OBJECTIVE: To determine the impact on the quality of life in patients with symptomatic uterine fibroids submitted to uterine artery embolization. MATERIALS AND METHODS: Forty patients with symptomatic fibroids submitted to embolization have answered a quality-of-life questionnaire before and 12 weeks after the procedure. RESULTS: Mean score for symptoms severity before the procedure was 62.07 ± 6.34 and decreased with statistical significance to 20.42 ± 3.81 after the procedure. Similarly, scores for quality of life have improved from 40.26 ± 2.98 before the procedure to 85.06 ± 2.57 after the procedure, which again was statistically significant. CONCLUSION: Uterine embolization results in evident symptoms relief and significant improvement in the quality of life of patients with symptomatic fibroids.

Keywords: Therapeutic embolization, Uterus, Leiomyoma, Quality of life, Interventional radiology

OBJECTIVE: To evaluate the prognostic value of bowel loops dilatation as a finding on radiographs in the development and mortality of neonates with necrotizing enterocolitis. MATERIALS AND METHODS: On abdominal radiographs of 53 patients for diagnostic suspicion of necrotizing enterocolitis, the major diameters of dilated bowel loops (AD) were measured, as well as the distance between the upper border of the first lumbar vertebra and the lower border of the second one (L1-L2), and the distance between the lateral borders of the first lumbar vertebra (L1) pedicles, and the subsequent association between AD/L1-L2, AD/L1. This measure was considered as a possible determining factor for potential complications, surgical intervention and mortality. RESULTS: The patients who needed surgical management and who had complications during progression and died of the disease had showed increased AD and AD/L1-L2 (p < 0.05). AD/L1 values and site of the most dilated bowel loop were not different in the groups with unfavorable progression. CONCLUSION: Bowel loop dilatation detected on initial supine abdominal radiographs suggests a worst prognosis in necrotizing enterocolitis. Furthermore, measurement of the most dilated bowel loop on these radiographs is a simple and reproducible method that adds diagnostic and prognostic information.

Keywords: Necrotizing enterocolitis, Radiography, Progression

OBJECTIVE: To evaluate the reproducibility of magnetic resonance imaging and the agreement between ultrasound and magnetic resonance imaging in the classification of periportal fibrosis in patients with schistosomiasis based on Niamey's qualitative criteria. MATERIALS AND METHODS: A prospective, double-blinded study was conducted between February 2005 and June 2006 with 20 patients (10 men and 10 women, with ages ranging between 24 and 60 years, mean age 42.7 years) diagnosed with schistosomiasis mansoni. Both ultrasound and magnetic resonance images were independently evaluated by two experienced observers. Interobserver agreement was evaluated for findings of periportal fibrosis on magnetic resonance images and in a comparison between magnetic resonance and ultrasound images. RESULTS: The analysis of magnetic resonance images showed total interobserver agreement in 14 patients (70%). The comparison between ultrasound and magnetic resonance imaging showed agreement between images in only six cases (30%) by observer 1, and in eight cases (40%) by observer 2. CONCLUSION: Magnetic resonance imaging presents a good reproducibility in the evaluation of periportal fibrosis in later stages of schistosomiasis, however, the correlation between magnetic resonance imaging and ultrasound is poor.

Keywords: Schistosomiasis, Periportal fibrosis, Ultrasound, Magnetic resonance imaging

OBJECTIVE: The present study was aimed at establishing the frequency of renal/perirenal and extrarenal computed tomography findings in patients with acute pyelonephritis, and evaluating the interobserver agreement. MATERIALS AND METHODS: Retrospective study based on the analysis of computed tomography images of 47 patients with clinical and laboratory findings of acute pyelonephritis. Two independent observers evaluated the main renal/perirenal and extrarenal alterations. The frequency of tomographic findings and interobserver agreement were analyzed by the kappa (k) test. RESULTS: The frequency of tomographic findings for the several parameters was the following: striated nephrogram, 100%; renal enlargement, 65%; perirenal fat heterogeneity, 62.5%; renal calculi, 16.6%; abscesses, 21%; pleural effusion, 36%; thickened gallbladder wall, 32.5%; periportal edema, 32.5%. The k test for interobserver agreement demonstrated reproducibility ranging between moderate (k = 0.511 for renal enlargement) to almost perfect (k = 0.87 for striated nephrogram) for all of the parameters analyzed, except for perirenal fat heterogeneity (k = 0.268). CONCLUSION: The frequency of findings of acute pyelonephritis on computed tomography is high. Overall, striated nephrogram was the most frequent finding. Peri- and extra-renal alterations were found in about 2/3 of the cases. Computed tomography demonstrated a good interobserver agreement.

Keywords: Acute pyelonephritis, Kidney, Computed tomography, Reproducibility

OBJECTIVE: The present study was aimed at describing the findings on high-resolution computed tomography in patients with exogenous lipoid pneumonia secondary to mineral oil aspiration MATERIALS AND METHODS: Eight adult patients - four men and four women - with mean age of 69.4 years were studied. All of the patients were users of mineral oil for treating intestinal constipation. High-resolution computed tomography studies of these patients were blindly evaluated by two radiologists. RESULTS: Air-space consolidation with areas of fat density and crazy paving pattern were the most frequent findings. The lesions were bilateral in six cases and unilateral in two CONCLUSION: Air-space consolidation with areas of fat density, associated with a clinical history of mineral oil ingestion virtually indicates a diagnosis of exogenous lipoid pneumonia.

Keywords: Exogenous lipoid pneumonia, High-resolution computed tomography, HRCT, Aspiration pneumonia, Lungs

OBJECTIVE: To evaluate the nonradiologist physicians' knowledge about adverse reactions to iodinated contrast media, as well as prevention and associated risk factors. MATERIALS AND METHODS: A transversal study was developed with 203 nonradiologist physicians (assistants, residents and trainees) of different specialties, who completed a questionnaire including ten multiple choice questions regarding prophylaxis, risk factors and conduct related to the development of adverse reactions to iodinated contrast media. The Statistic Package for Social Science version 12.0 for Windows® was utilized for statistical analysis. RESULTS: Asthma, food allergy, anxiety and ischemic heart disease were considered as risk factors by, respectively, 80.9%, 78.9%, 5.9% and 4.1% of the participants. According to 23.4% of the physicians, there is no absolute contraindication to the use of iodinated contrast media. Correct prophylactic measures for patients with previous adverse reaction to iodinated contrast media and in diabetic patients using metformin were indicated, respectively, by 84.5% and 53.7% of the respondents. Questions about contrast-induced nephropathy, use of iodinated topical antiseptics in patients with previous adverse reaction to iodinated contrast media, and anxiety were correctly answered by, respectively, 86.1%, 45.5% and 5.9% of the participants. CONCLUSION: Nonradiologist physicians have shown a reasonable knowledge about adverse reactions to iodinated contrast media. A better integration and communication among radiologists and physicians of other specialties is warranted.

Keywords: Iodinated contrast media, Radiology, Adverse reactions, Risk factors

OBJECTIVE: The present study was aimed at evaluating the possibility of a radiological study of the lumbar spine determining the correct identification of an individual despite the changes associated with aging. MATERIALS AND METHODS: The study sample included 60 pairs of lumbar spine radiographic images of both male and female, adult patients of different ages, acquired at different times, at three-year minimum intervals. The pairs of images were mixed up so two experienced radiologists could put them back together. The vertebrae of each pair were compared for similarities and differences in anatomical details. Pairing criteria adopted were finding a specific anatomical variation or detail, or finding two or more similarities among anatomical details, with no point of divergence. RESULTS: Correct pairing of radiographs of the whole sample was achieved by both observers, who presented countless coincidence points in their analyses. The statistical analysis demonstrated a good-to-perfect interobserver agreement. CONCLUSION: Comparison between radiographic images of lumbar spine can determine a correct identification of individuals, despite changes associated with aging. Therefore, radiography represents a potential tool to be utilized in forensic identification studies.

Keywords: Radiographic comparison, Identification, Forensic anthropology

OBJECTIVE: The critical analysis of the methodology for evaluating the x-ray beam half-value layer was based on technical standards for radiological protection and quality control in medical and dental diagnoses. MATERIALS AND METHODS: Exposure parameters, experimental set-up, scattering materials, instrumentation, size of radiation field and methodology of data analysis have been taken into consideration for measurements of half-value layer. RESULTS: The half-value layer, in good geometry, measured 2.44 ± 0.02 mmAl. A maximum deviation of 4.1% was found under other geometry conditions. A 98.8% deviation was observed with a different ionization chamber, and scattering material, and 29.5% with another type of detector. CONCLUSION: Results showed that no relevant variation is observed in the half-value layer for different radiation field sizes. On the other hand, the influence of the radiation scattering on the half-value layer overestimation was clearly observed, as well as the half-value layer reduction in the presence of lead used as scattering material. The practical methodology adopted for half-value layer evaluation has shown to be quite reliable, besides evidencing remarkable discrepancies resulting from the adoption of inappropriate methodologies, emphasizing the necessity of establishing a standard procedure for measuring the half-value layer.

Keywords: Half value layer, HVL, Quality control, Diagnostic radiology

OBJECTIVE: To study, by means of computed tomography, the repercussion of post-weaning dietary supplementation with soy oil or canola oil on the abdominal fat distribution in previously undernourished rats. MATERIALS AND METHODS: Dams submitted to 50% food restriction (FR) compared with dams receiving a standard diet (C). After weaning, undernourished rats received a diet supplemented with 19% soy oil (19% FR-soy) or 19% canola oil (19% FR-canola). Rats in the control group received a diet with 7% soy oil (7% C-soy) until the end of the experimental period. At the age of 60 days old, the rats were submitted to computed tomography for evaluation of total abdominal and visceral fat area. The rats' length and body mass were evaluated and, after their sacrifice, the abdominal fat depots were excised weighted. The data are reported as mean ± mean standard error, with p < 0.05 considered as significance level. RESULTS: Rats in the group 19% FR presented similar length, body weight and visceral fat mass. As a whole, the evaluations have shower results significantly lower in relation to the control group (7% C-soy). However, computed tomography has found significant differences in abdominal fat distribution for the groups 19% FR-soy and 19% FR-canola. CONCLUSION: Computed tomography has demonstrated that the abdominal fat distribution may be dependent on the type of vegetable oil included in the diet.

Keywords: Computed tomography, Abdominal fat tissue, Malnutrition, Soy oil, Canola oil, Rats

Telemedicine refers to the delivery of health care services over a distance. Videoconference is one of the different modalities of telemedicine, allowing real-time interaction. The present study is aimed at describing videoconference systems in a simplified way, focusing on their application in telemedicine. Videoconference involves the necessity of equipment for audio and video capture and reproduction, besides a communication link for connection with similar equipment through ISDN (integrated services digital network) or IP (internet protocol). Video and audio quality is essential for the success of a videoconference. Experiments using videoconferencing equipment in radiology and other fields of medicine are a reality at international level. In Brazil, reports account for some isolated initiatives in this field, most of them involving universities networks. Besides its remarkable impact on costs of medical care delivery for the population, videoconference represents an invaluable tool for physicians in their education and knowledge updating.

Keywords: Videoconference, Telemedicine, Teleassistance, Second opinion, Distance learning

Radiation therapy represents an important alternative for curative treatment of patients with nonsmall cell lung cancer. However, an accurate definition of the volume to be irradiated becomes even more important, considering that lungs are highly sensitive to radiation. Most recently, combined FDG-PET/CT scan has been utilized, and the literature reports its significant role in the planning of radiation therapy, since it seems to influence the target-volume delineation in cases of lung cancer. Differences between diagnostic and treatment equipments must be taken into consideration when FDG-PET/CT scan is utilized in the planning of radiation therapy. The present study discusses some of the many technical problems that must be solved when PET is incorporated into the planning of radiation therapy for non-small cell lung cancer.

Keywords: Radiotherapy, PET scan, Planning, Lung cancer

The fetal limb volume reflects the nutritional status and intra-uterine growth of the fetus. The arrival of the three-dimensional ultrasound has allowed a more accurate volumetric evaluation of irregularly shaped structures such as fetal organs. The three-dimensional multiplanar mode is the most efficient technique to evaluate fetal limb volume as a parameter for a more accurate birth weight prediction. Currently, this method is useful for monitoring the development of soft tissue and for early detection of fetal growth deviations. In our country, where fetal growth restriction is frequent, with poor access to a skilled neonatal assistance, the dissemination of this technique could definitely contribute to reduce the rates of perinatal morbidity and mortality.

Keywords: Three-dimensional ultrasound, Fetal limbs, Volume

The present study reports two histologically proven cases of pulmonary paracoccidioidomycosis where a reversed halo sign was found. The reversed halo, initially described as a pathognomonic sign of cryptogenic organizing pneumonia, has later been found and described in paracoccidioidomycosis.

Keywords: Reversed halo sign, Paracoccidioidomycosis, Cryptogenic organizing pneumonia

The authors report a case of a newborn term infant with horseshoe lung associated with supracardiac total anomalous pulmonary venous drainage; such association remains unreported in the Western literature.

Keywords: Horseshoe lung, Chest radiography, Computed tomography, Angiography