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Luz FM, Yacoub VRD, Silveira KAA, Reis F, Dertkigi SSJ. A model for training ultrasound-guided fine-needle punctures. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:948-952. [PMID: 35946773 PMCID: PMC9574963 DOI: 10.1590/1806-9282.20220150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/15/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the efficacy of a training program in ultrasound-guided fine needle puncture using a cost-effective model. METHODS We evaluated the training of 20 resident radiology physicians, based on a theoretical course and a practical simulation part with models that focused on the puncture technique of thyroid nodules. The total time to perform the procedure, the number of punctures on the model surface, and the application of a questionnaire were used to assess the performance and confidence of the resident physicians in performing the procedure. RESULTS The training model used was easy to reproduce, inexpensive, versatile, and capable of simulating the echotexture of thyroid tissue. There was a significant reduction in the total time needed to perform the procedure with a mean of 173.7 s±91.28 s from R1 and 112.8 s±17.66 s from R2 before the course vs. 19.2 s±112.8 s and 14.3 s±9.36 s, respectively, after the course (p<0.0001); as well as the number of superficial punctures, with a mean of 2.2 punctures±0.92 from R1 and 1.5 punctures±0.32 from R2 before the course vs 1.1 punctures±0.71 and 1.0 puncture±0.0, respectively, after the course (p<0.0001). There was also a subjective improvement in the performance and confidence in performing this procedure. CONCLUSIONS An inexpensive and easy-to-reproduce gelatin-based model enabled adequate training of resident physicians and proved capable of improving their skills and confidence in simulating the procedure, even with a short period of training.
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Affiliation(s)
| | | | | | - Fabiano Reis
- Universidade Estadual de Campinas, Department of Radiology – Campinas (SP), Brazil
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Tam Tam H, Putterman D, Sinha R, Woods Ludwig J, Gulersen M. Computed tomography-guided injection for management of caesarean scar pregnancy. Clin Radiol 2021; 76:696-700. [PMID: 34154834 DOI: 10.1016/j.crad.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/14/2021] [Indexed: 11/28/2022]
Affiliation(s)
- H Tam Tam
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - D Putterman
- Division of Vascular and Interventional Radiology, Department of Radiology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - R Sinha
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - J Woods Ludwig
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - M Gulersen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
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Tibana TK, Fornazari VAV, Gutierrez Junior W, Marchiori E, Szejnfeld D, Nunes TF. What the radiologist should know about the role of interventional radiology in urology. Radiol Bras 2019; 52:331-336. [PMID: 31656352 PMCID: PMC6808617 DOI: 10.1590/0100-3984.2018.0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Interventional radiology has been constantly developing in terms of the
techniques, materials, and methods of intervention. It interacts with all areas
of medicine, always with the ultimate goal of ensuring the well-being of
patients. Advances in imaging techniques, especially in the last two decades,
have led to a paradigm shift in the field of urological imaging interventions.
Many urologic diseases that were previously treated only surgically can now be
effectively managed using minimally invasive image-guided techniques, often with
shorter hospital stays and requiring only local anesthesia or conscious
sedation.
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Affiliation(s)
- Tiago Kojun Tibana
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | | | - Walberth Gutierrez Junior
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Denis Szejnfeld
- Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Thiago Franchi Nunes
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
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Tibana TK, Grubert RM, Camilo DMR, Marchiori E, Nunes TF. Computed tomography-guided puncture using a mobile application for a motion sensor-equipped smartphone. Radiol Bras 2019; 52:245-246. [PMID: 31435086 PMCID: PMC6696760 DOI: 10.1590/0100-3984.2018.0048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Tibana TK, Grubert RM, Fornazari VAV, Barbosa FCP, Bacelar B, Oliveira AF, Marchiori E, Nunes TF. The role of percutaneous transhepatic biliary biopsy in the diagnosis of patients with obstructive jaundice: an initial experience. Radiol Bras 2019; 52:222-228. [PMID: 31435082 PMCID: PMC6696750 DOI: 10.1590/0100-3984.2018.0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective To evaluate the accuracy of percutaneous transhepatic biliary biopsy (PTBB) in patients with suspected biliary obstruction. Materials and methods This was a retrospective analysis of 18 patients with obstructive jaundice who underwent PTBB. In each patient, three to ten fragments were collected from the lesion. The final diagnosis was confirmed in the pathology report. We also reviewed analyses of the results of laboratory tests performed before the procedure, as well as the Bismuth classification, clinical outcome, complications occurring during the procedure, access route, and materials used. Results Technical success was achieved in 100% of the PTBB procedures. Among the 18 patients clinically diagnosed with bile duct stenosis, the pathological analysis confirmed that diagnosis in 17. In one case, the pathological findings were considered false-negative. The predominant tumor was cholangiocarcinoma (seen in 50% of the cases). Sixteen of the procedures (88.9%) were performed without complications. Transient hemobilia occurred in one case, and cholangitis occurred in another. Conclusion PTBB is a safe, viable, simple technique with a high rate of true-positive results for the definitive diagnosis of obstructive jaundice.
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Affiliation(s)
- Tiago Kojun Tibana
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | - Renata Motta Grubert
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | | | - Fábio Colagrossi Paes Barbosa
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | | | | | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Thiago Franchi Nunes
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
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Abstract
Most tumors of the biliary tract are too small to have specific imaging
characteristics or for percutaneous puncture to provide sufficient material for
diagnosis. Percutaneous transhepatic biliary drainage, in addition to being a
well-established technique in the treatment of obstructive jaundice, provides
adequate access for sampling obstructive lesions. In cases of biliary lesions,
percutaneous transhepatic biopsy of the biliary tract has proven to be a useful
diagnostic technique, with a reported accuracy of over 90% at some referral
centers.
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Affiliation(s)
| | - Tiago Kojun Tibana
- Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | | | | | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Adôrno IF, Tibana TK, de Lima GCS, Martins LDA, Gutierrez Junior W, Goldman SM, Nunes TF. Acute spontaneous unilateral adrenal hemorrhage: etiology and imaging findings in six cases. Radiol Bras 2019; 52:12-16. [PMID: 30804610 PMCID: PMC6383530 DOI: 10.1590/0100-3984.2018.0041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the computed tomography characteristics of patients admitted with clinical suspicion of acute adrenal hemorrhage at three centers over a 3-year period and in whom that diagnosis was ultimately confirmed. Materials and Methods This was a retrospective analysis of computed tomography findings in patients with suspected acute adrenal hemorrhage. We included only those cases in which the diagnosis was confirmed. Patients with aortic rupture and retroperitoneal hemorrhage were excluded. The images were analyzed by an experienced radiologist and by two radiology residents. Results Six cases of unilateral adrenal hemorrhage (three on the left and three on the right) were analyzed. On computed tomography, each appeared as a rounded, oval mass altering the usual anatomy of the adrenal gland. The maximum diameter was 12.2 cm, and attenuation ranged from 45 to 70 HU. There was no appreciable contrast enhancement. No calcifications were observed. Conclusion Adrenal hemorrhage, albeit rare, is potentially fatal. Early diagnosis is essential. Therefore, recognition of the possible presentations of these lesions by radiologists may help prevent hemorrhage from progressing to adrenal insufficiency and death.
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Affiliation(s)
- Isa Félix Adôrno
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | - Tiago Kojun Tibana
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | | | | | - Walberth Gutierrez Junior
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | - Suzan Menasce Goldman
- Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Thiago Franchi Nunes
- Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
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