avaliados por meio de questionários específicos. Foi usado um questionário de autorrelato com as questões relativas a diferentes hábitos de sono: dormir com a mão sob o queixo, acordar com desconforto no rosto, ler ou assistir TV na cama, usar drogas ou álcool para dormir; e as questões relacionadas aos distúrbios do sono baseadas no Questionário de Saúde Geral (General Health Questionnaire - GHQ): dificuldade em manter o sono, acordar cedo e ficar sem dormir. O grau de DTM foi obtido com o índice de Fonseca. Um banco de dados foi criado e a análise estatística utilizada neste estudo foi o teste do qui-quadrado, com um nível de significância de 95% (p <0,05). Houve uma associação estatisticamente significativa entre a severidade da DTM e os pacientes que dormem com a mão sob o queixo (p = 0,004), acordam com desconforto na face (0 = 0,004) e leem ou assistem TV na cama (p = 0,009). Pode-se concluir que os pacientes com DTM requerem uma análise especial com relação à postura corporal habitual durante o sono...

Three-Dimensional Printing: Basic Principles and Applications in Medicine and Radiology

The advent of three-dimensional printing (3DP) technology has enabled the creation of a tangible and complex 3D object that goes beyond a simple 3D-shaded visualization on a flat monitor. Since the early 2000s, 3DP machines have been used only in hard tissue applications. Recently developed multi-materials for 3DP have been used extensively for a variety of medical applications, such as personalized surgical planning and guidance, customized implants, biomedical research, and preclinical education. In this review article, we discuss the 3D reconstruction process, touching on medical imaging, and various 3DP systems applicable to medicine. In addition, the 3DP medical applications using multi-materials are introduced, as well as our recent results.

O efeito da alteração da inclinação da posição natural da cabeça em 7º sobre medidas cefalométricas / The effect of altering the natural head position in 7º on cephalometric measurements

O objetivo do presente estudo foi avaliar as alterações das medidas angulares e lineares mais comumente utilizadas em cefalometria, quando a posição natural da cabeça (PNC) é modificada durante a tomada da telerradiografia em norma lateral (acréscimo e decréscimo de 7° em relação à PNC). Para tanto, foram analisadas 90 telerradiografias de 30 pacientes do sexo feminino (média de idade de 22,7 anos). Em cada paciente, foram obtidas três telerradiografias em um único momento: PNC, PNC acrescida de 7° e PNC com decréscimo de 7°. Os resultados apontaram alterações significativas para as medidas SN.VER, HF.VER e ângulo Z, porém, não foram observadas diferenças estatisticamente significantes para as demais grandezas: SNA, SNB, ANB, PP.GoGn, 1.PP, IMPA, 1.1, SN.GoGn, FMA, SN.PP, S-N, ENA-ENP, Co-Gn, Co-Go e Go-Gn. Sendo assim, concluiu-se que a inclinação da cabeça do paciente, dada pelo acréscimo ou decréscimo de 7° em relação à PNC, não apresenta interferência para as medidas cefalométricas aqui estudadas, salvo aquelas que levam em consideração a linha vertical verdadeira para sua construção...

The aim of the present study was to assess the alterations in angular and linear cephalometric measurements when modifying the natural head position (NHP) inclination to +7 or -7 degrees. Ninety cephalometric radiographs of 30 female patients (average of 22.7 years old) were obtained as follows: NHP, with +7 degrees and with -7 degrees. Statistically significant differences were observed for measurements SN.VER, HF.VER and Z angle. No influence was observed on all other measurements: SNA, SNB, ANB, PP.GoGn, 1. PP, IMPA, 1.1, SN.GoGn, FMA, SN.PP, S-N, ENA-ENP, Co-Gn, Co-Go and Go-Gn. It was concluded that tipping the head towards +7 or -7 degrees in relation to NHP has no interference to cephalometric measurements studied here, except those which use the true vertical line for its construction...

Utilização da tomografia computadorizada de feixe cônico no diagnóstico odontológico / Use of cone beam computed tomoghaphy in dental diagnosis

A tomografia computadorizada de feixe cônico, também conhecida como tomografia cone beam, foi especialmente desenvolvida para a Odontologia. Esta técnica imaginológica permite a reconstrução de imagens bidimensionais e tridimensionais, além de mensurações precisas em todos os planos de espaço (axial, sagital e coronal). Este artigo apresenta informações atualizadas colhidas na literatura, tendo como objetivo trazer dados sobre o equipamento tomográfico, o processo de formação da imagem e as principais aplicações clínicas desta tecnologia nas diferentes especialidades odontológicas, além de apresentar casos que demonstraram uma marcante discrepância entre o diagnóstico realizado quando da utilização de radiografias convencionais e de imagens obtidas da tomografia computadorizada de feixe cônico...

The cone beam computed tomography was specially developed for Dentistry. This imaging technique allows the reconstruction of two and three-dimensional images, and also precise mensurations in all space plans (axial, sagital, and coronal). This article presents up to date information obtained from literature, aiming to bring data about the tomographic equipment, the image creation process and the main applications in different dental areas, and presenting as well clinical cases that shows an outstanding discrepancy between the diagnosis realized by conventional radiographies and by images obtained from cone beam computed tomography...

Diagnostic Imaging Utilization in Cases of Acute Appendicitis: Multi-Center Experience

The purpose of this cross-sectional study was to measure imaging utilization rates and the negative appendectomy rate (NAR) in metropolitan Seoul, Korea. The study included 2321 adolescents and adults (> or =15 yr; median [interquartile range] age, 37 [27-50] yr; 46.7% female) undergoing appendectomy in 2011 at eight tertiary and three secondary hospitals. Imaging utilization rate was 99.7% (95% confidence interval, 99.4%-99.9%). CT and ultrasonography utilization rates as an initial imaging modality were 93.1% (92.0%-94.1%), and 6.5% (5.6%-7.6%), respectively. The NAR in patients undergoing CT only, complementary ultrasonography following CT, ultrasonography only, and complementary CT following ultrasonography were 3.3% (2.6%-4.1%), 27% (14%-44%), 9% (4%-16%), and 8% (2%-20%), respectively. The use of ultrasonography instead of CT as the initial imaging modality was significantly associated with higher NAR (adjusted odds ratio [AOR], 2.28 [1.22-4.27]; risk difference, 4.4 [0-8.8] percentage points), however, the population attributable risk was 0.3 [0-0.6] percentage points. We observed a very high CT utilization rate and a low NAR in metropolitan Seoul. Although the use of CT was significantly associated with the lower NAR, CT utilization rate already has reached the level that increase in CT utilization from the status quo would hardly decrease the NAR further.

La responsabilidad en la ultrasonografía / Responsability on ultrasonography

Descripción de diferentes causales de responsabilidad en el campo de la ultrasonografía y del diagnóstico por imágenes

Beneficio de la ecosonografía abdominal en la evaluación pediátrica de rutina / Routine abdominal ecosonografic scan in children

La ecografía abdominal es importante en el diagnóstico y tratamiento de un número elevado de patologías abdominales. El dolor abdominal es la principal indicación de ecografía. Se plan-tea la posibilidad de diagnosticar alteraciones y/o patologías asintomáticas, que pueden requerir intervención temprana. Determinar el beneficio de la ecosonografía abdominal en la evaluación pediátrica de rutina. Trabajo prospectivo y transversal. Se incluyen pacientes escogidos al azar, para realizarles ecografía abdominal. Distribuidos en grupo A, los niños con solicitud de evaluación gastrointestinal y grupo B, niños sin patología gastrointestinal. Se solicita consentimiento informado. Un total de 182 niños, promedio de edad 4,70 años (rango 1m-14 años), 92 varones y 90 hembras. De 131 niños, con enfermedad gastrointestinal, grupo A, 32(24,42%) presentaron alteraciones a la ecografía. De ellos 17/32(53,12%) con hallazgos ecográficos en relación a la enfermedad de base siendo lo más frecuentes hepatopatías (esteatosis, hepatomegalia, fibrosis periportal), litiasis vesicular, cambios en vísceras huecas y reflujo gastroesofágico; 15/32(46,88%) se detectaron alteraciones no relacionados con la enfermedad de base, como: enfermedad renal, tumoración abdominal, esplenomegalia. Grupo B: 16/51 (31,37%) se detectó alteraciones en órganos abdominales: barro biliar, esplenomegalia, hepatopatía, alteraciones renales y otras. Se encontró una diferencia significativa entre los grupos, en relación al hallazgo de alteraciones ecográficas no relacionadas con el motivo de consulta. Los resultados permiten inferir que la ecografía es una herramienta sensible que puede ser utilizada de rutina en la evaluación pediátrica para detectar alteraciones en órganos abdominales para una intervención temprana y tratamiento oportuno.

Abdominal ultrasound is important in the diagnosis and treatment of a large number of abdominal pathology. Abdominal pain is the main indication for ultrasound. It raises the possibility of diagnosing disorders and/or asymptomatic pathologies that may require early intervention. To determine the benefit of abdominal sonography in the routine pediatric evaluation. Prospective and cross. Includes patients are randomly selected for abdominal ultrasound and distributed in two groups: Group A, children with gastrointestinal application indication for assessment and group B, children without gastrointestinal pathology. Informed consent is requested. Results: A total of 182 children, mean age 4.70 years (range 1 m-14 years), 92 males and 90 females. Of 131 children with gastrointestinal disease, group A, 32 (24.42%) had alterations to the ultrasound. Of these 17/32 (53.12%) with ultrasound findings in relation to the underlying disease being the most common liver disease (steatosis, hepatomegaly, periportal fibrosis), gallstones, changes in hollow viscera and gastroesophageal reflux; 15/32 (46.88%) were detected abnormalities not related to underlying disease, such as kidney disease, abdominal tumor, splenomegaly. Group B: 16/51 (31.37%) resulted with detected abnormalities in abdominal organs, biliary sludge, spleen, liver, renal and others. We found a significant difference between groups in relation to the discovery of ultrasound abnormalities unrelated to the complaint. The results allow to conclude that ultrasound is a sensitive tool that can be used in routine pediatric evaluation to detect changes in abdominal organs for early intervention and treatment.

O perfil brasileiro de propriedade intelectual em radiologia e diagnóstico por imagem em um contexto internacional, nos anos 2000-2009 / The Brazilian profile of intellectual property in radiology and imaging diagnosis in an international context in the years 2000 to 2009

OBJETIVO: Analisar a inovação tecnológica brasileira na área de radiologia e diagnóstico por imagem, em termos de indicadores de patentes. MATERIAIS E MÉTODOS: Este é um estudo analítico-exploratório de informações recuperadas por meio de consultas cruzadas nas bases de dados dos escritórios de propriedade intelectual do Brasil (Instituto Nacional da Propriedade Industrial - INPI), dos Estados Unidos (United States Patent and Trademark Office - USPTO) e da Europa (European Patent Office - EPO). RESULTADOS: Foram encontradas 277.057 patentes. Desse total, 7.800 foram registradas no INPI (3 por cento), 65.428 (24 por cento) registradas no EPO e 203.829 (73 por cento) emitidas no USPTO. O Brasil é o país signatário em 1.732 patentes publicadas no INPI, 80 no EPO e 26 no escritório USPTO. Globalmente, 219.993 (79 por cento) patentes referiam-se a dispositivos eletrônicos ligados a informática em saúde, ultrassonografia, ressonância magnética, tomografia computadorizada e procedimentos de geração, comunicação e arquivamento de imagens, e 57.064 (21 por cento) das patentes tratavam das tecnologias relacionadas a radioproteção e dosimetria, física nuclear, eletroterapia, terapia magnética e radioterapia. CONCLUSÃO: Os resultados obtidos apontam para a fragilidade da produção nacional de inovação tecnológica registrada em patentes, no campo de radiologia e diagnóstico por Imagem.

OBJECTIVE: To analyze the Brazilian technological innovation in the field of radiology and imaging diagnosis, in terms of patent indicators. MATERIALS AND METHODS: Exploratory analytical study of information retrieved through cross queries in databases of intellectual property offices in Brazil (State Industrial Property Office [Instituto Nacional da Propriedade Industrial - INPI]), United States (United States Patent and Trademark Office - USPTO) and Europe (European Patent Office - EPO). RESULTS: There were 277,057 patents in the field of radiology and imaging diagnosis. Of this total, 7,800 were registered at INPI (3 percent), 65,428 (24 percent) registered at the EPO and 203,829 (73 percent) issued by USPTO. Brazil is a signatory to 1,732 patents published by the INPI, 80 by the EPO and 26 by the USPTO. Overall, 219,993 (79 percent) patents were related to electronic devices strongly linked to information technology in health care, ultrasonography, tomography, magnetic resonance imaging procedures as well as to images generation, communication and archiving, and 57,064 patents (21 percent) dealt with technologies related to radiation protection and dosimetry, nuclear physics, electrotherapy, magnetic therapy and radiotherapy. CONCLUSION: The results indicate the weakness of the domestic production of patented technological innovation in the field of radiology and imaging diagnosis.