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A Coordena????o de Aperfei??oamento de Pessoal de N??vel Superior (CAPES) e a Funda????o de Amparo ?? Pesquisa do Estado da Bahia (FAPESB)

O presente estudo foi desenvolvido no sentido de avaliar a rela????o entre par??metros morfom??tricos da cabe??a da mand??bula e o posicionamento do disco da articula????o temporomandibular. Foram avaliados indiv??duos que fizeram exame por Resson??ncia Magn??tica (RM) da ATM em uma cl??nica privada de diagn??stico por imagem da cidade de Salvador. O diagn??stico do posicionamento do disco articular para cada ATM, em boca fechada, foi estabelecido dentre a normalidade e oito tipos poss??veis de deslocamento. Foram feitas mensura????es lineares (D1 ??? largura da cabe??a da mand??bula; D2 ??? espessura da cabe??a da mand??bula) e angulares (A1 ??? ??ngulo horizontal da cabe??a da mand??bula; A2 ??? ??ngulo anterior da cabe??a da mand??bula; A3 ??? ??ngulo coronal medial da cabe??a da mand??bula). Estas foram correlacionadas entre si e associadas com faixa et??ria, g??nero, presen??a de deslocamento, tipos de deslocamento do disco articular e presen??a de redu????o, atrav??s de an??lise estat??stica, sendo considerado significativo um p<0,05. Respeitando os crit??rios de inclus??o e exclus??o, 109 indiv??duos compuseram a amostra, com um total de 209 cabe??as da mand??bula avaliadas. O deslocamento do disco articular ocorreu em 119 ATMs (57%), sendo o deslocamento bilateral o mais prevalente (78%). As mulheres foram significativamente mais afetadas pelo deslocamento de disco do que os homens (p=0,001) e n??o houve diferen??a significativa quanto ao deslocamento de disco em diferentes faixas et??rias (p=0,137). Observou-se uma tend??ncia maior para os deslocamentos anterior parcial do segmento lateral (24%), rotacional ??ntero-lateral (22%) e anterior (18%). A situa????o menos prevalente foi o deslocamento rotacional ??ntero-medial, com apenas dois casos (2%). Os discos deslocados, em sua grande maioria (76%), apresentaram redu????o em boca aberta. A medida D1 apresentou-se maior em homens do que em mulheres (p???0,001), assim como a medida D2 no polo lateral (p=0,007). Diferen??as significativas foram observadas na associa????o das medidas D1, D2 e A1com a presen??a ou aus??ncia de deslocamento de disco e os tipos de deslocamento, enquanto que D2, A1 e A3 estiveram relacionadas significativamente com a redu????o do disco articular. Conclui-se, portanto, que par??metros morfom??tricos da cabe??a da mand??bula influenciam no posicionamento do disco articular.

This study was designed to assess the relation between condyle morphometric parameters and the position of the temporomandibular…

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In this work we investigated the synthesis, characterization and contrast properties of core-shell nanoparticles of iron oxide coated with dextran and functionalized with amine groups. Fluorophores groups were incorporated on the nanoparticles surface, allowing their use as contrast agents for magnetic resonance imaging and optical microscopy. The nanoparticles synthesis was performed by the coprecipitation method of iron salts in basic medium, along with the polymer coating. The synthesis parameters were modified to investigate their influence on the size distribution of nanoparticles. Transmission electron microscopy observations and dynamic light scattering showed a magnetic iron oxide core with an average diameter around 10-15 nm and the total average hydrodynamic diameters between 16-50 nm, depending on the synthesis conditions. The FTIR spectra showed characteristics absorption bands pure dextran in the synthesized core-shell nanoparticles. The zeta potential analysis showed positive values close to zero and stability at neutral pH. The magnetization curves of the nanoparticles revealed superparamagnetic behavior, with the characteristic absence of hysteresis and no magnetization at zero field. The UV-vis and flow cytometry analysis revealed the presence of fluorescent groups in the nanoparticles and the feasibility of their use in optical imaging. Studies of relaxation times of the nuclear magnetization have shown the decrease of the magnetic resonance signal with increasing nanoparticles concentration, reducing the relaxation times T1 and T2 in the nanoparticle aqueous solutions. The relaxivities ratios (r2/r1) ranged between 5.06 and 51.0 and were within the value of iron oxide contrast agents commercially available.

Neste trabalho, pesquisou-se a s?ntese, a caracteriza??o e as propriedades de contraste por imagem de nanopart?culas core-shell de ?xido de ferro, revestidas com dextran e funcionalizadas com grupos amina. Grupos fluor?foros foram incorporados na superf?cie das nanopart?culas, possibilitando seu uso como agente de contraste para imageamento por resson?ncia magn?tica e por microscopia ?ptica. As s?nteses das nanopart?culas foram realizadas pelo m?todo de coprecipita??o de sais de ferro, com o pol?mero de revestimento. Par?metros da s?ntese foram modificados para averiguar sua influ?ncia na distribui??o de tamanho das nanopart?culas. Os resultados da morfologia e da distribui??o de tamanhos por TEM e DLS mostraram um n?cleo com di?metros m?dios entre 10-15 nm e di?metros hidrodin?micos m?dios entre 16-50 nm, dependendo do procedimento de s?ntese. Os espectros de FTIR apresentaram bandas de absor??o caracter?sticas das liga??es presentes no dextran puro e nas nanopart?culas sintetizadas. A an?lise do potencial zeta revelou valores positivos pr?ximos de zero e estabilidade em pH neutro As medidas de…

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In this study we investigated the synthesis and characterization (morphological structural and magnetic) of iron oxide nanoparticles coated with dextran and functionalized with amino groups, which are useful as contrast agents for magnetic resonance imaging. For the synthesis we used the method of co-precipitation of Fe (III) and Fe (II) with ammonium hydroxide. Three batches of samples were synthesized under identical conditions. The analysis of samples from each batch revealed some differences in the stability against agglomeration and iron concentrations (ranging from 10 to 8 mg / mL). A narrow size distribution of the nanoparticles was observed by DLS (Dynamic Light Scattering) in all cases with a mean hydrodynamic diameter of about 10 nm. The mean particle size was confirmed by TEM (Transmission Electron Microscopy), images. Elemental analysis by Rutherford Backscattering Spectrometry (RBS) and Energy Dispersive Spectroscopy (EDS) revealed a structure compatible with iron oxide, and a thermal decomposition pattern dominated by the polymer coating of the particles. The magnetic properties of the particles were confirmed by Alternating Gradient Force Magnetometer (AGFM) whit reveals a vanishing hysteresis loop. Measurements of the magnetic nuclear relaxivity were performed directly in a magnetic resonance imaging (MRI) equipment Whit an MRI phantom containing samples with different concentrations of the FeNP. The study of magnetic relaxation with test objects indicated a clear effect of the FeNP or the MRI signal through the decreases and T1 and T2 in aqueous solutions. Measured relaxivities obtaining from the curves of the relaxation rate versus FeNP concentration were between 41 and 24 mM-1s-1 for r2 and 2,0 to 1,7 mM-1s-1 for r1. We conclude that the method applied in the synthesis of the FeNP was be very efficient in producing NPs with suitable properties for use as a contrast agent in MRI images

Nesse trabalho investigou-se a s?ntese e caracteriza??o morfol?gica, estrutural e magn?tica de nanopart?culas de ?xido de ferro, recobertas com dextran e funcionalizadas com grupos amina, ?teis como uma plataforma de agentes de contraste para imageamento por resson?ncia magn?tica. Para a s?ntese, foi usado o m?todo de coprecipitac?o do Fe (III) e Fe (II) com hidr?xido de am?nio. Foram sintetizados tr?s lotes de amostras. A an?lise de amostras de cada um dos lotes revelou algumas diferen?as quanto ? estabilidade frente a aglomera??o e a concentra??o de ferro (variando de 8 -10 mg/mL). Foi observado por Espalhamento de Luz Din?mico uma distribui??o estreita de tamanho das nanopart?culas em todos os casos, com um di?metro hidrodin?mico m?dio em torno de 5-8 nm, confirmados pelas imagens de TEM (Microscopia Eletr?nica de Transmiss?o). Atrav?s de an?lise de Espectroscopia de Energia Dispersiva (EDS) e Retroespalhamento Rutherford…

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With the use of resting state functional magnetic resonance imaging (rs-FMRI) we can analyze the functional connectivity between different brain areas. However, recent studies show that this connectivity undergoes fluctuations over time (also known as dynamic Resting State). In this study, the analysis of Graph Theoretical (GT) metrics will be used to assess the variability of the correlation between these areas, through a windowing technique. For this study, we used images of 15 patients with ADHD that underwent a clinical treatment with the medication (Ritalin?). Images were taken before treatment (Visit 1 - PRE) and after 6 months of treatment (Visit 2 - POST). We determined the GT metrics for windows between 75 and 150s generated from the correlation between the various groups after applying a mask that divided the brain into 190 regions. The results showed statistically significant differences between visits for the metric of the characteristic path length. Were also generated graphs that show the fluctuations of each of the metrics. GT analysis identified an increase in the average value of the characteristic path length after drug treatment for most patients. However, some patients behaved differently and therefore results are not conclusive. Furthermore, it was observed that there is a dependence of GT metrics based on the size of the window. Conclusion show that based on the analysis of the dynamics of the brain network by the GT metrics show to be an auxiliary tool in the diagnosis of ADHD, but still requires further studies to test the viability of this tool as a diagnostic test in neuroimaging.

Atrav?s da Resson?ncia Magn?tica Funcional no estado de repouso (RMf-er) podemos analisar a conectividade funcional entre as diversas ?reas do c?rebro. Entretanto, estudos recentes mostram que a correla??o desta conectividade sofre flutua??es ao longo do tempo (Dynamic Resting State). No presente trabalho, foi feita uma an?lise por interm?dio de m?tricas da Teoria dos Grafos da variabilidade da correla??o entre as ?reas cerebrais atrav?s de t?cnicas de janelamento. Para este estudo, foram utilizadas imagens de 15 pacientes com transtorno de d?ficit de aten??o com hiperatividade (TDAH) e que passaram por um tratamento cl?nico com o uso do medicamento (Ritalina?). As imagens de resson?ncia foram adquiridas antes do pr?-tratamento (Visita 1 - PR?) e ap?s 6 meses de tratamento (Visita 2 ? P?S). Foram desenvolvidas m?tricas de Teoria dos Grafos (TG) para janelas entre 75 e 150s geradas a partir da correla??o entre as diversas regi?es, ap?s aplicar uma m?scara que dividiu o…

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Dyslexia is a developmental reading disorder characterized by persistent difficulty to learn how to read fluently despite normal cognitive abilities. It is a complex learning difficulty that is often hard to quantify. Traditional methods based on questionnaires are not only imprecise in quantifying dyslexia, they are also not very accurate in diagnosing it. Consequently, we aim to investigate the neural underpinnings of this reading disorder in children and teenagers, as part of a project that aims to unravel some of the neurological causes of dyslexia among children at preliteracy age. In this dissertation, we develop a study of brain activation within functional MRI scans taken when children carried out pseudo-word tasks. Our study expands recently developed machine learning-based techniques that identify which type of word the study participants were reading based solely on participant?s brain activation. Because such functional MRI data contains about 30,000 voxels, we try several feature selection techniques for removing voxels that are not very helpful for the machine learning algorithm.This procedure is widely used for maximizing the machine learning algorithm accuracy, and some of these feature selection approaches allowed us to achieve very accurate results.

Dislexia ? um transtorno de aprendizagem de leitura caracterizado pela dificuldade persistente de uma crian?a a aprender a ler fluentemente, mesmo apresentando outras habilidades cognitivas normais. A dislexia ? uma dificuldade de aprendizado complexo e dif?cil de diagnosticar. M?todos de diagnostico tradicionais, como question?rios, n?o s?o somente imprecisos em quantificar a dislexia, como tamb?m tamb?m n?o s?o precisos no diagn?stico. Consequentemente, n?s visamos investigar a base neural deste transtorno de leitura em crian?as e adolescentes, como parte de um projeto que tem como objetivo desvendar algumas das causas neurol?gicas da dislexia entre crian?as em alfabetiza??o. Nesta disserta??o, desenvolvemos um estudo da ativa??o do c?rebro com o uso de exames de imagem de resson?ncia magn?tica (IRM) funcional coletados enquanto as crian?as realizavam uma tarefa de pseudo-palavras. Este estudo amplia t?cnicas de aprendizado de m?quina recentemente desenvolvidas que identificam que tipo de palavra os participantes de um estudo estavam lendo, baseado somente em sua atividade neural. Como dados de IRM funcional contem aproximadamente 30.000 voxels, neste trabalho experimentamos com algumas t?cnicas de sele??o de features para remover voxels que n?o s?o relevantes para o algoritmo de aprendizado de m?quina. Esse…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

In the present study, some physical characteristics and nuclear magnetic relaxation properties of iron oxide nanoparticles coated with different coatings and synthesized in our laboratories were investigated. Eight nanoparticle systems were obtained, one of these systems being a linked fluorophore group (Cy5.5). Raman spectroscopy and X-rays diffraction have shown that the iron oxide in question is magnetite. The magnetization measurements revealed superparamagnetic behavior of the nanoparticles due to the absence of hysteresis of the nanoparticles and a saturation magnetization ranging from 3.8-61.6 emu/g. The iron concentration of each synthesis was obtained by UV-Vis spectrophotometry and relaxometry and the results obtained ranged from 0.46-11.2 mg/mL. ZFC/FC measurements showed a distribution of the blocking temperature of the nanoparticles not exceeding 50 K. Aqueous solutions with different concentrations of the nanoparticles and the Lumirem commercial contrast agent were prepared to give the relaxation times T1 and T2 and the relaxivities r1 and r2. In these measurements, the nanoparticles showed contrast effects, disturbing the signal intensity, decreasing the relaxation times T1 and T2. The ratio of relaxivities (r2/r1) ranged from 3.13-64.14, which is within the values of the commercially available iron oxide contrast agents. It is concluded that the nanoparticles evaluated in this work are suitable as a T2-type contrast agent.

No presente estudo, algumas caracter?sticas f?sicas e propriedades de relaxa??o magn?tica nuclear de nanopart?culas de ?xido de ferro revestidas com diferentes recobrimentos e sintetizadas em nossos laborat?rios foram investigadas. Obtiveram-se oito sistemas de nanopart?culas, sendo um destes sistemas com um grupo fluor?foro ligado (Cy5.5). An?lises de espectroscopia Raman e difra??o de raios-X demonstraram que o ?xido de ferro em quest?o ? a magnetita. As medidas de magnetiza??o revelaram comportamento superparamagn?tico das nanopart?culas, devido ? aus?ncia de histerese das mesmas, e uma magnetiza??o de satura??o variando entre 3,8-61,6 emu/g. A concentra??o de ferro de cada s?ntese foi obtida por espectrofotometria UV-Vis e relaxometria. Os resultados obtidos variaram entre…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

In the present study, some physical characteristics and nuclear magnetic relaxation properties of iron oxide nanoparticles coated with different coatings and synthesized in our laboratories were investigated. Eight nanoparticle systems were obtained, one of these systems being a linked fluorophore group (Cy5.5). Raman spectroscopy and X-rays diffraction have shown that the iron oxide in question is magnetite. The magnetization measurements revealed superparamagnetic behavior of the nanoparticles due to the absence of hysteresis of the nanoparticles and a saturation magnetization ranging from 3.8-61.6 emu/g. The iron concentration of each synthesis was obtained by UV-Vis spectrophotometry and relaxometry and the results obtained ranged from 0.46-11.2 mg/mL. ZFC/FC measurements showed a distribution of the blocking temperature of the nanoparticles not exceeding 50 K. Aqueous solutions with different concentrations of the nanoparticles and the Lumirem commercial contrast agent were prepared to give the relaxation times T1 and T2 and the relaxivities r1 and r2. In these measurements, the nanoparticles showed contrast effects, disturbing the signal intensity, decreasing the relaxation times T1 and T2. The ratio of relaxivities (r2/r1) ranged from 3.13-64.14, which is within the values of the commercially available iron oxide contrast agents. It is concluded that the nanoparticles evaluated in this work are suitable as a T2-type contrast agent.

No presente estudo, algumas caracter?sticas f?sicas e propriedades de relaxa??o magn?tica nuclear de nanopart?culas de ?xido de ferro revestidas com diferentes recobrimentos e sintetizadas em nossos laborat?rios foram investigadas. Obtiveram-se oito sistemas de nanopart?culas, sendo um destes sistemas com um grupo fluor?foro ligado (Cy5.5). An?lises de espectroscopia Raman e difra??o de raios-X demonstraram que o ?xido de ferro em quest?o ? a magnetita. As medidas de magnetiza??o revelaram comportamento superparamagn?tico das nanopart?culas, devido ? aus?ncia de histerese das mesmas, e uma magnetiza??o de satura??o variando entre 3,8-61,6 emu/g. A concentra??o de ferro de cada s?ntese foi obtida por espectrofotometria UV-Vis e relaxometria. Os resultados obtidos variaram entre…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

The white matter lesion detection is an important procedure for the diagnostic of Multiple Sclerosis in patients. As important as the detection, monitoring the progression of the disease, by calculating the volumes of the lesions, also shows itself necessary. In clinical practice, this procedure is done manually by a professional or, in many cases, only a qualitative analysis is made. The manual nature of this procedure implies in a series of deficiencies on the procedure, such as variations between diagnoses from different experts on the same subject and variation between diagnostics from the same expert to the same subject at distinct moments. Yet, the manual procedure shows itself time consuming, due the large amount of slices acquired by exam and the need for a careful analysis from the expert to quantify the lesions. In order to avoid these problems, automatic approaches for Multiple Sclerosis lesion detection and quantification using computer aided diagnostic systems are proposed. These methods, mostly, demand for the acquisition of an extra modality of magnetic resonance images, where the anatomy of the brain is evidenced, thus allowing the white matter lesion identification. This additional exam goes beyond the scope of the traditional clinical practice, which implies in additional costs and prevents the method of being applied to old exams, for monitoring the disease progression. This work proposes a method for automatic detection and segmentation of Multiple Sclerosis Lesions that uses only the modality of magnetic resonance exam adopted for clinical practice, using probabilistic atlases spatially aligned to the patient?s exams for identifying the brain structures. The results obtained through the usage of the method into a set of 24 patients and 6 healthy controls of different ages, showed that the developed method is capable of detecting white matter lesions with some precision. However, the quantification of these lesions was impaired mostly due divergences between the white matter probabilistic atlas and the real white matter region of the exams.

A detec??o de les?es de subst?ncia branca ? um procedimento importante para o diagn?stico da Esclerose M?ltipla em pacientes. T?o importante quanto a detec??o, o acompanhamento da progress?o da doen?a, por meio do c?lculo da volumetria destas les?es, tamb?m se mostra necess?rio. Na pr?tica cl?nica, este procedimento ? realizado manualmente por um profissional, ou em muitas vezes ? somente realizada uma an?lise qualitativa. O car?ter manual deste procedimento…

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Hippocampus segmentation in magnetic resonance imaging is an important procedure in many clinical situations, such as monitoring changes in patients with Alzheimer's disease. However, the manual delineation of this structure, in three-dimensional images, is a laborious task and prone to subjective interpretation of the health professional. Some automated methods have been proposed in recent years. Much of these methods use pre-segmented templates, also known as atlas, which are aligned to the input image in the segmentation process. However, using a single standard atlas increases the dif?culty targeting individuais that have non-normal anatomy, such as the elders and patients with AD. To achieve a good precision in these cases, without any manual intervention of the user, new methods employ techniques in which several different atlases are used. The alignment of these atlases with the image, leads to a high computational cost. This work proposes employing and atlas selection technique by meta-information in order to choose the ideal tiemplate for an individual, enabling low computational cost segmentation technique. The results obtained, by testing 350 individuals, in various clinical conditions and ages, showed that the use of atlas selection significantly increases segmentation accuracy, when compared to a method using a default atlas, while keeping the computational cost low. The relevance of three selection parameters medical condition, age and gender - has been evaluated and confirmed by the test suite.

A segmenta??o do hipocampo em imagens de resson?ncia magn?tica ? um importante procedimento em variadas situa??es cl?nicas, como por exemplo, no acompanhamento da evolu??o da doen?a de Alzheimer. Por?m, a delimita??o manual desta estrutura, em imagens tridimensionais, ? uma tarefa bastante trabalhosa e sujeita a interpreta??o subjetiva do profissional de sa?de. Alguns m?todos automatizados foram propostos nos ?ltimos anos. Grande parte destes m?todos utilizam modelos pr?-segmentados, tamb?m conhecidos como atlas, que s?o alinhados ? imagem de entrada no processo de segmenta??o. No entanto, a utiliza??o de um ?nico atlas padr?o dificulta a segmenta??o de indiv?duos com anatomia diferente da normal, como idosos e pacientes com a doen?a de Alzheimer. Para alcan?ar boa precis?o nestes casos, sem nenhuma interven??o manual do usu?rio, novos m?todos empregam t?cnicas nas quais v?rios atlas diferentes s?o utilizados. O alinhamento destes atlas com a coagem leva a um custo computacional elevado. Este trabalho prop?em o emprego de uma t?cnica de sele??o de atlas por meta-informa??o de modo a escolher o atlas ideal para um indiv?duo e possibilitar o emprego de uma t?cnica de segmenta??o com baixo custo computacional. Os resultados, obtidos atrav?s de testes com exames de 350 indiv?duos em variadas condi??es cl?nicas e faixas…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Introduction-objective: Retrospective study to compare the accuracy of nuclear magnetic resonance with and without intravenous contrast in multiple myeloma. Methods: Thesis developed in collaboration with the Irmandade da Santa Casa de Miseric?rdia de Porto Alegre (ISCMPA), [CAAE: 83269817.1.0000.5335; Process Number: 2,974,279]. Data collection was performed among the entire population diagnosed from April 2017 to November 2018, ISCMPA, RS - Brazil. This project has financial support from the Foundation for Research Support of the State of Rio Grande do Sul, Protocol 02/2017 - PqG, Process Number: 17 / 2551-00001 007-8. Results: Fifty-four patients with newly diagnosed multiple myeloma were prospectively submitted to MRI of the entire body. In all patients included, a bone marrow biopsy was performed on the iliac crest. The images were evaluated by two specialist radiologists (10 years of experience in MRI) in a consensual reading. The skeleton was divided into 6 regions. We did not identify differences between the accuracy of the method with and without contrast, 92.5 (82.1 to 97.4) and 94.4 (84.6 to 98.8), respectively. The values of sensitivity, specificity, positive predictive value (PPV) and negative (NPV) values were also similar. Conclusion: The accuracy of the whole body resonance method did not show differences between its use with and without contrast, as well as the values of sensitivity, specificity, PPV and NPV.

Introdu??o-objetivo: Estudo retrospectivo com objetivo de comparar a acur?cia da resson?ncia nuclear magn?tica com e sem contraste endovenoso no mieloma m?ltiplo. M?todos: Tese desenvolvida em colabora??o com a Irmandade da Santa Casa de Miseric?rdia de Porto Alegre (ISCMPA), [CAAE: 83269817.1.0000.5335; N?mero do Parecer: 2.974.279]. A coleta dos dados foi realizada entre toda a popula??o diagnosticada de abril de 2017 a novembro de 2018, ISCMPA, RS ? Brasil. Este projeto conta com apoio financeiro da Funda??o de Amparo ? Pesquisa do Estado do Rio Grande do Sul, Edital 02/2017 ? PqG, N?mero do Processo: 17/2551-00001 007-8. Resultados: Cinquenta e quatro pacientes com mieloma m?ltiplo rec?m-diagnosticado foram prospectivamente submetidos ? resson?ncia magn?tica de corpo inteiro. Em todos os pacientes inclu?dos foi realizada uma bi?psia da medula ?ssea na crista il?aca. As imagens foram avaliadas por…

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INTRODUCTION : Posterior Reversible Encephalopathy Syndrome (PRES) is a clinico-radiological entity that presents with headache, altered mental status, seizure and visual disturbance and is associated with a reversible probably vasogenic edema, predominantly in occipital and parietal lobes. The precise physiopathology remains unclear and there isn t an experimental model of this disorder. OBJECTIVES : The objectives of this paper were (1) the clinical and radiological evaluation of patients with PRES in the Hospital S?o Lucas-PUCRS and (2) the development of a translational model based on clinical features that mimetize this syndrome in pregnants Wistar rats. METHODS : It was performed a review of clinical data, neuroimage and blood basic test of 25 patients with PRES, that were followed in Hospital S?o Lucas-PUCRS in the period from March 15 of 2007 to September 15 of 2011. Based on clinical features and neuroimagem findings, we developed a rat model of PRES using pregnant Wistar rats, which were submitted to a reduction of uterine pressure perfusion (RUPP), measurement of arterial blood pressure with an invasive catheter and a brain anatomo-pathologic study, after Evans s blue venous infusion to verify the permeability of the blood-brain-barrier. RESULTS : Our clinical sample consisted of 25 patients (4 men and 21 women) with mean age of 27,84 years old (range from 2 to 74 years old). The most common causes of PRES reported in this series were associated with pregnant situations that occurred in 11 cases (44%). The symptom more commonly reported was headache in 18 patients (72%). The occipital lobe was the most common topography of the magnetic ressonance abnormality (edema) and occurred in 23 cases (92%). The highest value of the systolic blood pressure presented the mean of 176 mmHg and the highest value of the diastolic blood pressure presented the mean of 95,2 mmHg. Animals submitted to RUPP to simulate the PRES presented increase of the blood-brain-barrier permeability and elevation of blood pressure, when compared with the control animals. CONCLUSION : In our series, PRES occurred predominantly in women and the most frequent triggers were obstetric causes; headache was the most common symptom and the neuroimage findings showed a predominance of posterior alteration suggesting a vasogenic edema due a breakdown of blood brain barrier. The experimental rat model was developed based on these clinical observations, so, we used pregnant rats submitted to reduction of uterine pressure perfusion. We identified in these animals increase of blood pressure and a breakdown of blood brain barrier corroborating to establish an experimental model of PRES. We believe that an experimental model of PRES could be important for future studies allowing a better comprehension of this syndrome.

INTRODU??O : A S?ndrome Encefalopatia Revers?vel…

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A obten??o do diagn?stico das disfun??es temporomandibulares (DTMs) se faz atrav?s de uma anamnese acurada e do uso de exames de imagem complementares. O objetivo deste estudo foi avaliar a influ?ncia da informa??o cl?nica na reprodutibilidade intra e interexaminadores na interpreta??o de imagens por resson?ncia magn?tica (IRM) da articula??o temporomandibular (ATM). Quarenta exames de resson?ncia magn?tica foram avaliados por sete especialistas em disfun??o temporomandibular e dor orofacial em tr?s momentos distintos. Na ?ltima avalia??o foi informado aos avaliadores os dados cl?nicos dos pacientes. A reprodutibilidade intra-examinador foi avaliada mediante utiliza??o da medida de concord?ncia Cohen s Kappa e, a concord?ncia interexaminadores, pelo teste de Friedman. A hipermobilidade articular foi a patologia que obteve maior concord?ncia (kappa 0,770) e a altera??o degenerativa no osso temporal foi a de menor concord?ncia (kappa 0,447) entre os examinadores. A informa??o cl?nica n?o teve influ?ncia na interpreta??o de imagens por IRM da ATM e n?o houve diferen?a estatisticamente significativa entre os avaliadores quanto a sua reprodutibilidade neste modelo de estudo.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Functional Magnetic Resonance Imaging is a noninvasive technique used to map and explore brain networks through the changes in the oxyhemoglobin concentration that is caused by neural activity. One of the techniques to evaluate and measure these brain funcions is resting-state fMRI, which is indicated to subjects with some degree of neurological impairment since no cognitive task is necessary. The main problem of this exam is that it is more sensitive to noise during scanning - from physiological sources, for example, such as heart beating and breathing. The most common and hardest to correct is noise caused by a subject?s head movement. Given this fact, the objective of this thesis is to study and evaluate the effectiveness of implement empirical decomposition methods in the preprocessing stage of fMRI data. Empirical Mode Decomposition and Empirical Mean Curve Decomposition were the chosen algorithms because of their use in non-stationary and nonlinear signals. Thirty-three children participating in the ACERTA Project were classified in two groups: good readers (14 subjects) and poor readers (19 subjects). These data were submitted to five different preprocessing strategies: two for the usual preprocessing steps using or not the movements censoring; one for the Empirical Mode Decomposition method; and two for the Empirical Mean Curve Decomposition, being that one strategy uses changes proposed in this work in original algorithm. According to statistical analysis, the Empirical Mean Curve Decomposition, both the original and the modified, proved to be a promissing method for noise reduction in real fMRI data.

A t?cnica de imagem por resson?ncia magn?tica funcional ? um exame n?o invasivo que permite mapear e explorar diversas fun??es cerebrais por meio de varia??es na concentra??o de oxi-hemoglobina nas regi?es de atividade neural. Uma das t?cnicas para avaliar e mapear essas fun??es cerebrais ? o exame em estado de repouso, que ? mais indicado em pacientes/volunt?rios que tenham algum tipo de problema neurol?gico, pois n?o faz o uso de tarefas cognitivas para gerar as imagens de mapeamento cerebral. O principal problema desse exame ? ser muito sens?vel aos diferentes tipos de ru?do presentes ao longo do exame, como os de origem fisiol?gica, principalmente provenientes da respira??o e dos batimentos card?acos. O tipo de ru?do mais comum e que mais afeta os dados ? causado pela movimenta??o da cabe?a do paciente/volunt?rio. Pensando nisso, esta disserta??o tem como objetivo estudar e avaliar a efic?cia…

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A t?cnica de dissec??o de fibras ? um m?todo cl?ssico, utilizado por renomados anatomistas do passado, para a demonstra??o dos tractos e fasc?culos integrantes da subst?ncia branca do c?rebro. Esta t?cnica envolve a dissec??o em camadas da subst?ncia branca cerebral para demonstrar a organiza??o anat?mica interna do par?nquima. Com a possibilidade atual de se visualizarem os feixes de subst?ncia branca do enc?falo in vivo pela resson?ncia magn?tica (RM), atrav?s da tractografia baseada em imagens do tensor de difus?o, os fundamentos anat?micos antigos obtidos com a cl?ssica t?cnica de dissec??o de fibras tornam-se, paradoxalmente, ainda mais relevantes e atuais. Este trabalho possui tr?s objetivos fundamentais: estudar os principais feixes de subst?ncia branca do c?rebro, atrav?s do m?todo cl?ssico de dissec??o, e faz?-lo tamb?m por dissec??o virtual, atrav?s do m?todo tractogr?fico; estimar a reprodutibilidade da reconstru??o de feixes do lobo frontal a partir do atlas criado pelos autores; finalmente, determinar as estruturas e vari?veis com os melhores indicadores de reprodutibilidade, visando seu uso em estudos cl?nicos.As informa??es anat?micas e tractogr?ficas utilizadas pelos autores na identifica??o dos tractos, em trabalho anat?mico original, foram compiladas e fornecidas a dois observadores sem experi?ncia no m?todo de tractografia. Os feixes uncinado (UNC), arqueado (ARQ), longitudinal superior (FLS), fronto-pontino (FP), frontooccipital inferior (FOI) e joelho do corpo caloso (JCC) foram reconstru?dos duas vezes por cada observador, a partir das imagens de tensor de difus?o por RM adquiridas do exame de 15 sujeitos h?gidos, num total de 30 hemisf?rios estudados. Na identifica??o de cada feixe, foram registradas as respectivas medidas de fra??o de anisotropia (FA), volume (VOL), n?mero de voxels (NVO), n?mero de tractos (NTR), comprimento de fibras (LEN) e coeficiente de difus?o aparente (ADC). Para o estudo de concord?ncia intra-observadores foram comparadas as medidas das duas reconstru??es de cada observador, e para o estudo de concord?ncia interobservadores foram comparadas as m?dias dos resultados de cada observador. A an?lise quantitativa foi descrita por medidas de associa??o (r: coeficiente de Pearson) e de concord?ncia (ICC: coeficiente de correla??o intra-classe por m?todo de concord?ncia) intra e interobservadores na reconstru??o dos feixes, sendo que r se mostrou estatisticamente sempre superior ao ICC em valores absolutos.O n?vel de magnitude foi muito alto (ICC 0.7-0.9) ou quase perfeito (ICC 0.9-1) em todas as estruturas nas medidas de FA e ADC, intra e interobservadores. Na an?lise interobservadores, as estruturas FOI, JCC, ARQ e FLS apresentaram ICC superior a 0.7 em todas as vari?veis medidas (exceto no NTR do JCC e do FLS e no LEN do ARQ). Entre os observadores, as estruturas com escore na escala de…

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Introdu??o: A Resson?ncia Magn?tica Funcional (RMf), como m?todo de investiga??o n?oinvasivo do funcionamento cerebral, permite a localiza??o topogr?fica das ?reas relacionadas ? mem?ria e outras fun??es corticais superiores em indiv?duos normais. Embora n?o nos forne?a, no momento atual, a riqueza e a din?mica das inter-rela??es dos processos cognitivos, vem trazendo grandes avan?os ao conhecimento cient?fico, planejamento terap?utico de patologias que envolvem o Sistema Nervoso Central e para a pesquisa em Neuroci?ncia. Objetivo: Este estudo buscou investigar, com RMf, as regi?es encef?licas ativadas por diferentes tarefas de mem?ria visual em uma amostra de volunt?rios saud?veis. Metodologia: Foi realizado um estudo transversal para avalia??o da ativa??o funcional das ?reas encef?licas relacionadas ? mem?ria visual, em um grupo de 15 volunt?rios h?gidos. Todos os sujeitos realizaram avalia??o neuropsicol?gica, preencheram duas escalas para investiga??o de sintomatologia neuropsiqui?trica (Invent?rio de Depress?o de Beck e Invent?rio de Ansiedade de Beck), responderam a um question?rio para exclus?o de qualquer patologia que pudesse alterar a performance durante as tarefas propostas (Question?rio para exclus?o de patologia neurol?gica ou psiqui?trica), realizaram investiga??o da domin?ncia manual atrav?s de question?rio espec?fico (Teste de Domin?ncia Manual modificado), preencheram o informativo ao paciente do Centro de Diagn?stico por Imagem do Hospital S?o Lucas da PUCRS e se submeteram ao exame de RMf, ap?s afirmarem sua concord?ncia em participar do estudo (Termo de Consentimento Livre e Esclarecido). Para estimula??o da mem?ria visual, durante a RMf, foram utilizadas duas tarefas de memoriza??o para posterior reconhecimento, incluindo est?mulos de faces e figuras abstratas. Todas as tarefas foram alternadas com per?odo de repouso. Resultados: As regi?es ativadas na tarefa de memoriza??o de faces n?o-familiares inclu?ram o giro angular (lobo parietal), culmen (cerebelo anterior), ?nsula, precuneus (lobo parietal), giro frontal inferior (lobo frontal) e put?men; a regi?o ativada no reconhecimento de faces n?ofamiliares foi o precuneus (lobo parietal). As regi?es ativadas na memoriza??o de padr?es abstratos inclu?ram o t?lamo, giro temporal transverso (giro de Heschl), declive (cerebelo posterior), put?men, ?nsula e regi?o occipital inferior; as regi?es ativadas no reconhecimento de padr?es abstratos inclu?ram cerebelo anterior, giro temporal inferior (lobo temporal) e declive (cerebelo posterior). Conclus?o: Foram observadas ativa??es em diversas regi?es encef?licas, indicando que circuitos neuronais multifocais s?o engajados na realiza??o destas opera??es mentais. O estudo da mem?ria mant?m-se como algo complexo, imposs?vel de redu??o a uma ?nica teoria geral, seja ela em bases psicol?gicas, neurofisiol?gicas, entre outras.…

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OBJETIVOS: O objetivo deste estudo ? avaliar o ap?ndice cecal normal em crian?as e adolescentes assintom?ticos atrav?s da RM. MATERIAIS E M?TODOS: O ap?ndice cecal foi avaliado atrav?s da RM em 40 volunt?rios assintom?ticos, 22 do sexo feminino e 18 masculinos, com idade variando de 8 e 18 anos e m?dia de 12 anos. O estudo foi aprovado pelo comit? de ?tica m?dica desta institui??o. O protocolo de RM incluiu as sequ?ncias: axial T1 fast spin-echo (T1 FSE); T2 fast spin-echo nos planos axial e coronal (T2 FSE) e axial T2 fast spin-echo com supress?o de gordura (T2 FSE FAT SAT). Os estudos foram avaliados por 2 examinadores independentes e a concord?ncia entre os 2 foi avaliada pelo coeficiente kappa. Foi avaliado o ?ndice de massa corporal (IMC) dos indiv?duos. RESULTADOS: O ap?ndice normal foi identificado em 19 casos por um observador 1 (47,5%) e em 20 casos pelo outro observador (50%). A propor??o de detec??o do ap?ndice ap?s o consenso entre os dois examinadores foi de 47,5% (95% CI 31,5-63,9). O coeficiente kappa entre os observadores na identifica??o do ap?ndice cecal foi muito boa na maioria das seq??ncias analisadas, sendo que a seq??ncia axial T2 FSE apresentou o maior kappa (k: 0.75). T2 FSE sem satura??o de gordura foi a seq??ncia que apresentou maior propor??o de detec??o do ap?ndice normal (47,5%). O ap?ndice foi detectado em uma propor??o maior em crian?as com IMC menor. CONCLUS?O: A RM detectou 47,5% dos ap?ndices normais com uma boa concord?ncia entre os dois examinadores.

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Studies of the neurobiology of aggression suggest that, in general, higher levels of aggression are associated with abnormal brain structure and function. However, the relationship between brain abnormalities and aggression has not been studied systematically, but several lines of evidence imply that abnormal function in brain different regions may be associated with aggression and psychopathy. Objective: The aim of our study was to systematically review the reported studies that addressed this topic brain abnormalities and aggression in an effort to clarify the available evidence and develop hypotheses for future studies.Methodological Issues: Medline and PsycINFO data bases from 1987 to 2008 was searched to identify studies of structural and functional brain imaging of persons who engaged in aggressive behavior. The term "violence" was used in many of the articles reviewed, and throughout we use the authors' terminology when describing each study and report the study design. We considered for this review only case-control or cohort studies. In conducting the review, we made an effort to distinguish those studies that included patients with child abuse history. Also, we evaluate case-control studies with (1) aggression-violence possible or probable and (2) functional studies with functional MRI or PET which include activation task of patients with certain or probable aggressive behavior.Results: Our search identified 30 published studies (29 case-control and 01 cohort) comparing structural brain imaging of violent and nonviolent persons. Some results are inconsistent and contradictory. This situation is primarily due to varying definitions of violence, characteristics of the samples, and the use of different measures to tap neurobiological correlates of violent behavior. The samples in the studies reviewed were generally small, for instance some studies did not include a comparison group of healthy participants. Conclusion: In conclusion, our review highlights evidence that among people with violent or antisocial behavior as compared with those with no such history, had abnormalities in different brain areas most in the frontal lobes including the orbito-frontal, pre-frontal and anterior cingulated cortex among others. These findings also indicate the necessity of future researches taking account not only of the onset and persistence of the aggressive behavior but also gender of the protagonist, child abuse history and larger and more homogeneous samples.

Estudos sobre a neurobiologia do comportamento violento sugerem que, em geral, altos n?veis de agress?o est?o associados com anormalidades estruturais e funcionais do c?rebro. Entretanto, a rela??o entre anormalidades cerebrais e agress?o, ainda n?o foi sistematicamente estudada, mas s?o muitas as evid?ncias de que o funcionamento anormal de diferentes regi?es do…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Introduction-objective: Cystic fibrosis is the most common genetic disease in the Caucasian population. The reduction in life expectancy is due to progressive lung disease, characterized by severe changes in the pulmonary structure, more precisely, bronchiectasis and air catabolization. Computed tomography of the chest is considered the most sensitive method to monitor lung disease in cystic fibrosis. The main disadvantage is the patient's exposure to radiation. Magnetic resonance imaging of the chest, a radiation-free technique, has been introduced as an alternative to computed tomography. Magnetic resonance has been compared to computed tomography in several studies using various sequences, but none have used the combined sensing, parallel imaging, and golden-angle radial sampling technique. The aim of this study was to evaluate the combined golden-angle radial technique of magnetic resonance imaging in patients with cystic fibrosis in relation to conventional magnetic resonance imaging and computed tomography of the chest. Cystic fibrosis has been compared to computed tomography in several studies using various sequences, but none have used the combined sensing, parallel imaging, and golden-angle radial sampling technique. The aim of this study was to evaluate the combined radial-angle golden-angle technique of magnetic resonance imaging in patients with cystic fibrosis in relation to conventional magnetic resonance imaging and computed tomography of the chest. Methods: Computed tomography and magnetic resonance of the chest were performed in 29 patients with cystic fibrosis who were followed at the pediatric pulmonology outpatient clinic of the S?o Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul. The Cartesian K-space sampling and, after the free-breathing magnetic resonance techniques, using the Golden_Angle Radial Sparse Parallel technique. Magnetic resonance imaging and computed tomography of the chest were evaluated by two independent observers using the Helbich-Bhalla score. Intraclass correlation coefficient and Bland-Altman analysis were used to assess agreement and reproducibility in the Helbich-Bhalla severity score. No patient was sedated or used contrast medium. Results: Intraclass correlation coefficients and the Bland-Altman graphical model between the Helbich-Bhalla scores and the evaluated methods, computed…

As entidades hospitalares t?m enfrentado constantes mudan?as, enfatizando-se as corriqueiras transforma??es tecnol?gicas, as quais exigem investimentos consider?veis, sejam em termos de substitui??o de tecnologias antigas, sejam na incorpora??o de servi?os essenciais para o melhor atendimento do paciente. Atualmente, a Resson?ncia Magn?tica tem-se mostrado um consider?vel exemplo do avan?o tecnol?gico incorporado ?s entidades hospitalares, se revelou inovadora na ?rea de diagn?stico por imagem, sendo capaz de dar grande seguran?a ao m?dico quando da emiss?o do diagn?stico. Este estudo apresenta uma an?lise de como as vari?veis que influenciam a presta??o do servi?o de resson?ncia magn?tica nas entidades hospitalares impactam na forma??o do seu custo. Para tanto, realizou-se estudo comparativo em dois hospitais universit?rios localizados em regi?es distintas ? UnB e UFRN; no horizonte de tempo de julho de 2005 a julho de 2006, sendo as vari?veis investigadas representadas por todos os fatores que envolvem direta ou indiretamente os custos. Os resultados encontrados mostram que a utiliza??o da capacidade ? uma vari?vel importante em ambos os hospitais, tanto que dependendo do seu aproveitamento se tem a determina??o se o hospital trabalhar? com recursos superiores ao custo sacrificado ou n?o. E ainda no contexto das conseq??ncias da incorpora??o de tecnologia avan?ada, vari?veis como deprecia??o e manuten??o tamb?m se mostram significativas. No caso do HUOL, que trabalha em capacidade real consideravelmente superior ? capacidade pr?tica, seus recursos obtidos s?o inferiores aos custos sacrificados. Diferentemente, o HUB, trabalhando com capacidade real bem pr?xima da capacidade pr?tica, consegue com que seus recursos obtidos sejam superiores ao custo sacrificado. A complexidade dos servi?os tamb?m se tornou um forte impactador, j? que demonstra que quanto mais incrementada for a presta??o de servi?o, mais se ter? reflexo no aumento dos custos, como no caso da diferen?a entre o HUOL e o HUB, quanto ?s especificidades dos exames realizados. Enfim, a pesquisa demonstrou as principais vari?veis a serem observadas pelo gestor quando na an?lise da viabilidade e do gerenciamento do servi?o de resson?ncia magn?tica.

The hospitals have faced constant changes, emphasizing technological modifications that require investments, either substituting old technologies or incorporating essential services, providing a better patient care. Nowadays the magnetic resonance has showed an example of the incorporated technological advance to hospitals. It also has showed innovation in the area of diagnostic through image, giving confidence to the doctor before emitting a final diagnostic. This research presents an analysis of how the variables that influence the required service of magnetic resonance in hospitals have impact in the cost of its formation. For this, it was developed a comparative study between two hospitals from the university, situated in different cities ? UnB and UFRN, from July 2005 to July 2006. The variables that were…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Patient head motion can cause failure in the analysis of functional magnetic resonance imaging (fMRI). Even very small movements (less than 5 mm) can corrupt volumes (3- dimensional images), invalidating the assumption that the variation in signal intensity between volumes is exclusive of changes in brain physiology. This behavior can cause problems such as: changes in neural activation patterns, emergence of false regions of activity and on many occasions the exam must be discarded. In an attempt to reduce the number of exams excluded due to excessive head motion, we developed a system capable of detecting individuals who have excessive movement while the images are being acquired. This real time analysis allows the test to be stopped and the subject can be redirected to not move. The implementation of this system was used based on the functional magnetic resonance imaging project in Real Time (rtFMRI) of AFNI platform. The system performance was evaluated in a simulated environment using an image database containing 162 acquisitions of functional images later collected from 81 volunteers. In addition, the system was also evaluated in real time during acquisition of RMF 10 tests. In a simulated environment, the motion detection method proposed in this project demonstrated an ability to detect early a failure in the exams in more than 75% of the cases.

O movimento da cabe?a do paciente pode causar falha na an?lise de imagens em exames de resson?ncia magn?tica funcional (RMF). Mesmo movimentos muito pequenos (inferiores a 5 mm) podem corromper os volumes (imagens de 3 dimens?es), invalidando a suposi??o de que a varia??o na intensidade do sinal entre volumes ? exclusiva das mudan?as na fisiologia cerebral. Este comportamento pode causar problemas como: altera??o nos padr?es de ativa??o neural, surgimento de falsas regi?es de atividade e em muitas ocasi?es o descarte total do exame. Na tentativa de reduzir o n?mero de exames descartados por falhas desta ordem, foi desenvolvido um sistema capaz de detectar sujeitos que apresentam movimento excessivo enquanto o exame ? realizado. Esta an?lise em tempo real permite que o exame possa ser interrompido e o sujeito possa ser reorientado a n?o movimentar mais a cabe?a. Para a implementa??o deste sistema foi utilizado como base o projeto de Resson?ncia Magn?tica Funcional em Tempo Real (RMF-TR) da plataforma AFNI. O desempenho do sistema foi avaliado em ambiente simulado utilizando um banco de imagens contendo 162 aquisi??es de imagens funcionais posteriormente coletadas de…

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In the last three decades, neuroimaging studies have provided significant advances in knowledge of the human brain, especially of brain areas hitherto little explored, such as olfaction. Many factors have been reported as able to alter the olfactory threshold and, more recently, the clinical relevance related to changes in this threshold has been largely addressed, principally in relation to neurodegenerative diseases. In parallel, many industries have sought innovative tools for assessing the impact of aromas in the population. Given the lack of adequate national tools for these applications, the present research aimed to develop a robust, automated and instrumented method for olfactory stimuli in neuroimaging studies, with a man-machine interface able to control and visualize the function in a user-friendly way. The results showed that the system was instrumented in a manner compatible with the functional magnetic resonance imaging environment. Furthermore, it nebulized the aromatic sample homogeneously and presented a similar velocity and flow of the air in the three valves. Therefore, this instrument will be able to help identify the mechanisms involved in olfactory threshold change in different situations and may provide important clinical advances. Additionally, it can be an auxiliary tool in business marketing strategies.

Os estudos de neuroimagem, nas ?ltimas tr?s d?cadas, proporcionaram avan?os significativos no conhecimento do c?rebro humano, especialmente, de ?reas cerebrais at? ent?o pouco exploradas, como, o olfato. Muitos fatores t?m sido referidos como capazes de alterar o limiar olfativo, e nos ?ltimos tempos, a relev?ncia cl?nica relacionada ?s altera??es nesse limiar tem sido bastante abordada, principalmente, em rela??o a doen?as neurodegenerativas. Em paralelo, muitas ind?strias t?m buscado instrumentos inovadores para avaliar o impacto dos aromas na popula??o. Dada a car?ncia de ferramentas nacionais adequadas para essas aplica??es, o presente trabalho desenvolveu um sistema para est?mulo olfativo robusto, instrumentado e automatizado para estudos de neuroimagens, com uma interface homem-m?quina capaz de controlar e visualizar o funcionamento de forma amig?vel. Os resultados obtidos demonstraram que o sistema desenvolvido foi instrumentado de forma compat?vel com o ambiente de Resson?ncia Magn?tica funcional. Al?m disso, nebulizou a amostra arom?tica de forma homog?nea. Dessa forma, esse instrumento ser? capaz de auxiliar na identifica??o dos mecanismos envolvidos na altera??o do limiar olfativo em diferentes situa??es, podendo proporcionar avan?os cl?nicos importantes; al?m, de poder ser uma ferramenta auxiliar em estrat?gias de marketing empresarial.

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INTRODU????O: Identificar o mecanismo do AVC isqu??mico ?? um dos pilares fundamentais para a preven????o secund??ria. Apesar das t??cnicas diagn??sticas apropriadas, 30-40% dos AVC isqu??micos permanecem classificados como embolic stroke of undetermined source (ESUS). OBJETIVOS: Determinar o papel da resson??ncia magn??tica card??aca (RMC) e Doppler transcraniano (DTC) em pacientes ESUS. Avaliar vari??veis cl??nicas associadas a achados patol??gicos na RMC e no DTC. MATERIAIS E M??TODOS: Pacientes acompanhados no Ambulat??rio de AVC do Complexo do Hospital Universit??rio Professor Edgard Santos, com diagn??stico ESUS, foram submetidos RMC e DTC. Vari??veis associadas a potenciais fontes emb??licas na RMC (trombo intracard??aco, aneurisma, edema de parede ou fibrose) foram avaliadas por regress??o log??stica bin??ria e regress??o log??stica ordinal. DTC avaliou propor????es de estenose intracraniana e microembolias e as vari??veis cl??nicas foram avaliadas pela regress??o log??stica bin??ria. RESULTADOS: Foram avaliados 66 pacientes pela RMC, idade media 52 +/- 14 anos, 36 (54%) mulheres. Fontes potenciais de cardioembolismo foram encontradas em 17 (26%) pacientes: 16 (24%) com fibrose, quatro (6%) com edema de parede, quatro (6%) com trombo intracard??aco e seis (9%) com aneurisma de ventr??culo esquerdo. Doen??a de Chagas e FE estiveram independentemente associadas com qualquer altera????o emb??lica (OR=4,96; IC 95% = 1,29 ??? 18,94, p=0,019, OR=0,89; IC 95% = 0,82 ??? 0,96, p=0,003, respectivamente) e com o n??mero de altera????es emb??licas (OR 7,02; IC 95% = 1,84 - 26,80, p=0,004, OR 0,87; IC 95% = 0,81 ??? 0,93, p<0,001, respectivamente). Adicionalmente, DAC esteve associada ao n??mero de altera????es emb??licas (OR 14,21; IC 95% = 1,79 - 112,79, p=0,012). 71 pacientes realizaram DTC, sendo encontrada estenose intracraniana em 6 (8,5%). A ACM direita (7%) foi o local mais acometido por estenose. N??o foram encontradas microembolias. CONCLUS??ES: Potenciais causas de cardioembolismo s??o encontradas na RMC em uma propor????o significativa de pacientes classificados como ESUS, principalmente em pacientes com doen??a de Chagas e DAC. A propor????o de estenose IC encontrada foi compat??vel com a literatura, mostrando que o DTC ?? um bom m??todo de rastreio desta patologia.

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O objetivo desse estudo foi avaliar as caracter??sticas dos deslocamentos de disco da articula????o temporomandibular, em imagens de exames de resson??ncia magn??tica, em pacientes adolescentes. Foi avaliado o tipo e a preval??ncia do deslocamento de disco, distribui????o por g??nero e lado afetado. Al??m disso, sinais cl??nicos como estalido, crepita????o, dor e amplitude do movimento de abertura bucal foram avaliados. A amostra constou de 72 indiv??duos, na faixa eta??ria de 10 ?? 20 anos (m??dia de 16,7 ?? 2,5 anos), sendo 51 do g??nero feminino e 21 do g??nero masculino. Os exames foram procedidos em equipamento modelo Signa Horizon (GE), magnitude do campo magn??tico de 1,5 T, com bobina bilateral de superf??cie de 6,0 x 8,0 cm. A preval??ncia do deslocamento de disco na amostra foi de 75%. Mais da metade dos pacientes com deslocamento de disco (44 pacientes ??? 61,1%) apresentaram deslocamento de disco bilateral. Os deslocamentos de disco em geral ocorreram mais no g??nero feminino. No que tange aos deslocamentos de disco unilaterais, o g??nero masculino foi mais acometido, enquanto que nos deslocamentos de disco bilaterais, o g??nero feminino foi o mais acometido. Os deslocamentos de disco com redu????o apresentaram um aumento desta condi????o com o avan??ar da idade. O sinal/sintoma do estalido sugeriu fortemente o deslocamento de disco com redu????o. O deslocamento de disco sem redu????o apresentou uma rela????o direta com a limita????o de abertura bucal. O que se conclui do estudo ?? que os deslocamentos de disco em pacientes adolescentes vem apresentando um aumento em sua preval??ncia. Existe uma correla????o entre o avan??ar da idade e o aumento na incid??ncia do deslocamento de disco na popula????o adolescente.

In this study, it was evaluated the characteristics of disc displacement of the temporomandibular joint (TMJ) of patients indicated for adolescents Nuclear Magnetic Resonance (NMR), regarding the type and prevalence of disc displacement, gender distribution, affected side , click, crepitus, pain and…

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Objetivo: O objetivo deste estudo ? verificar a acur?cia da resson?ncia nuclear magn?tica (RNM) do joelho, realizada em Porto Alegre/RS, utilizando a artroscopia como padr?o ouro, representando as condi??es de uma cidade/capital de um pa?s em desenvolvimento e se esta reproduz os resultados publicados na literatura. Metodologia: Foi realizado um estudo transversal, com coleta prospectiva dos dados, em 327 pacientes que fizeram RNMs, realizadas em 11 diferentes servi?os de radiologia de Porto Alegre/RS, com protocolos de investiga??o global da articula??o do joelho. Para a aquisi??o das imagens, os servi?os de radiologia utilizaram protocolos de avalia??o global da articula??o do joelho. As les?es foram descritas pelos radiologistas e classificadas de acordo com modifica??es nas classifica??es de Stoller e Tyrrell (meniscos), Outerbridge e Tyrrell (cartilagens) e Heron e Calvert (ligamentos). Para a an?lise dos dados, os exames dos pacientes foram divididos em cinco grupos distintos: grupo 1, composto por 299 exames, de todos os servi?os estudados, com aparelho de campo magn?tico fechado, independente da pot?ncia do mesmo; grupo 2, com 195 exames realizados em aparelhos de 1,5T; grupo 3, com 61 exames feitos em aparelho de 2,0T; grupo 4, com 28 exames efetivados em aparelho de campo aberto de 0,23T, e grupo 5, com 84 exames realizados no centro de diagn?stico por imagem da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (CDI-PUCRS), com aparelho de 1,5T. Em todos os grupos utilizou-se a artroscopia, realizada no Hospital S?o Lucas da PUCRS, por um ?nico cirurgi?o, como padr?o-ouro. Resultados: Quando analisada a concord?ncia entre o ortopedista e o radiologista em classificar as les?es na RNM e na artroscopia, respectivamente, por meio do coeficiente kappa, p?de-se considerar boa para o ligamento cruzado anterior (LCA), razo?vel para os meniscos e ruim para as les?es condrais. Em geral, a RNM mostrou alta sensibilidade para o menisco medial (MM) e LCA; boa para o menisco lateral (ML) e baixa para todas as regi?es condrais analisadas. A especificidade da RNM foi boa para a totalidade das estruturas pesquisadas. Conclus?o: A RNM realizada em Porto Alegre/RS, com protocolos de avalia??o global da articula??o do joelho, representando as condi??es de uma cidadecapital de um pa?s em desenvolvimento, tem acur?cia pr?xima ? de estudos publicados na literatura consultada. A acur?cia da RNM realizada neste meio ? considerada muito boa, com altas sensibilidade e especificidade para as les?es do LCA e boas sensibilidade e especificidade para as les?es meniscais, o que contribui com o diagn?stico cl?nico. A presen?a de uma les?o condral na RNM constitui-se em um forte indicativo da sua exist?ncia.

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Artigo 1: OBJETIVO: O joelho ? a articula??o mais frequentemente lesada durante a pr?tica de futebol por jovens atletas com idade entre 12 e 15 anos. A resson?ncia magn?tica (RM), por sua vez, ? um m?todo de imagem bastante acurado no diagn?stico de les?es relacionadas ao esporte. O objetivo deste estudo transversal de casos e controles foi avaliar os joelhos de jogadores de futebol adolescentes assintom?ticos utilizando uma resson?ncia magn?tica de campo aberto.M?TODOS: Foram avaliados 56 joelhos de 28 adolescentes assintom?ticos do sexo masculino com idade entre 14 e 15 anos. Os participantes foram divididos em dois grupos pareados por idade e peso: jogadores de futebol (28 joelhos) e controles (28 joelhos). Todos os exames foram realizados em uma RM de campo aberto com 0.35 tesla e avaliados por dois radiologistas experientes, cegados para os 2 grupos em estudo. As seguintes anormalidades forma acessadas: derrame articular; edema ?sseo medular; e anormalidades meniscais, ligamentares, tend?neas e cartilaginosas.RESULTADOS: No grupo de jogadores de futebol, 18 joelhos (64,2%) tinham uma ou mais altera??es ? RM, sendo que, no grupo controle, apenas nove joelhos (32,1%) tiveram uma ou mais anormalidade (p = 0,003). A preval?ncia de edema ?sseo medular foi maior no grupo de jogadores de futebol (14 joelhos, 50%), sendo detectada em apenas um joelho (3,5%) do grupo controle (p = 0,0001). Outras altera??es de imagem sem diferen?a estat?stica significativa foram encontradas nos dois grupos: edema coxim adiposo infrapatelar, cistos popl?teos e cistos gangli?nicos.CONCLUS?O: Edema ?sseo medular ? uma anormalidade prevalente encontrada na RM de joelho de jovens atletas jogadores de futebol. Os achados de RM devem ser interpretados com cautela e com estreita correla??o cl?nica.Artigo 2: OBJETIVO: A nata??o ? uma atividade esportiva amplamente difundida, sendo considerada uma forma ideal de exerc?cio, com pouco ou nenhum impacto sobre os joelhos. No entanto, les?es por microtrauma repetitivo ou uso excessivo podem frequentemente afetar a articula??o do joelho de jovens atletas nadadores de n?vel competitivo. As les?es iniciais geralmente s?o assintom?ticos por um per?odo de tempo consider?vel antes de causarem desconforto ou dor articular. O objetivo do presente estudo foi avaliar por resson?ncia magn?tica (RM) os joelhos de jovens atletas assintom?ticos nadadores de elite e compar?-los com um grupo controle pareado por idade e peso, que n?o pratica nenhum esporte de impacto regularmente.M?TODOS: Realizamos um estudo transversal controlado para avaliar 54 joelhos de 27 adolescentes assintom?ticos com 14 a 15 anos de idade, pareados por idade e peso. Os participantes foram divididos em dois grupos: 13 atletas nadadores de elite e 14 controles. Todos os exames foram realizados em uma RM de campo aberto com 0.35 tesla e avaliados por dois…

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Introduction: The process of healthy aging is accompanied by a gradual decline in some cognitive abilities, particularly those related to executive functioning and episodic memory, which makes learning slower. Anatomical changes in neural structures, such as the reduction of total brain volume are observed, making it vulnerable during aging. Behavioral changes such as symptoms of depression and anxiety may also influence the performance in cognitive functions during aging. A major challenge when it comes to cognition in the elderly is to establish the boundaries between normal and pathological. Recent studies on healthy aging demonstrate that the hippocampal volume decreases in late adulthood and this phenomenon is correlated with cognitive decline. Objectives: Correlate the hippocampal volumetry with performance in cognitive and behavioral functioning in a group of elderly subjects. Patients and Methods: The study sample consisted of elderly adults that had undergone the hippocampal volumetry by Magnetic Resonance Imaging (MRI) at the Center of Diagnostic imaging Hospital S?o Lucas PUCRS. From these patients, 58 participants, with complaints of forgetfulness, aged 60 years or older were invited to take part of the study. The tests used to asses behavioral and cognitive functions were: Wechsler Memory Scale - III (WMS - III), frontal Assessment Battery (FAB), Geriatric Depression Scale (GDS) and the Beck Anxiety inventory (BAI). Results and Conclusions: The results demonstrated correlation (0.65; P < 0.001) between hippocampal volume and performance of executive tasks, and episodic memory (0.48; P < 0.001). However, the hippocampal volume was not correlated with behavioral outcomes (depression and anxiety). There was a correlation between the volume of the hippocampus, episodic memory, and the socio-demographic variables: age, gender, income and years of education.

Introdu??o: O processo de envelhecimento saud?vel ? acompanhado de um decl?nio gradual em algumas habilidades cognitivas, particularmente aquelas relacionadas ao funcionamento executivo, ? mem?ria epis?dica, assim como, altera??es anat?micas nas estruturas neurais, como a redu??o do volume cerebral total. Altera??es comportamentais como os sintomas de depress?o e ansiedade tamb?m podem influenciar no desempenho das fun??es cognitivas durante o envelhecimento. Um dos grandes desafios na atualidade quando se trata da cogni??o no idoso ? estabelecer os limites entre o normal e o patol?gico. Estudos recentes sobre o envelhecimento saud?vel demonstram que o volume do hipocampo diminui na idade adulta tardia e este fen?meno apresenta rela??o com o decl?nio cognitivo. Objetivos: Correlacionar a volumetria hipocampal com o desempenho do funcionamento cognitivo e comportamental em um grupo de idosos. Pacientes e M?todos: A amostra do estudo constou de idosos que realizaram…

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Cystic fibrosis (CF) has long been described as a fatal genetic disease. Currently, improvement in the care of these patients contributes to longer survival and thereby allows the observation of other symptoms related to mutations of the cystic fibrosis transmembrane chloride regulator (CFTR) gene, responsible for the disease. Although pulmonary disease continues to be the leading cause of morbidity and mortality, CF also requires that attention be given to manifestations of the disease in other organs, such as liver disease. CF-associated liver disease (CFLD) can be considered an independent risk factor for mortality and lung transplantation. The major challenge is to diagnose CFLD, because the changes may remain asymptomatic until advanced stages of the disease. There is currently no single test that is sensitive and specific enough to assess liver function, and early diagnosis of CFLD requires a combination of regular clinical examination, biochemical tests, and imaging studies. There are high expectations for noninvasive tests that are harmless to patients and can be easily repeated and compared in order to detect changes as early as possible. Imaging techniques have improved significantly over the past decade and new technologies are being incorporated into clinical practice. Ultrasonography (US), computed tomography and magnetic resonance imaging (MRI) are the main imaging modalities currently used for examination, but new MRI-based techniques have acquired great importance. Thus, it would be desirable to develop a more accurate method than US, which is the most widely used routine examination, as well as the ultrasound scoring system described by Williams et al in 1995 and used so far. This study aimed to describe possible MRI abnormalities in children with CF and correlate them with US findings, particularly in relation to parameters of parenchyma, border, and liver fibrosis. Methods: Patients with a diagnosis of CF underwent clinical examination, anthropometric measurements, US, and MRI. MRI was performed without sedation or contrast. The liver was evaluated using the scoring system described by Williams et al on US and MRI images. Other MRI features were also analyzed, including degenerative nodules, atrophy of the right hepatic lobe, and posterior notch sign of the hepatic lobe.…

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Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq

Introduction: Crohn's disease (CD) is an idiopathic inflammatory bowel disease, which mainly affects the terminal ileum A biopsy colonoscopy with regard to the gold standard in the assessment of disease and the area of education costly and with anesthetic risks. Noninvasive methods of evaluation such as magnetic resonance enterography (MRE) have been developed in the last decade. Evaluation systems such as the magnetic resonance index of activity (MaRIA) and Clermont score are used in clinical studies to quantify inflammation in patients with CD. A diffusion-weighted magnetic resonance imaging (DWI) evaluates a restitution of the water molecules in the tissues. Studies have shown a correlation between a restriction of diffusion on the wall of the intestine with inflammation. However, few studies with MRE of 3 Tesla support analysis a apparent diffusion coefficient (ADC) correlactionan in inflammatory proces in the terminal ileum. Purpose: To determine the applicability of the sequence DWI in 3 Tesla MRE in the identification of inflammatory signs in the distal ileum in patients with Crohn?s disease. Materials and Methods: We retrospectively studied 38 individuals with CD, who underwent MRE between March 2014 to september 2017 and had an anatomopathological and endoscopic evaluation in the distal ileum. The following variables were evaluated: diffusion (DWI), quantitative ADC, wall thickening, intramural edema, ulcerations, stricture, segmental mural hyperenhancement, relativo contrast enchancement (RCE), MaRIA and Clermont score. Results: The mean duration of the disease was 7 ? 5 years, 19 patients (50%) were male. Eighteen patients (47%) had active inflammatory disease and twenthy (53%) had disease in remission in the terminal ileum. Patients with active inflammatory disease in the distal ileum had a greater restriction on DWI, intramural edema, wall thickening, MaRIA and Clermont score, when compared to the group of patients without inflammation. The correlation between MaRIA and Clermont score (r = 0.975) was strong. The Kappa coefficient of interobserver agreement was excellent for the MaRIA, Clermont score and restriction DWI, moderate for ADC and weak for RCE. The best cut-off point in this study for the inflammation identified by the colonoscopy for the ADC was 2.1x103mm2/s, with sensitivity of 88.8% and specificity of…

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Introduction: Patellar chondropathy has an insidious onset, affecting patients with progressive, diffuse pain on the anterior aspect of the knee joint, and is one of the earliest signs of patellofemoral joint degenerative disease. Its etiology is still ill?defined, although risk factors such as female gender, increased body weight, and older age have been wellstablished in literature. There has been a prevalence of 40?60% under patellar cartilage macroscopic examination. The gold standard method for diagnosis is the arthroscopy; nonetheless, being a surgical procedure with high complication rates, its use is limited. With the advent of newer imaging methods, these modalities have been much more employed than diagnostic arthroscopy. Both conventional radiographs and CT scans provide indirect information on the condition of joint cartilage, whilst MRI provides more accurate data. There are no studies, however, highlighting the prevalence of patellar chondropathy in more recent imaging techniques such as the 3.0 Tesla MRI. Objective: To establish the prevalence of patellar chondropathy in 3.0 Tesla MRIs performed at Instituto do C?rebro da PUCRS between October 2016 and September 2017. Method: Data were collected by 3.0 Tesla MRIs of patients' knees obtained at Instituto do C?rebro da Pontif?cia Universidade Cat?lica do Rio Grande do Sul between September 2016 and August 2017, comprising a period of 12 months. Those MRIs were assessed by an experienced musculoskeletal radiologist, who confirmed the presence of patellar chondropathy and, when present, rated the finding into the four grades ascribed by the International Cartilage Repair Society. Results: A number of 291 patients were assessed during the period with 389 MRI scans. Of those patients, 308 (79.2%) were diagnosed with patellar chondropathy, whilst 81 (20.8%) were not. Chondropathy was more prevalent in the female gender, in subjects above 40 years of age, and in obese patients. When the results were weighed in ICRS classification, the milder grades (1 and 2) were seen in younger man (<30 years of age), while the more severe grades (3 and 4) were present in females, those above 40 years of age, and in obese patients.

Introdu??o: A condropatia patelar ? uma patologia de car?ter insidioso e que cursa com dor difusa na regi?o anterior do joelho, com caracter?stica progressiva, e ? um dos primeiros…

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The Nipple-areolar Complex-sparing Mastectomy (NSM) enables rebuild a symmetrical and quite natural breast body. This technique can be a safe alternative to Modified Radical Mastectomy in patients with well-selected breast cancer and cause less impact on quality of life. However, NSM has its oncological safety questioned by the theoretical risk of persistence of breast fibroglandular tissue (BFT) along with the skin envelope and the nipple-areolar complex, which could increase the risk of recurrence. The objective of this study was to develop a methodology for determining the remaining BFT volume after NSM surgery using magnetic resonance imaging and through it, to evaluate the presence and the residual BFT volume of a group of patients. Descriptive statistical analysis of frequency, mean, standard deviation and confidence interval for the mean volume of BFT was performed using SPSS 17 program. Initially it was verified if that there was a difference between the results obtained on different hardware / manufacturers. It was tested whether there was a correlation between the resulting volume method and variables. For this sample we used the Shapiro-Wilk test and a significance level of 5%. The method developed in this paper for targeting the BFT used semi-automatic segmentation tools, based on level set and live wire, and other features available in MIPAV software. The methodology starts by pre-processing the images and the withdrawal of all tissues that do not constitute the BFT, called Regions of No-Interest (RNI). These tissues are excluded from the image and constitute the following regions: the breast implant (RNI-1), the skin (RNI-2), the fatty tissue (RNI-3) and the pectoralis muscle (RNI-4). The residual BFT volume was calculated in a sample of 18 breasts, with an mean volume of 1.47 ? 1.69 cm 3 (at least 0.12 cm3 and 7.11 cm3 maximum). The mean proportion of residual BFT volume in relation to the estimated total volume of the breast was 0.419 ? 0.328%. In spite of all patients show some amount of residual BFT, the proportion of the residual volume BFT in patients relative to the total volume of the breast was extremely low and could justify oncological safety of NSM demonstrated in previous retrospective studies.

A cirurgia de mastectomia preservadora de pele e de complexo ar?olo-papilar (MPPCAP) possibilita reconstruir um corpo mam?rio sim?trico e bastante natural. Esta t?cnica pode ser uma alternativa segura ? Mastectomia Radical Modificada em pacientes com C?ncer de Mama bem selecionadas, al?m de causar menor impacto na qualidade de vida. Contudo, a MPCCAP tem sua…