Retrospective study on structural neuroimaging in first-episode psychosis

Background. No consensus between guidelines exists regarding neuroimaging in firstepisode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI) and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification). No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.

É simples o que faço com os quistos simples do ovário

É cada vez mais frequente o diagnóstico de quisto do ovário pelo uso crescente de exames radiológicos. É essencial a distinção entre quisto simples e quisto complexo, pois a sua abordagem é diferente, sendo o algoritmo de abordagem adaptado à mulher pré- ou pós-menopáusica [1]. A recomendação inicial a seguir varia em função do tamanho da lesão e do valor do CA 125.

Algoritmo de abordagem das lesões anexiais indeterminadas na ecografia

O esclarecimento do órgão de origem, ou principalmente da natureza benigna ou maligna de um tumor anexial ecograficamente indeterminado surge com frequência na prática clínica e obriga a uma investigação complementar da sua natureza de modo a evitar cirurgias inúteis, sem deixar de diagnosticar precocemente a patologia maligna. Neste trabalho apresentamos um algoritmo de diagnóstico por Ressonância Magnética (RM), que recentemente foi proposto pela European Society of Urogenital Radiology (ESUR), o qual permite um diagnóstico preciso dos casos indeterminados à ecografia e uma intervenção responsável na abordagem clínica destas doentes.