Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Contribuição do contraste negativo na artrografia tomográfica do joelho normal de cães

A ruptura do ligamento cruzado cranial é uma das causas mais comuns de claudicação do membro pélvico de cães. A radiografia e a ultrassonografia são métodos de diagnóstico frequentemente utilizados na rotina clínica de pequenos animais, porém a tomografia computadorizada é uma modalidade de imagem ainda pouco estudada para avaliar a articulação do joelho de cães. O presente trabalho teve por objetivo avaliar a contribuição do contraste negativo na artrografia tomográfica do joelho normal de cães, para visibilizar as estruturas intra-articulares e padronizar o uso desse contraste na articulação. Foram utilizados 24 membros pélvicos de cães de raças variadas, selecionados pela ausência de histórico de doença articular prévia do joelho e por apresentarem exames radiográficos, ultrassonográficos e macroscópicos normais. O experimento foi delineado em dois grupos, sendo o grupo I constituído de animais com peso até 20 kg e grupo II acima de 20 kg. Foram feitos cortes tomográficos com o membro flexionado e estendido. A quantidade média de ar empregada para a distensão da cápsula articular foi de 49 ml para o Grupo I e de 81 ml para o Grupo II. Utilizou-se um tubo de látex na porção distal à articulação do joelho para reduzir o escape de ar pelo tendão extensor digital profundo, que possui comunicação intra-articular. Foi possível visibilizar pela imagem tomográfica, em todas as articulações, as seguintes estruturas: ligamento cruzado cranial e caudal, meniscos medial e lateral, ligamento patelar, ligamentos colaterais e cápsula articular. Desta forma, o contraste negativo se mostrou uma alternativa eficaz para auxiliar a identificação das estruturas anatômicas do joelho na artrografia tomográfica.

Ultrassonografia do espaço intervertebral lombossacro em cães

Pós-graduação em Cirurgia Veterinária - FCAV

Controle de qualidade em equipamentos de tomografia computadorizada

The computed tomography, devised by Godfrey Hounsfield and Allan Cormack, is in its fourth decade of the clinical use and has presented to be a very useful tool in the diagnosis of several pathologies. For this reason, its use is increasing each day, due to technological progress since its creation. Due to be more and more utilized, the equipment must be in good operating conditions, because it is subject to variance and wearing, damage the quality of diagnosis. To evaluate whether the performance of the scanner remains constant along the time and the dose received by the patient is within the desired limits, periodic tests of quality control must be performed. For this subject, the regulation 453 (June 01, 1998) was created, which determines the need of the implementation of a program for quality assurance (PGQ), where, in addition to the tests of quality control, are established the necessary measurements for the proper functioning of the equipment, generating a trustworthy diagnosis, reducing the dose for the patient and the costs. In this document, are presented tests of quality control carried out in hospitals of the city of Sao Paulo carried out together with the Technical Section of Applications by Imaging Diagnostic (STADI) of the Institute of Electrotechnics and Energy of the University of São Paulo (IEE/USP)

Diagnóstico por imagem nas enfermidades tireoidianas em cães: revisão

The diagnosis of various diseases has become more accessible and accurate with the rapid development of imaging modalities aiming to assist in medical diagnosis, and thereby in veterinary medicine. Different diagnostic imaging modalities such as ultrasonography, computed tomography, magnetic resonance imaging and scintigraphy can be performed to obtain information about thyroid diseases, each one with advantages and disadvantages, depending on the thyroid disease in question. Diagnostic imaging is a tool that not only assists in the diagnosis, but also helps treatment and assessment of prognosis of thyroid diseases. The aim of this article is to discuss the limitations and benefits of each diagnostic imaging modality available in the veterinary medical field, and also to present the newest diagnostic imaging modalities in order to maximize and make more accurate diagnosis of thyroid diseases.

Nasoendoscopy of velopharynx before and during diagnostic therapy

Nasoendoscopy is an important tool for assessing velopharyngeal function. The purpose of this study was to analyze velar and pharyngeal wall movement and velopharyngeal gap during nasoendoscopic evaluation of the velopharynx before and during diagnostic therapy. Nasoendoscopic recordings of 10 children with operated cleft lip and palate were analyzed according to the International Working Group Guidelines. Ratings of movement of velum and pharyngeal walls, and size, location and shape of gaps were analyzed by 3 speech-language pathologists (SLPs). Imaging was obtained during repetitions of the syllable /pa/ during a single nasoendoscopic evaluation: (a) before diagnostic therapy, and (b) after the children were instructed to impound and increase intraoral air pressure (diagnostic therapy). Once the patients impounded and directed air pressure orally, the displacement of the velum, right, left and posterior pharyngeal walls increased 40, 70, 80, and 10%, respectively. Statistical significance for displacement was found only for right and left lateral pharyngeal walls. Reduction in gap size was observed for 30% of the patients and other 40% of the gaps disappeared. Changes in gap size were found to be statistically significant between the two conditions. In nasoendoscopic assessment, the full potential of velopharyngeal displacement may not be completely elicited when the patient is asked only to repeat a speech stimulus. Optimization of information can be done with the use of diagnostic therapy's strategies to manipulate VP function. Assuring the participation of the SLP to conduct diagnostic therapy is essential for management of velopharyngeal dysfunction.

Cardiovascular assessment of patients with Ullrich-Turner's Syndrome on Doppler echocardiography and magnetic resonance imaging

OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta). Their ages ranged from 10 to 28 (mean of 16.7) years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100%); 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7), mosaics (n=5), and deletions (n=3). No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5% to 20%, and 6.3% to 29%, respectively). This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome.

Radiography, computed tomography and magnetic resonance imaging at 0.5 Tesla of mechanically inducedosteoarthritis in rabbit knees

In the present experimental study we assessed induced osteoarthritis data in rabbits, compared three diagnostic methods, i.e., radiography (XR), computed tomography (CT) and magnetic resonance imaging (MRI), and correlated the imaging findings with those obtained by macroscopic evaluation. Ten young female rabbits of the Norfolk breed were used. Seven rabbits had the right knee immobilized in extension for a period of 12 weeks (immobilized group), and three others did not have a limb immobilized and were maintained under the same conditions (control group). Alterations observed by XR, CT and MRI after the period of immobilization were osteophytes, osteochondral lesions, increase and decrease of joint space, all of them present both in the immobilized and non-immobilized contralateral limbs. However, a significantly higher score was obtained for the immobilized limbs (XT: P = 0.016, CT: P = 0.031, MRI: P = 0.0156). All imaging methods were able to detect osteoarthritis changes after the 12 weeks of immobilization. Macroscopic evaluation identified increased thickening of joint capsule, proliferative and connective tissue in the femoropatellar joint, and irregularities of articular cartilage, especially in immobilized knees. The differences among XR, CT and MRI were not statistically significant for the immobilized knees. However, MRI using a 0.5 Tesla scanner was statistically different from CT and XR for the non-immobilized contralateral knees. We conclude that the three methods detected osteoarthritis lesions in rabbit knees, but MRI was less sensitive than XR and CT in detecting lesions compatible with initial osteoarthritis. Since none of the techniques revealed all the lesions, it is important to use all methods to establish an accurate diagnosis.

DETECTION OF INFECTIOUS-DISEASE AGENTS IN TISSUE BY IMMUNOCYTOCHEMISTRY

1. Immunocytochemical procedures have played an increasingly larger role in the identification of infectious disease agents in tissue sections owing to the increased availability and specificity of antibody reagents, the great sensitivity of the methods, and the relative facility with which the studies are performed.2. Immunocytochemical methods can be applied to routine formalin-fixed tissue for the detection of infectious agents such as viruses, bacteria, fungi, and protozoa among other microorganisms for diagnostic and research purposes.

Comparison of direct digital and conventional imaging with Ekta Speed Plus and INSIGHT films for the detection of approximal caries

Purpose: To evaluate the accuracy of approximal caries detection comparing enhanced and unenhanced Sidexis CCD-based digital image with Ektaspeed Plus and INSIGHT films. Methods: Fifty-two extracted premolars were imaged under identical standardized geometric and exposure conditions. Four observers, using five points confidence scale, rated 104 approximal surfaces for the presence or absence of carious lesions by means of four image modalities: (1) observer enhanced; (2) unenhanced Sidexis displays; (3) E speed films and (4) F speed film. Histologic sections served as validating criterion for the presence and depth of carious lesions. Diagnostic accuracy was measured as the area beneath the ROC curve. Results: Mean ROC (receiver operating characteristic) curve areas for approximal surfaces were 0.865 (E speed), 0.856 (F speed), 0.816 (unenhanced Sidexis) and 0.776 (observer enhanced). There were no significant differences between unenhanced digital Sidexis and films. Observer enhanced Sidexis images exhibited a statistically significant lower diagnostic accuracy than the film images for two of the observers.

The diagnostic value of Gram stain for initial identification of the etiologic agent of peritonitis in CAPD patients

Objective: To evaluate the effectiveness of the Gram stain in the initial diagnosis of the etiologic agent of peritonitis in continuous ambulatory peritoneal dialysis (CAPD). Design: Retrospective study analyzing the sensitivity (S), specificity (SS), positive predictive value (+PV), and negative predictive value (-PV) of the Gram stain relating to the results of cultures in 149 episodes of peritonitis in CAPD. The data were analyzed in two studies. In the first, only the cases with detection of a single agent by Gram stain were taken (Study 1). In the second, only the cases with two agents in Gram stain were evaluated (Study 2). Setting: Dialysis Unit and Laboratory of Microbiology of a tertiary medical center. Patients: Sixty-three patients on regular CAPD who presented one or more episodes of peritonitis from May 1992 to May 1995. Results: The positivity of Gram stain was 93.2% and the sensitivity was 95.7%. The values of S, SS, +PV, and -PV were respectively: 94.9%, 53.5%, 68.3%, and 90.9% for gram-positive cocci and 83.3%, 98.8%, 95.2%, and 95.6% for gram-negative bacilli. The association of gram-positive cocci plus gram-negative bacilli were predictive of growth of both in 6.8%, growth of gram-positive cocci in 13.7%, and growth of gram-negative bacilli in 72.5%. Conclusions: The Gram stain is a method of great value in the initial diagnosis of the etiologic agent of peritonitis in CAPD, especially for gram-negative bacilli.

Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

Retrospective study of 32 encephalic tumors diagnosed by advanced - image magnetic resonance imaging and computed tomography

The incidence of encephalic tumors in dogs and cats has increased in recent years due to the constant advancement of methods of specialist Diagnostic Imaging: Magnetic Resonance Imaging (MRI) and Computed Tomography (CT), used in small animals. These tools, which were distant in the past, are now becoming increasingly important as an additional aid to the identification of tumor processes in the Central Nervous System. The objective, of the present study, was describe imaging findings obtained in 32 cases of encephalic tumors, through techniques of CT and MR imaging procedures during the years 2004 to 2011. Were diagnosed 19/32 by MRI and 13/32 by CT, being the most affected breed Boxer (9/32), the mean age was 10 years.

Usefulness of computed tomography and magnetic resonance imaging in radiotherapy planning for the treatment of brain tumors

Advanced diagnostic techniques such as magnetic resonance imaging and computed tomography have become useful tools for confirmation of presumptive diagnosis of structural lesions in the brain such as encephalic neoplasms in small animal veterinary practice in Colombia, allowing an effective treatment planning that is more specific and less invasive for this type of pathology.