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de Almeida CÁ, Nakamura R, Leverone A, Marchiori E, Canella C. High-frequency ultrasonography for subungual glomus tumor evaluation - imaging findings. Skeletal Radiol 2024; 53:891-898. [PMID: 37945770 DOI: 10.1007/s00256-023-04506-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE This article aimed to describe the common imaging features of subungual glomus tumors. METHODS The study involved data collected between January 2019 and December 2022. Twenty-three patients with a total of 31 glomus tumors underwent high-frequency ultrasound examinations with a 24-MHz probe. Two experienced radiologists independently evaluated the images, and only data from the more experienced radiologist were used for subsequent analyses. RESULTS The average size of the tumors was 4.6 mm, and most of them appeared homogeneously hypoechogenic (90.3%). Bone remodeling of the distal phalanx was observed in 87.1% of cases, with an average axial circumference loss of 0.8 mm, indicating the slow and expansive growth of glomus tumors. Intense vascularization was found in 54.8% of cases on Doppler images, and the stalk sign, reflecting the vascular origin of the tumor, was present in 64.5% of cases. The most common clinical feature was pain, reported in 84.6% of cases, with a mean pain scale score of 7.0, indicating a negative impact on patients' lives despite being benign tumors. CONCLUSION The study concludes that ultrasound evaluation is highly useful for diagnosing glomus tumors, especially when multiple findings, such as bone remodeling, hypervascularization, and the stalk sign, are present. This method allows for accurate diagnosis, observation of periungual structures, and proper surgical planning, ultimately reducing recurrence rates.
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Affiliation(s)
- Carolina Ávila de Almeida
- Department of Radiology, Diagnósticos da América S/A (DASA), Rio de Janeiro, Rio de Janeiro, Brazil.
- Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Robertha Nakamura
- Department of Dermatology, Centro de Estudos das Unhas, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andreia Leverone
- Department of Dermatology, Centro de Estudos das Unhas, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Edson Marchiori
- Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Clarissa Canella
- Clínica Alta Excelência Diagnóstica, DASA, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Radiology, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil
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Marchiori E, Hochhegger B, Zanetti G. Bullous emphysema in a cannabis user. J Bras Pneumol 2024; 50:e20230352. [PMID: 38422341 DOI: 10.36416/1806-3756/e20230352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Correia R, Corrêa D, Doring T, Theodoro C, Correia A, Coelho V, Dib JG, Marchiori E, Alves Leon SV, Rueda Lopes FC. Severity of white matter microstructural damage in a Brazilian relapsing-remitting multiple sclerosis cohort: A possible window to optimize treatment. Neuroradiol J 2024; 37:60-67. [PMID: 37915211 PMCID: PMC10863572 DOI: 10.1177/19714009231212372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is an important cause of acquired neurological disability in young adults, characterized by multicentric inflammation, demyelination, and axonal damage. OBJECTIVE The objective is to investigate white matter (WM) damage progression in a Brazilian MS patient cohort, using diffusion tensor imaging (DTI) post-processed by tract-based spatial statistics (TBSS). METHODS DTI scans were acquired from 76 MS patients and 37 sex-and-age matched controls. Patients were divided into three groups based on disease duration. DTI was performed along 30 non-collinear directions by using a 1.5T imager. For TBSS analysis, the WM skeleton was created, and a 5000 permutation-based inference with a threshold of p < .05 was used, to enable the identification of abnormalities in fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). RESULTS Decreased FA and increased RD, MD, and AD were seen in patients compared to controls and a decreased FA and increased MD and RD were seen, predominantly after the first 5 years of disease, when compared between groups. CONCLUSION Progressive WM deterioration is seen over time with a more prominent pattern after 5 years of disease onset, providing evidence that the early years might be a window to optimize treatment and prevent disability.
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Affiliation(s)
- Rafael Correia
- Department of Radiology, Federal Fluminense University (UFF), Niterói – RJ, Brazil
| | - Diogo Corrêa
- Department of Radiology, Federal Fluminense University (UFF), Niterói – RJ, Brazil
| | - Thomas Doring
- Department of Radiology, Clinicas de Diagnóstico por Imagem (CDPI), Rio de Janeiro – RJ, Brazil
| | - Carmem Theodoro
- Department of Gastroenterology, Federal Fluminense University, Niterói – RJ, Brazil
| | - Aline Correia
- Department of Internal Medicine, University of Fortaleza, Fortaleza – CE, Brazil
| | - Valeria Coelho
- Department of Neurology, Federal University of Rio de Janeiro(UFRJ), Rio de Janeiro – RJ, Brazil
| | - João Gabriel Dib
- Department of Neurology, Federal University of Rio de Janeiro(UFRJ), Rio de Janeiro – RJ, Brazil
| | - Edson Marchiori
- Department of Radiology, Federal University of Rio de Janeiro (UFRJ), Rio de janeiro – RJ, Brazil
| | - Soniza V Alves Leon
- Department of Neurology, Federal University of Rio de Janeiro(UFRJ), Rio de Janeiro – RJ, Brazil
| | - Fernanda C Rueda Lopes
- Department of Radiology, Federal Fluminense University (UFF), Niterói – RJ, Brazil
- Department of Radiology, Federal University of Rio de Janeiro (UFRJ), Rio de janeiro – RJ, Brazil
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Torres PPTES, Marchiori E. Subsolid nodules, adenocarcinomas, and COVID-19: looking for needles in a haystack. J Bras Pneumol 2024; 49:e20230392. [PMID: 38232257 PMCID: PMC10769469 DOI: 10.36416/1806-3756/e20230392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Affiliation(s)
| | - Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Marchiori E, Hochhegger B, Zanetti G. Paraseptal emphysema. J Bras Pneumol 2024; 49:e20230340. [PMID: 38198348 PMCID: PMC10760424 DOI: 10.36416/1806-3756/e20230340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Marchiori E, Hochhegger B, Zanetti G. Pulmonary hypertension. J Bras Pneumol 2023; 49:e20230275. [PMID: 37909553 PMCID: PMC10759981 DOI: 10.36416/1806-3756/e20230275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Sousa C, Pasini RA, Pasqualotto A, Marchiori E, Altmayer S, Irion K, Mançano A, Hochhegger B. Imaging Findings in Aspergillosis: From Head to Toe. Mycopathologia 2023; 188:623-641. [PMID: 37380874 DOI: 10.1007/s11046-023-00766-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
Aspergillosis is a mycotic infection induced by airborne fungi that are ubiquitous. Inhalation of Aspergillus conidia results in transmission through the respiratory tract. The clinical presentation is dependent on organism and host specifics, with immunodeficiency, allergies, and preexisting pulmonary disease constituting the most important risk factors. In recent decades, the incidence of fungal infections has increased dramatically, due in part to the increased number of transplants and the pervasive use of chemotherapy and immunosuppressive drugs. The spectrum of clinical manifestations can range from an asymptomatic or mild infection to a swiftly progressive, life-threatening illness. Additionally, invasive infections can migrate to extrapulmonary sites, causing infections in distant organs. Recognition and familiarity with the various radiological findings in the appropriate clinical context are essential for patient management and the prompt initiation of life-saving treatment. We discuss the radiological characteristics of chronic and invasive pulmonary aspergillosis, as well as some of the typically unexpected extrapulmonary manifestations of disseminated disease.
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Affiliation(s)
- Célia Sousa
- Radiology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | | | - Alessandro Pasqualotto
- Radiology Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Edson Marchiori
- Radiology Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Klaus Irion
- Radiology Department, University of Florida, Gainesville, FL, USA
| | | | - Bruno Hochhegger
- Radiology Department, University of Florida, Gainesville, FL, USA.
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8
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Guedes Pinto E, Penha D, Ravara S, Monaghan C, Hochhegger B, Marchiori E, Taborda-Barata L, Irion K. Factors influencing the outcome of volumetry tools for pulmonary nodule analysis: a systematic review and attempted meta-analysis. Insights Imaging 2023; 14:152. [PMID: 37741928 PMCID: PMC10517915 DOI: 10.1186/s13244-023-01480-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/08/2023] [Indexed: 09/25/2023] Open
Abstract
Health systems worldwide are implementing lung cancer screening programmes to identify early-stage lung cancer and maximise patient survival. Volumetry is recommended for follow-up of pulmonary nodules and outperforms other measurement methods. However, volumetry is known to be influenced by multiple factors. The objectives of this systematic review (PROSPERO CRD42022370233) are to summarise the current knowledge regarding factors that influence volumetry tools used in the analysis of pulmonary nodules, assess for significant clinical impact, identify gaps in current knowledge and suggest future research. Five databases (Medline, Scopus, Journals@Ovid, Embase and Emcare) were searched on the 21st of September, 2022, and 137 original research studies were included, explicitly testing the potential impact of influencing factors on the outcome of volumetry tools. The summary of these studies is tabulated, and a narrative review is provided. A subset of studies (n = 16) reporting clinical significance were selected, and their results were combined, if appropriate, using meta-analysis. Factors with clinical significance include the segmentation algorithm, quality of the segmentation, slice thickness, the level of inspiration for solid nodules, and the reconstruction algorithm and kernel in subsolid nodules. Although there is a large body of evidence in this field, it is unclear how to apply the results from these studies in clinical practice as most studies do not test for clinical relevance. The meta-analysis did not improve our understanding due to the small number and heterogeneity of studies testing for clinical significance. CRITICAL RELEVANCE STATEMENT: Many studies have investigated the influencing factors of pulmonary nodule volumetry, but only 11% of these questioned their clinical relevance in their management. The heterogeneity among these studies presents a challenge in consolidating results and clinical application of the evidence. KEY POINTS: • Factors influencing the volumetry of pulmonary nodules have been extensively investigated. • Just 11% of studies test clinical significance (wrongly diagnosing growth). • Nodule size interacts with most other influencing factors (especially for smaller nodules). • Heterogeneity among studies makes comparison and consolidation of results challenging. • Future research should focus on clinical applicability, screening, and updated technology.
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Affiliation(s)
- Erique Guedes Pinto
- R. Marquês de Ávila E Bolama, Universidade da Beira Interior Faculdade de Ciências da Saúde, 6201-001, Covilhã, Portugal.
| | - Diana Penha
- R. Marquês de Ávila E Bolama, Universidade da Beira Interior Faculdade de Ciências da Saúde, 6201-001, Covilhã, Portugal
- Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Dr, Liverpool, L14 3PE, UK
| | - Sofia Ravara
- R. Marquês de Ávila E Bolama, Universidade da Beira Interior Faculdade de Ciências da Saúde, 6201-001, Covilhã, Portugal
| | - Colin Monaghan
- Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Dr, Liverpool, L14 3PE, UK
| | | | - Edson Marchiori
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro, Bloco K - Av. Carlos Chagas Filho, 373 - 2º Andar, Sala 49 - Cidade Universitária da Universidade Federal Do Rio de Janeiro, Rio de Janeiro - RJ, 21044-020, Brasil
- Faculdade de Medicina, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303 - Centro, Niterói - RJ, 24220-000, Brasil
| | - Luís Taborda-Barata
- R. Marquês de Ávila E Bolama, Universidade da Beira Interior Faculdade de Ciências da Saúde, 6201-001, Covilhã, Portugal
| | - Klaus Irion
- Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Oxford Rd, Manchester, M13 9WL, UK
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Vieira ADA, Marchiori E, Mogami R. Disseminated miliary tuberculosis with cutaneous involvement in a patient with HIV. Rev Soc Bras Med Trop 2023; 56:e02762023. [PMID: 37792833 PMCID: PMC10550094 DOI: 10.1590/0037-8682-0276-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/21/2023] [Indexed: 10/06/2023] Open
Affiliation(s)
- André de Almeida Vieira
- Universidade do Estado do Rio de Janeiro, Departamento de Medicina Interna, Disciplina de Radiologia, Rio de Janeiro, RJ, Brasil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro, RJ, Brasil
| | - Roberto Mogami
- Universidade do Estado do Rio de Janeiro, Departamento de Medicina Interna, Disciplina de Radiologia, Rio de Janeiro, RJ, Brasil
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10
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Souza LVS, Souza AS, Marchiori E. Pulmonary emphysema associated with skin nodules. J Bras Pneumol 2023; 49:e20230053. [PMID: 37610958 PMCID: PMC10578919 DOI: 10.36416/1806-3756/e20230053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Affiliation(s)
| | - Arthur Soares Souza
- . Ultra X, São José do Rio Preto (SP) Brasil
- . Faculdade de Medicina de Rio Preto, São José do Rio Preto (SP) Brasil
| | - Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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11
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Marchiori E, Hochhegger B, Zanetti G. Bronchiectasis with tracheobronchial dilation. J Bras Pneumol 2023; 49:e20230235. [PMID: 37610963 PMCID: PMC10578933 DOI: 10.36416/1806-3756/e20230235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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12
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Marchiori E, Hochhegger B, Zanetti G. Transfusion-related acute lung injury: an uncommon cause of pulmonary edema. J Bras Pneumol 2023; 49:e20230175. [PMID: 37610961 PMCID: PMC10578943 DOI: 10.36416/1806-3756/e20230175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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13
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Marchiori E, Hochhegger B, Zanetti G. Multiple vascular nodules. J Bras Pneumol 2023; 49:e20230173. [PMID: 37493792 PMCID: PMC10578903 DOI: 10.36416/1806-3756/e20230173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Silva JAM, Hochhegger B, Amorim VB, Zanetti G, Marchiori E. Computed tomography aspects of thoracic metastases from osteosarcoma: pictorial essay. Radiol Bras 2023; 56:215-219. [PMID: 37829585 PMCID: PMC10567086 DOI: 10.1590/0100-3984.2022.0107-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 10/14/2023] Open
Abstract
Osteosarcoma is the most common primary bone tumor, with a higher incidence in the second decade of life, and it often leads to pulmonary metastases. The most common pattern seen on computed tomography is one of multiple well-defined nodules in the lung parenchyma, often with calcifications. Because of the variety of presentations of pulmonary metastases in osteosarcoma, including atypical forms, knowledge of the computed tomography aspects of these lesions is important for characterizing and evaluating the extent of the disease, as well as for distinguishing metastatic disease from other benign or malignant lung diseases. This essay discusses the main tomographic findings of pulmonary metastases from osteosarcoma.
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Affiliation(s)
| | | | | | - Gláucia Zanetti
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ,
Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ,
Brazil
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15
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Marchiori E, Hochhegger B, Zanetti G. Fat embolism syndrome causing a crazy-paving pattern on CT. J Bras Pneumol 2023; 49:e20230149. [PMID: 37283404 PMCID: PMC10578928 DOI: 10.36416/1806-3756/e20230149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Marchiori E, Hochhegger B, Zanetti G. Left upper lobe atelectasis. J Bras Pneumol 2023; 49:e20230064. [PMID: 37194819 DOI: 10.36416/1806-3756/e20230064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Marchiori E, Hochhegger B, Zanetti G. COVID-19 and infectious diseases: a frequent association. Clin Imaging 2023; 97:70-71. [PMID: 36905886 PMCID: PMC9991325 DOI: 10.1016/j.clinimag.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Bruno Hochhegger
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Gláucia Zanetti
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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18
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Mango ALD, Gomes ACP, Hochhegger B, Zanetti G, Marchiori E. Computed tomography findings of pulmonary histoplasmosis: pictorial essay. Radiol Bras 2023; 56:162-167. [PMID: 37564080 PMCID: PMC10411766 DOI: 10.1590/0100-3984.2022.0106-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 08/12/2023] Open
Abstract
Endemic systemic mycoses are prevalent in specific geographic areas of the world and are responsible for high rates of morbidity and mortality in the populations of such areas, as well as in immigrants and travelers returning from endemic regions. Pulmonary histoplasmosis is an infection caused by Histoplasma capsulatum, a dimorphic fungus. This infection has a worldwide distribution, being endemic in Brazil. Histoplasmosis can affect the lungs, and its diagnosis and management remain challenging, especially in non-endemic areas. Therefore, recognition of the various radiological manifestations of pulmonary histoplasmosis, together with the clinical and epidemiological history of the patient, is essential to narrowing the differential diagnosis. This essay discusses the main computed tomography findings of pulmonary histoplasmosis.
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Affiliation(s)
- Ana Luiza Di Mango
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ,
Brazil
| | | | | | - Gláucia Zanetti
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ,
Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ,
Brazil
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Silva JAM, Marchiori E, Amorim VB, Barreto MM. CT features of osteosarcoma lung metastasis: a retrospective study of 127 patients. J Bras Pneumol 2023; 49:e20220433. [PMID: 37132704 PMCID: PMC10171270 DOI: 10.36416/1806-3756/e20220433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/26/2023] [Indexed: 03/31/2023] Open
Abstract
Objective: Osteosarcoma lung metastases have a wide variety of CT presentations, representing a challenge for radiologists. Knowledge of atypical CT patterns of lung metastasis is important to differentiate it from benign lung disease and synchronous lung cancer, as well as to determine the extent of primary disease. The objective of this study was to analyze CT features of osteosarcoma lung metastasis before and during chemotherapy. Methods: Two radiologists independently reviewed chest CT images of 127 patients with histopathologically confirmed osteosarcoma treated between May 10, 2012 and November 13, 2020. The images were divided into two groups for analysis: images obtained before chemotherapy and images obtained during chemotherapy (initial CT examination). Results: Seventy-five patients were diagnosed with synchronous or metachronous lung metastases. The most common CT findings were nodules (in 95% of the patients), distributed bilaterally (in 86%), with no predominance regarding craniocaudal distribution (in 71%). Calcification was observed in 47%. Less common findings included intravascular lesions (in 16%), cavitation (in 7%), and the halo sign (in 5%). The primary tumor size was significantly greater (i.e., > 10 cm) in patients with lung metastasis. Conclusions: On CT scans, osteosarcoma lung metastases typically appear as bilateral solid nodules. However, they can have atypical presentations, with calcification being the most common. Knowledge of the typical and atypical CT features of osteosarcoma lung metastasis could play a key role in improving image interpretation in these cases.
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Affiliation(s)
| | - Edson Marchiori
- . Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Viviane Brandão Amorim
- . Departamento de Radiologia, Instituto Nacional do Câncer, Rio de Janeiro (RJ) Brasil
- . Departamento de Radiologia, Grupo Fleury S.A., Rio de Janeiro (RJ) Brasil
| | - Miriam Menna Barreto
- . Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Marchiori E, Hochhegger B, Zanetti G. Hyperdensities within the pulmonary arteries. J Bras Pneumol 2023; 49:e20230048. [PMID: 36946822 PMCID: PMC10171279 DOI: 10.36416/1806-3756/e20230048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Alvarenga Fernandes D, de Fátima Ferreira Santana Boin I, Batista Araújo Filho JDA, Cristina de Ataíde E, Marchiori E, Reis F. Hepatic involvement in hereditary hemorrhagic telangiectasia mimicking focal nodular hyperplasia. Rev Esp Enferm Dig 2023; 115:152-154. [PMID: 36043536 DOI: 10.17235/reed.2022.9069/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Accurate diagnosis of hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber disease, is important for reducing the risk of complications. Hepatic involvement in HHT is usually asymptomatic, but when present can cause noted morbidity and mortality. A 62-year-old woman presented with moderate upper-abdominal pain and tachycardia. A diagnosis of HHT was made based on the findings of hepatic involvement in a contrast-enhanced abdominal computed tomography (CT) scan, the presence of arteriovenous malformations (AVMs; a.k.a. telangiectasias) on mucocutaneous surfaces, and a history of recurrent epistaxis. Imaging methods are important diagnostic tools in patients suspected of having HHT.
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Affiliation(s)
| | | | | | | | - Edson Marchiori
- Radiology, Federal University of Rio de Janeiro (UFRJ), BRAZIL
| | - Fabiano Reis
- Radiology, University of Campinas (UNICAMP), BRAZIL
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22
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de Godoy MF, Chatkin JM, Rodrigues RS, Forte GC, Marchiori E, Gavenski N, Barros RC, Hochhegger B. Artificial intelligence to predict the need for mechanical ventilation in cases of severe COVID-19. Radiol Bras 2023; 56:81-85. [PMID: 37168039 PMCID: PMC10165968 DOI: 10.1590/0100-3984.2022.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/22/2022] [Indexed: 03/12/2023] Open
Abstract
Objective To determinate the accuracy of computed tomography (CT) imaging assessed by deep neural networks for predicting the need for mechanical ventilation (MV) in patients hospitalized with severe acute respiratory syndrome due to coronavirus disease 2019 (COVID-19). Materials and Methods This was a retrospective cohort study carried out at two hospitals in Brazil. We included CT scans from patients who were hospitalized due to severe acute respiratory syndrome and had COVID-19 confirmed by reverse transcription-polymerase chain reaction (RT-PCR). The training set consisted of chest CT examinations from 823 patients with COVID-19, of whom 93 required MV during hospitalization. We developed an artificial intelligence (AI) model based on convolutional neural networks. The performance of the AI model was evaluated by calculating its accuracy, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve. Results For predicting the need for MV, the AI model had a sensitivity of 0.417 and a specificity of 0.860. The corresponding area under the ROC curve for the test set was 0.68. Conclusion The high specificity of our AI model makes it able to reliably predict which patients will and will not need invasive ventilation. That makes this approach ideal for identifying high-risk patients and predicting the minimum number of ventilators and critical care beds that will be required.
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Affiliation(s)
| | - José Miguel Chatkin
- Pontifícia Universidade Católica do Rio Grande do Sul
(PUCRS), Porto Alegre, RS, Brazil
| | | | - Gabriele Carra Forte
- Pontifícia Universidade Católica do Rio Grande do Sul
(PUCRS), Porto Alegre, RS, Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Nathan Gavenski
- Pontifícia Universidade Católica do Rio Grande do Sul
(PUCRS), Porto Alegre, RS, Brazil
| | - Rodrigo Coelho Barros
- Pontifícia Universidade Católica do Rio Grande do Sul
(PUCRS), Porto Alegre, RS, Brazil
| | - Bruno Hochhegger
- Pontifícia Universidade Católica do Rio Grande do Sul
(PUCRS), Porto Alegre, RS, Brazil
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Hochhegger B, Pasini R, Roncally Carvalho A, Rodrigues R, Altmayer S, Kayat Bittencourt L, Marchiori E, Forghani R. Artificial Intelligence for Cardiothoracic Imaging: Overview of Current and Emerging Applications. Semin Roentgenol 2023; 58:184-195. [PMID: 37087139 DOI: 10.1053/j.ro.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 03/07/2023]
Abstract
Artificial intelligence algorithms can learn by assimilating information from large datasets in order to decipher complex associations, identify previously undiscovered pathophysiological states, and construct prediction models. There has been tremendous interest and increased incorporation of artificial intelligence into various industries, including healthcare. As a result, there has been an exponential rise in the number of research articles and industry participants producing models intended for a variety of applications in medical imaging, which can be challenging to navigate for radiologists. In thoracic imaging, multiple applications are being evaluated for chest radiography and computed tomography and include applications for lung nodule evaluation and cancer imaging, quantifying diffuse lung disorders, and cardiac imaging, to name a few. This review aims to provide an overview of current clinical AI models, focusing on the most common clinical applications of AI in cardiothoracic imaging.
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Nunes TF, Inchingolo R, Kikuti CF, Faria BBD, Galhardo CAV, Tognini JRF, Marchiori E, Hochhegger B. Fluoroscopia por tomografia computadorizada - biópsia percutânea guiada de nódulos pulmonares ≤ 10 mm: análise retrospectiva de procedimentos realizados no período de pandemia de COVID-19. Radiol Bras 2023. [DOI: 10.1590/0100-3984.2022.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Resumo Objetivo: Avaliar o desempenho diagnóstico da biópsia pulmonar percutânea transtorácica (BPPT) guiada por fluoroscopia associada a tomografia computadorizada (FTC) em nódulos pulmonares ≤ 10 mm no período de pandemia de COVID-19. Materiais e Métodos: No período de 1º de janeiro de 2020 a 30 de abril de 2022, 359 BPPTs guiadas por FTC foram realizadas em um centro terciário de radiologia intervencionista. As lesões pulmonares mediam entre 2 mm e 108 mm. Dessas 359 BPPTs, 27 (7,5%) foram realizadas com agulha 18G em nódulos de 2 mm a 10 mm. Resultados: Das 27 BPPTs realizadas nos nódulos ≤ 10 mm, quatro lesões tinham dimensões menores que 5 mm e 23 lesões mediam entre 5 e 10 mm. Sensibilidade e acurácia diagnóstica das BPPTs guiadas por FTC foram de 100% e 92,3%, respectivamente. A dose média de radiação ionizante para os pacientes durante o procedimento de BPPT guiada por FTC foi de 581,33 mGy*cm, variando de 303 a 1129 mGy*cm. A média de tempo dos procedimentos de biópsia foi de 6,6 minutos, variando de 2 a 12 minutos. Nas 27 BPPTs, nenhuma complicação maior foi descrita. Conclusão: A BBPT guiada por FTC resultou em alto rendimento diagnóstico e baixas taxas de complicações.
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Alves Júnior SF, Marchiori E, Ventura N. Paracoccidioidomycosis of the central nervous system with pulmonary involvement: typical imaging findings. Acta Neurol Belg 2023; 123:227-229. [PMID: 33394382 DOI: 10.1007/s13760-020-01571-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/08/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Sérgio Ferreira Alves Júnior
- Radiology Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
- Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
| | - Edson Marchiori
- Radiology Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nina Ventura
- Radiology Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
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26
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Hartmann A, Noro F, Bahia PRV, Fontes-Dantas FL, Andreiuolo RF, Lopes FCR, Pereira VCSR, Coutinho RA, Araujo ADD, Marchiori E, Alves-Leon SV. The clinical-radiological paradox in multiple sclerosis: myth or truth? Arq Neuropsiquiatr 2023; 81:55-61. [PMID: 36918008 PMCID: PMC10014204 DOI: 10.1055/s-0042-1758457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory, degenerative, demyelinating disease that ranges from benign to rapidly progressive forms. A striking characteristic of the disease is the clinical-radiological paradox. OBJECTIVES The present study was conducted to determine whether, in our cohort, the clinical-radiological paradox exists and whether lesion location is related to clinical disability in patients with MS. METHODS Retrospective data from 95 patients with MS (60 women and 35 men) treated at a single center were examined. One head-and-spine magnetic resonance imaging (MRI) examination from each patient was selected randomly, and two independent observers calculated lesion loads (LLs) on T2/fluid attenuation inversion recovery sequences manually, considering the whole brain and four separate regions (periventricular, juxtacortical, posterior fossa, and spinal cord). The LLs were compared with the degree of disability, measured by the Kurtzke Expanded Disability Status Scale (EDSS), at the time of MRI examination in the whole cohort and in patients with relapsing-remitting (RR), primarily progressive, and secondarily progressive MS. RESULTS High LLs correlated with high EDSS scores in the whole cohort (r = 0.34; p < 0.01) and in the RRMS group (r = 0.27; p = 0.02). The EDSS score correlated with high regional LLs in the posterior fossa (r = 0.31; p = 0.002) and spinal cord (r = 0.35; p = 0.001). CONCLUSIONS Our results indicate that the clinical-radiological paradox is a myth and support the logical connection between lesion location and neurological repercussion.
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Affiliation(s)
- Ana Hartmann
- Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil
| | - Fabio Noro
- Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil
| | | | - Fabricia Lima Fontes-Dantas
- Universidade Estadual do Rio de Janeiro, Departamento de Farmacologia e Psicobiologia, Rio de Janeiro RJ, Brazil
| | | | | | | | - Renan Amaral Coutinho
- Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil
| | - Amanda Dutra de Araujo
- Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil
| | - Soniza Vieira Alves-Leon
- Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil.,Universidade Federal do Estado do Rio de Janeiro, Laboratório de Neurociências Translacional. Soniza Vieira Alves-Leon, Rio de Janeiro RJ, Brazil
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27
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Nunes TF, Inchingolo R, Kikuti CF, de Faria BB, Galhardo CAV, Tognini JRF, Marchiori E, Hochhegger B. Computed tomography fluoroscopy-guided percutaneous biopsy of pulmonary nodules ≤ 10 mm: retrospective analysis of procedures performed during the COVID-19 pandemic. Radiol Bras 2023; 56:1-7. [PMID: 36926361 PMCID: PMC10013188 DOI: 10.1590/0100-3984.2022.0062-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/24/2022] [Indexed: 03/15/2023] Open
Abstract
Objective To evaluate the diagnostic performance of computed tomography (CT) fluoroscopy-guided percutaneous transthoracic needle biopsy (PTNB) in pulmonary nodules ≤ 10 mm during the coronavirus disease 2019 pandemic. Materials and Methods Between January 1, 2020 and April 30, 2022, a total of 359 CT fluoroscopy-guided PTNBs were performed at an interventional radiology center. Lung lesions measured between 2 mm and 108 mm. Of the 359 PTNBs, 27 (7.5%) were performed with an 18G core needle on nodules ≤ 10 mm in diameter. Results Among the 27 biopsies performed on nodules ≤ 10 mm, the lesions measured < 5 mm in four and 5-10 mm in 23. The sensitivity and overall diagnostic accuracy of PTNB were 100% and 92.3%, respectively. The mean dose of ionizing radiation during PTNB was 581.33 mGy*cm (range, 303-1,129 mGy*cm), and the mean biopsy procedure time was 6.6 min (range, 2-12 min). There were no major postprocedural complications. Conclusion CT fluoroscopy-guided PTNB appears to provide a high diagnostic yield with low complication rates.
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Affiliation(s)
- Thiago Franchi Nunes
- Hospital Universitário Maria Aparecida Pedrossian da Universidade
Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | - Riccardo Inchingolo
- Ospedale Generale Regionale Francesco Miulli, Acquaviva delle
Fonti, Puglia, Italy
| | - Cristina Faria Kikuti
- Hospital Universitário Maria Aparecida Pedrossian da Universidade
Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil
| | | | | | - João Ricardo Filgueiras Tognini
- Universidade Federal de Mato Grosso do Sul (UFMS), Fundação de
Ensino e Pesquisa Miguel Couto da Unimed Campo Grande, Campo Grande, MS,
Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ,
Brazil
| | - Bruno Hochhegger
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS),
Porto Alegre, RS, Brazil
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28
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da Silva MDMC, Rodrigues RS, Marchiori E. Takayasu's arteritis with pulmonary artery involvement. J Bras Pneumol 2022; 48:e20220266. [PMID: 36629633 PMCID: PMC9747162 DOI: 10.36416/1806-3756/e20220266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
| | - Rosana Souza Rodrigues
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil.,. Instituto D’Or de Pesquisa e Ensino (IDOR), Rio de Janeiro (RJ), Brasil
| | - Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
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29
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Hochhegger B, Patel PP, Zanon M, Müller E, Ferreira Correa L, Verma N, Mohammed TL, Quinto Dos Reis Hochhegger D, Irion K, Marchiori E. Narrowing the Differential Diagnosis of Cystic Lesions in Smokers with Expiratory CT Acquisition Using the Cyst-Airway Communication Hypothesis. Lung 2022; 200:817-820. [PMID: 36271930 DOI: 10.1007/s00408-022-00576-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/25/2022] [Indexed: 12/30/2022]
Abstract
The aim of this study was to assess percentage respiratory changes (δ) in the size of pulmonary cysts of different smoking-related etiologies. Retrospectively, we measured the cystic lesions due to histopathological-confirmed honeycombing from interstitial pulmonary fibrosis, pulmonary Langerhans cell histiocytosis (PLCH), and paraseptal emphysema, using paired inspiratory and expiratory CT scans. In a sample of 72 patients and 216 lesions, the mean diameter of PLCH and honeycombing decreased during expiration (PLCH, δ = 60.9%; p = 0.001; honeycombing, δ = 47.5%; p = 0.014). Conversely, paraseptal emphysema did not show any changes (δ = 5.2%; p = 0.34). In summary, our results demonstrated that cysts in smokers with PLCH and honeycombing fibrosis get smaller during expiratory CT scans, whereas the size of cystic-like lesions due to paraseptal emphysema and bullae tend to remain constant during respiratory cycles. These results support the hypothesis of cyst-airway communication in some cystic diseases, which could assist in the differential diagnosis in smoking-related lung diseases.
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Affiliation(s)
- Bruno Hochhegger
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL, 32610, USA. .,Department of Radiology, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619-900, Brazil. .,Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil.
| | - Pratik P Patel
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL, 32610, USA
| | - Matheus Zanon
- Department of Radiology, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619-900, Brazil.,Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil
| | - Enrico Müller
- Department of Radiology, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619-900, Brazil
| | - Liana Ferreira Correa
- Department of Radiology, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619-900, Brazil
| | - Nupur Verma
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil
| | - Tan-Lucien Mohammed
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil
| | - Daniela Quinto Dos Reis Hochhegger
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL, 32610, USA.,Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil
| | - Klaus Irion
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL, 32610, USA.,Department of Radiology, Central Manchester University Hospitals, NHS Foundation Trust - Trust Headquarters, Cobbett House, Manchester Royal Infirmary, Oxford Road, Manchester, M139WL, UK
| | - Edson Marchiori
- Department of Radiology, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Rio de Janeiro, 21941-902, Brazil
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Hochhegger B, Zanon M, Patel PP, Verma N, Eifer DA, Torres PPTES, Souza AS, Souza LVS, Mohammed TL, Marchiori E, Ackman JB. The diagnostic value of magnetic resonance imaging compared to computed tomography in the evaluation of fat-containing thoracic lesions. Br J Radiol 2022; 95:20220235. [PMID: 36125174 PMCID: PMC9733611 DOI: 10.1259/bjr.20220235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/09/2022] [Accepted: 08/30/2022] [Indexed: 11/05/2022] Open
Abstract
Intrathoracic fat-containing lesions may arise in the mediastinum, lungs, pleura, or chest wall. While CT can be helpful in the detection and diagnosis of these lesions, it can only do so if the lesions contain macroscopic fat. Furthermore, because CT cannot demonstrate microscopic or intravoxel fat, it can fail to identify and diagnose microscopic fat-containing lesions. MRI, employing spectral and chemical shift fat suppression techniques, can identify both macroscopic and microscopic fat, with resultant enhanced capability to diagnose these intrathoracic lesions non-invasively and without ionizing radiation. This paper aims to review the CT and MRI findings of fat-containing lesions of the chest and describes the fat-suppression techniques utilized in their assessment.
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Affiliation(s)
| | - Matheus Zanon
- Department of Radiology, Hospital São Lucas, Pontificia Universidade Catolica do Rio Grande do Sul - Av. Ipiranga, Porto Alegre, Brazil
| | - Pratik P Patel
- Department of Radiology, College of Medicine, University of Florida, Gainesville, United States
| | - Nupur Verma
- Department of Radiology, College of Medicine, University of Florida, Gainesville, United States
| | - Diego André Eifer
- Department of Radiology, Hospital São Lucas, Pontificia Universidade Catolica do Rio Grande do Sul - Av. Ipiranga, Porto Alegre, Brazil
| | | | - Arthur S Souza
- Department of Radiology, Rio Preto Radiodiagnostic Intitute – R. Cila, São José do Rio Preto, Brazil
| | | | - Tan-Lucien Mohammed
- Department of Radiology, College of Medicine, University of Florida, Gainesville, United States
| | - Edson Marchiori
- Department of Radiology, Federal University of Rio de Janeiro - Av. Carlos Chagas Filho, Rio de Janeiro, Brazil
| | - Jeanne B Ackman
- Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School - Founders House, Boston, United States
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Marchiori E, Hochhegger B, Zanetti G. Dense reticular pattern. J Bras Pneumol 2022; 48:e20220383. [PMID: 36449824 PMCID: PMC9747176 DOI: 10.36416/1806-3756/e20220383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Sousa C, Marchiori E, Youssef A, Mohammed TL, Patel P, Irion K, Pasini R, Mançano A, Souza A, Pasqualotto AC, Hochhegger B. Chest Imaging in Systemic Endemic Mycoses. J Fungi (Basel) 2022; 8:1132. [PMID: 36354899 PMCID: PMC9692403 DOI: 10.3390/jof8111132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/14/2022] [Accepted: 10/24/2022] [Indexed: 09/20/2023] Open
Abstract
Endemic fungal infections are responsible for high rates of morbidity and mortality in certain regions of the world. The diagnosis and management remain a challenge, and the reason could be explained by the lack of disease awareness, variability of symptoms, and insidious and often overlooked clinical presentation. Imaging findings are nonspecific and frequently misinterpreted as other more common infectious or malignant diseases. Patient demographics and clinical and travel history are important clues that may lead to a proper diagnosis. The purpose of this paper is to review the presentation and differential diagnosis of endemic mycoses based on the most common chest imaging findings.
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Affiliation(s)
- Célia Sousa
- Radiology Department, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Edson Marchiori
- Radiology Department, Universidade Federal de Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Ali Youssef
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
| | - Tan-Lucien Mohammed
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
| | - Pratik Patel
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
| | - Klaus Irion
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
| | - Romulo Pasini
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
| | - Alexandre Mançano
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
| | - Arthur Souza
- Radiology Department, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto 15090-000, Brazil
| | | | - Bruno Hochhegger
- Radiology Department, University of Florida Health Shands Hospital, Gainesville, FL 32608, USA
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Machado MGL, Rodrigues RS, Marchiori E. Pulmonary and cerebral paracoccidioidomycosis. Rev Soc Bras Med Trop 2022; 55:e0188. [PMID: 36134863 PMCID: PMC9491227 DOI: 10.1590/0037-8682-0188-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/15/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Rosana Souza Rodrigues
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.,Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brasil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Pinto E, Penha D, Hochhegger B, Monaghan C, Marchiori E, Taborda-Barata L, Irion K. Variability of pulmonary nodule volumetry on coronary CT angiograms. Medicine (Baltimore) 2022; 101:e30332. [PMID: 36107569 PMCID: PMC9439735 DOI: 10.1097/md.0000000000030332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aims to investigate the variability of pulmonary nodule (PN) volumetry on multiphase coronary CT angiograms (CCTA). Two radiologists reviewed 5973 CCTA scans in this cross-sectional study to detect incidental solid noncalcified PNs measuring between 5 and 8 mm. Each radiologist measured the nodules' diameters and volume, in systole and diastole, using 2 commercially available software packages to analyze PNs. Bland-Altman analysis was applied between different observers, software packages, and cardiac phases. Bland-Altman subanalysis for the systolic and diastolic datasets were also performed. A total of 195 PNs were detected within the inclusion criteria and measured in systole and diastole. Bland-Altman analysis was used to test the variability of volumetry between cardiac phases ([-47.0%; 52.3%]), software packages ([-50.2%; 68.2%]), and observers ([-14.5%; 27.8%]). The inter-observer variability of the systolic and diastolic subsets was [-13.6%; 31.4%] and [-13.9%; 19.7%], respectively. Using diastolic volume measurements, the variability of PN volumetry on CCTA scans is similar to the reported variability of volumetry on low-dose CT scans. Therefore, growth estimation of PNs on CCTA scans could be feasible.
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Affiliation(s)
- Erique Pinto
- Universidade da Beira Interior Faculdade de Ciências da Saúde, Covilha, Portugal
- *Correspondence: Erique Pinto, MD, EBIR, Rua Luís DE Camões, nº 102, lt 8, 3º esq, 1300—356 Lisbon, Portugal. (e-mail: )
| | - Diana Penha
- Universidade da Beira Interior Faculdade de Ciências da Saúde, Covilha, Portugal
- Imaging Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Bruno Hochhegger
- Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Colin Monaghan
- Radiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro Faculdade de Medicina, Rio DE Janeiro, RJ, Brazil
- Universidade Federal Fluminense Faculdade de Medicina, Niteroi, RJ, Brazil
| | | | - Klaus Irion
- Imaging Department, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Muniz BC, Niemeyer B, Makita LS, Marchiori E. Sturge-Weber Syndrome with Bilateral Cerebral and Facial Involvement. Neurol India 2022; 70:2296-2297. [PMID: 36352685 DOI: 10.4103/0028-3886.359273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
| | - Bruno Niemeyer
- Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brasil
| | | | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Louza GF, Zanetti G, Marchiori E. Madelung's Disease: A Rare Cause of Dyspnea. Arch Bronconeumol 2022; 58:612. [PMID: 35312558 DOI: 10.1016/j.arbres.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/12/2021] [Accepted: 09/18/2021] [Indexed: 11/15/2022]
Affiliation(s)
| | - Gláucia Zanetti
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Marchiori E, Hochhegger B, Zanetti G. Diffuse thickening of the tracheal wall, with calcifications. J Bras Pneumol 2022; 48:e20220223. [PMID: 35894417 PMCID: PMC9496260 DOI: 10.36416/1806-3756/e20220223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS), Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
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Gomes ACP, Medeiros AK, Marchiori E. Pulmonary vein stenosis after radiofrequency ablation. J Bras Pneumol 2022; 48:e20220013. [PMID: 35830053 PMCID: PMC9262429 DOI: 10.36416/1806-3756/e20220013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
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Penha D, Pinto E, Marchiori E, Taborda-Barata L, Irion K. Pulmonary diseases that cause abnormal lung parenchymal density: is this a problem in lung cancer screening? J Bras Pneumol 2022; 48:e20220002. [PMID: 35703672 PMCID: PMC9262443 DOI: 10.36416/1806-3756/e20220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Diana Penha
- . Universidade da Beira Interior, Covilhã, Portugal
| | - Erique Pinto
- . Universidade da Beira Interior, Covilhã, Portugal
| | - Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Klaus Irion
- . Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Marchiori E, Hochhegger B, Zanetti G. Widening of the mediastinum. J Bras Pneumol 2022; 48:e20220158. [PMID: 35703621 PMCID: PMC9262426 DOI: 10.36416/1806-3756/e20220158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Marchiori E, Souza Rodrigues R, Menna Barreto M. Exuberant Paraseptal Emphysema Associated With Pulmonary Alveolar Microlithiasis: 12 Years of Evolution. Arch Bronconeumol 2022; 58:507-508. [PMID: 35312605 DOI: 10.1016/j.arbres.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Rosana Souza Rodrigues
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Brazil
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Pinto E, Penha D, Hochhegger B, Monaghan C, Marchiori E, Taborda-Barata L, Irion K. Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal. J Bras Pneumol 2022; 48:e20220015. [PMID: 35584528 PMCID: PMC9064655 DOI: 10.36416/1806-3756/e20220015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Many health systems have been using coronary CT angiography (CCTA) as a first-line examination for ischaemic heart disease patients in various countries. The rising number of CCTA examinations has led to a significant increase in the number of reported incidental extracardiac findings, mainly in the chest. Pulmonary nodules are the most common incidental findings on CCTA scans, as there is a substantial overlap of risk factors between the population seeking to exclude ischaemic heart disease and those at risk of developing lung cancer (i.e., advanced age and smoking habits). However, most incidental findings are clinically insignificant and actively pursuing them could be cost-prohibitive and submit the patient to unnecessary and potentially harmful examinations. Furthermore, there is little consensus regarding when to report or actively exclude these findings and how to manage them, that is, when to trigger an alert or to immediately refer the patient to a pulmonologist, a thoracic surgeon or a multidisciplinary team. This pictorial essay discusses the current literature on this topic and is illustrated with a review of CCTA scans. We also propose a checklist organised by organ and system, recommending actions to raise awareness of pulmonologists, thoracic surgeons, cardiologists and radiologists regarding the most significant and actionable incidental findings on CCTA scans.
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Affiliation(s)
- Erique Pinto
- . Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - Diana Penha
- . Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.,. Imaging Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Bruno Hochhegger
- . Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Colin Monaghan
- . Imaging Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Edson Marchiori
- . Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil.,. Faculdade de Medicina, Universidade Federal Fluminense, Niterói (RJ) Brasil
| | - Luís Taborda-Barata
- . Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - Klaus Irion
- . Imaging Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
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Franquet T, Franks TJ, Lee KS, Marchiori E, Mazzini S, Giménez A, Johkoh T, Cho J, Galvin JR. Human Oncoviruses and Thoracic Tumors: Understanding the Imaging Findings. Radiographics 2022; 42:644-660. [PMID: 35363552 DOI: 10.1148/rg.210157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Approximately 1.4 million virus-induced cancers occur annually, representing roughly 10% of the cancer burden worldwide. Seven oncogenic DNA and RNA viruses (ie, oncoviruses) are implicated in approximately 12%-25% of all human cancers owing to a variety of mechanisms as uncommon consequences of the normal viral life cycle. These seven well-recognized human oncoviruses are Epstein-Barr virus (EBV), human T-lymphotropic virus 1, hepatitis B virus, hepatitis C virus, HIV, human papilloma virus (HPV), and human herpesvirus 8 (HHV-8). Several viruses-namely, EBV, HPV, and Kaposi sarcoma herpesvirus or HHV-8-are increasingly being recognized as being related to HIV and/or AIDS, the growing number of transplant cases, and the use of immunosuppressive therapies. Infectious and inflammatory processes, and the accompanying lymphadenopathy, are great mimickers of human oncovirus-related tumors. Although it is often difficult to differentiate these entities, the associated clinical setting and radiologic findings may provide clues for an accurate diagnosis and appropriate management. Malignant lymphoid lesions are best evaluated with multidetector chest CT. The radiologic findings of these lesions are often nonspecific and are best interpreted in correlation with clinical data and histopathologic findings. ©RSNA, 2022.
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Affiliation(s)
- Tomás Franquet
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Teri J Franks
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Kyung Soo Lee
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Edson Marchiori
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Sandra Mazzini
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Ana Giménez
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Takeshi Johkoh
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Junhun Cho
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
| | - Jeffrey R Galvin
- From the Department of Diagnostic Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, C/ Sant Quintí 89, 08041, Barcelona, Spain (T.F., S.M., A.G.); Department of Pulmonary and Mediastinal Pathology, Department of Defense, the Joint Pathology Center, Silver Spring, Md, and Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (T.J.F.); Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), ChangWon, Gyeongsangnam-Do, Korea (K.S.L.); Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (E.M.); Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan (T.J.); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (J.C.); and Departments of Diagnostic Radiology and Internal Medicine, University of Maryland School of Medicine, Baltimore, Md (J.R.G.)
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Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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Silva JAM, Marchiori E, Macedo FCD, Silva PRGD, Amorim VB. Pulmonary metastasis of osteosarcoma: multiple presentations in a single patient. J Bras Pneumol 2022; 48:e20210478. [PMID: 35475867 PMCID: PMC9064642 DOI: 10.36416/1806-3756/e20210478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Edson Marchiori
- . Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | | | | | - Viviane Brandão Amorim
- . Departamento de Radiologia, Instituto Nacional do Câncer, Rio de Janeiro (RJ), Brasil.,. Departamento de Radiologia, Grupo Fleury S.A., Rio de Janeiro (RJ), Brasil
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Costa RD, Zanon M, Watte G, Altmayer SPL, Mohammed TL, Verma N, Backer JD, Lavon BR, Marchiori E, Hochhegger B. Expiratory CT scanning in COVID-19 patients: can we add useful data? J Bras Pneumol 2022; 48:e20210204. [PMID: 35475863 PMCID: PMC9064648 DOI: 10.36416/1806-3756/e20210204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To evaluate small airway disease in COVID-19 patients using the prevalence of air trapping (AT) and correlating it with clinical outcomes. The relationship between CT-based opacities in small blood vessels and ventilation in patients with SARS-CoV-2 pneumonia was also assessed. METHODS We retrospectively included 53 patients with positive RT-PCR results for SARS-CoV-2 between March and April of 2020. All subjects underwent HRCT scanning, including inspiratory and expiratory acquisitions. Subjects were divided into two groups based on visual identification of AT. Small blood vessel volumes were estimated by means of cross-sectional areas < 5 mm2 (BV5) derived from automated segmentation algorithms. Mixed-effect models were obtained to represent the BV5 as a function of CT-based lobar opacities and lobar ventilation. RESULTS Of the 53 participants, AT was identified in 23 (43.4%). The presence of AT was associated with increased SpO2 at admission (OR = 1.25; 95% CI, 1.07-1.45; p = 0.004) and reduced D-dimer levels (OR = 0.99; 95% CI, 0.99-0.99; p = 0.039). Patients with AT were less likely to be hospitalized (OR = 0.27; 95% CI, 0.08-0.89; p = 0.032). There was a significant but weak inverse correlation between BV5 and CT-based lobar opacities (R2 = 0.19; p = 0.03), as well as a nonsignificant and weak direct correlation between BV5 and lobar ventilation (R2 = 0.08; p = 0.54). CONCLUSIONS AT is a common finding in patients with COVID-19 that undergo expiratory CT scanning. The presence of AT may correlate with higher SpO2 at admission, lower D-dimer levels, and fewer hospitalizations when compared with absence of AT. Also, the volume of small pulmonary vessels may negatively correlate with CT opacities but not with lobar ventilation.
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Affiliation(s)
- Ruhana Dalla Costa
- . Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Matheus Zanon
- . Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Guilherme Watte
- . Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | | | - Tan-Lucien Mohammed
- . Department of Radiology, University of Florida College of Medicine, Gainesville (FL) USA
| | - Nupur Verma
- . Department of Radiology, University of Florida College of Medicine, Gainesville (FL) USA
| | - Jan De Backer
- . Department of Respiratory Medicine, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Ben R Lavon
- . Department of Respiratory Medicine, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Edson Marchiori
- . Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Bruno Hochhegger
- . Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
- . Department of Radiology, University of Florida College of Medicine, Gainesville (FL) USA
- . Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
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Guedes Pinto E, Penha D, Hochhegger B, Monaghan C, Marchiori E, Taborda-Barata L, Irion K. The impact of cardiopulmonary hemodynamic factors in volumetry for pulmonary nodule management. BMC Med Imaging 2022; 22:49. [PMID: 35303820 PMCID: PMC8932130 DOI: 10.1186/s12880-022-00774-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The acceptance of coronary CT angiogram (CCTA) scans in the management of stable angina has led to an exponential increase in studies performed and reported incidental findings, including pulmonary nodules (PN). Using low-dose CT scans, volumetry tools are used in growth assessment and risk stratification of PN between 5 and 8 mm in diameter. Volumetry of PN could also benefit from the increased temporal resolution of CCTA scans, potentially expediting clinical decisions when an incidental PN is first detected on a CCTA scan, and allow for better resource management and planning in a Radiology department. This study aims to investigate how cardiopulmonary hemodynamic factors impact the volumetry of PN using CCTA scans. These factors include the cardiac phase, vascular distance from the main pulmonary artery (MPA) to the nodule, difference of the MPA diameter between systole and diastole, nodule location, and cardiomegaly presence. MATERIALS AND METHODS Two readers reviewed all CCTA scans performed from 2016 to 2019 in a tertiary hospital and detected PN measuring between 5 and 8 mm in diameter. Each observer measured each nodule using two different software packages and in systole and diastole. A multiple linear regression model was applied, and inter-observer and inter-software agreement were assessed using intraclass correlation. RESULTS A total of 195 nodules from 107 patients were included in this retrospective, cross-sectional and observational study. The regression model identified the vascular distance (p < 0.001), the difference of the MPA diameter between systole and diastole (p < 0.001), and the location within the lower or posterior thirds of the field of view (p < 0.001 each) as affecting the volume measurement. The cardiac phase was not significant in the model. There was a very high inter-observer agreement but no reasonable inter-software agreement between measurements. CONCLUSIONS PN volumetry using CCTA scans seems to be sensitive to cardiopulmonary hemodynamic changes independently of the cardiac phase. These might also be relevant to non-gated scans, such as during PN follow-up. The cardiopulmonary hemodynamic changes are a new limiting factor to PN volumetry. In addition, when a patient experiences an acute or deteriorating cardiopulmonary disease during PN follow-up, these hemodynamic changes could affect the PN growth estimation.
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Affiliation(s)
| | - Diana Penha
- Universidade da Beira Interior, Covilhã, Portugal.,Imaging Department, Liverpool Heart and Chest Hospital NHS Foundation Trust: Liverpool, Liverpool, UK
| | - Bruno Hochhegger
- Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Colin Monaghan
- Imaging Department, Liverpool Heart and Chest Hospital NHS Foundation Trust: Liverpool, Liverpool, UK
| | - Edson Marchiori
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Klaus Irion
- Imaging Department, University of Manchester, Manchester, UK
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Torres PPTES, Rabahi MF, Marchiori E. Dendriform pulmonary ossification in coronavirus disease 2019 pneumonia. Rev Soc Bras Med Trop 2022; 55:e0621. [PMID: 35293549 PMCID: PMC8932321 DOI: 10.1590/0037-8682-0621-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/09/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Marcelo Fouad Rabahi
- Hospital Geral de Goiânia, Goiânia, GO, Brasil.,Universidade Federal de Goiás, Goiânia, GO, Brasil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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50
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Hochhegger B, Lonzetti L, Rubin A, de Mattos JN, Verma N, Mohammed TLH, Patel PP, Marchiori E. Chest MRI with CT in the assessment of interstitial lung disease progression in patients with systemic sclerosis. Rheumatology (Oxford) 2022; 61:4420-4426. [PMID: 35258556 DOI: 10.1093/rheumatology/keac148] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the performance of CT and MRI in the assessment of the progression of interstitial lung disease (ILD) associated with systemic sclerosis (SSc) and demonstrate the correlations of MRI with pulmonary function test (PFT) and CT scores. METHODS This prospective single-center observational study included patients with SSc diagnoses and MR images were assessed visually using the Scleroderma Lung Study (SLS) I system. Differences in the median scores were assessed with t-test and the Wilcoxon rank-sum test. Pearson's and Spearman's Rank correlation coefficients were calculated to correlate imaging scores and PFT results. Using disease progression as the gold standard, we calculated the AUCs of the CT and MRI scores with Harrel's c-index. The best thresholds for the prediction of disease progression were determined by ROC curve analysis with maximum Youden's Index (p < 0.05). The sensitivity, specificity, PPV, and NPV of the scores were calculated. RESULTS The AUCs for MRI and CT scores were 0.86 (0.72-0.98; p = 0.04) and 0.83 (0.70-0.99; p = 0.05), respectively. CT and MRI scores correlated with FVC% (MR: r = -0.54, p= 0.0045-CT: r = -0.44; p= 0.137) and DCO (MR: r = -0.39; p= 0.007-CT r = -0.36: p= 0.006). The sensitivity, specificity, PPV, and NPV were 85%, 87.5%, 88.34% and 86.11% (MR score) and 84.21%, 82.35%, 84.14% and 82.4% (CT score). CONCLUSIONS MRI scores from patients with SSc may be an alternative modality for the assessment of ILD progression in patients with SSc.
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Affiliation(s)
- Bruno Hochhegger
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Lilian Lonzetti
- Santa Casa de Misericórdia de Porto Alegre. Prof. Annes Dias, 285. 90020090. Porto Alegre, RS, Brazil
| | - Adalberto Rubin
- Santa Casa de Misericórdia de Porto Alegre. Prof. Annes Dias, 285. 90020090. Porto Alegre, RS, Brazil
| | - Juliane Nascimento de Mattos
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.,Santa Casa de Misericórdia de Porto Alegre. Prof. Annes Dias, 285. 90020090. Porto Alegre, RS, Brazil
| | - Nupur Verma
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32611, USA
| | - Tan-Lucien H Mohammed
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32611, USA
| | - Pratik P Patel
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32611, USA
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina. Avenida Brigadeiro Trompowski-Galeão 21941590. Rio de Janeiro, RJ, Brazil
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