MARCOS ROBERTO DE MENEZES
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Improved Hemodynamic Parameters in Middle Cerebral Artery Infarction After Decompressive Craniectomy(2014) AMORIM, Robson Luis; ANDRADE, Almir Ferreira de; GATTAS, Gabriel S.; PAIVA, Wellingson Silva; MENEZES, Marcos; TEIXEIRA, Manoel Jacobsen; BOR-SENG-SHU, EdsonBackground and Purpose Decompressive craniectomy (DC) reduces mortality and improves functional outcome in patients with malignant middle cerebral artery infarction. However, little is known regarding the impact of DC on cerebral hemodynamics. Therefore, our goal was to study the hemodynamic changes that may occur in patients with malignant middle cerebral artery infarction after DC and to assess their relationship with outcomes. Methods Twenty-seven patients with malignant middle cerebral artery infarction who were treated with DC were studied. The perfusion CT hemodynamic parameters, mean transit time, cerebral blood flow, and cerebral blood volume were evaluated preoperatively and within the first 24 hours after DC. Results There was a global trend toward improved cerebral hemodynamics after DC. Preoperative and postoperative absolute mean transit times were associated with mortality at 6 months, and the ratio of post- and preoperative cerebral blood flow was significantly higher in patients with favorable outcomes than those with unfavorable outcomes. Patients who underwent surgery 48 hours after stroke, those with midline brain shift >10 mm, and those who were >55 years showed no significant improvement in any perfusion CT parameters. Conclusions DC improves cerebral hemodynamics in patients with malignant middle cerebral artery infarction, and the level of improvement is related to outcome. However, some patients did not seem to experience any additional hemodynamic benefit, suggesting that perfusion CT may play a role as a prognostic tool in patients undergoing DC after ischemic stroke.
- Ultrasonography During Surgery to Approach Cerebral Metastases: Effect on Karnofsky Index Scores and Tumor Volume(2017) OLIVEIRA, Marcelo de Lima; PICARELLI, Helder; MENEZES, Marcos Roberto; AMORIM, Robson Luis; TEIXEIRA, Manoel Jacobsen; BOR-SENG-SHU, EdsonBACKGROUND: The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patient quality of life. The aim of this study was to analyze the effect of conventional surgery supported by intraoperative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined the postoperative Karnofsky Performance Status Scale (KPS) scores and tumor resection grades. METHODS: Patients with a CM diagnosis were included in this study. Surgical treatment was either supported or not by IOUS. Pre-and postoperative KPS scores were determined by the oncology team, and cerebral tumor volume was estimated through pre-and postoperative magnetic resonance imaging. The surgical team determined whether it was possible to perform a total CM resection. RESULTS: There were 78 patients treated using surgical management (35 with and 43 without IOUS). In the IOUS group, the postoperative KPS scores were higher (80 vs. 70, respectively; P = 0.045) and the KPS evolution was superior (P = 0.036), especially in the following subgroups: difficulty of tumor resection ranking score < 4 (P = 0.037), tumor in an eloquent area (P = 0.043), tumor not associated with vessels or nerves (P = 0.007), and solitary lesions (P = 0.038). The residual tumor volume was lower in the IOUS group (9.5% and 1.6 mm(3) vs. 30.8% and 9 mm(3), respectively; P = 0.05). In patients with a KPS score >= 70, 62% of them had <10% residual tumors (76% in the IOUS group and 45% in the non-IOUS group; P = 0.032; odds ratio, 3.8). CONCLUSIONS: IOUS may improve postoperative KPS scores and decrease residual tumor volumes in CM surgeries. These findings should be confirmed in future studies.
- MAGNETIC RESONANCE-GUIDED HIGH-INTENSITY FOCUSED ULTRASOUND ABLATION OF OSTEOID OSTEOMA: A CASE SERIES REPORT(2016) ROVELLA, Marcello S.; MARTINS, Guilherme L. P.; CAVALCANTI, Conrado F. A.; BOR-SENG-SHU, Edson; CAMARGO, Olavo P.; CERRI, Giovanni G.; MENEZES, Marcos R.Osteoid osteoma is painful benign tumor. The aim of this study was to report our initial experience using magnetic resonance-guided focused ultrasound to treat osteoid osteomas. This retrospective single-center study included four patients treated with magnetic resonance-guided focused ultrasound. They presented with severe pain with reduced quality of life and a poor response to clinical treatment. The pre- and post-treatment evaluation comprised computed tomography and magnetic resonance imaging and focused on quality of life and the impact of pain on daily activities. After treatment, three patients had complete pain resolution with no recurrence. One patient had a recurrence of symptoms after 2 wk and underwent a new successful treatment with increased energy levels. On average, 13 sonications were administered (8-18 sonications/treatment) with an average energy of 2,003 J (range: 1,063-3,522 J). Magnetic resonance-guided focused ultrasound appears to be a feasible, tolerable and effective treatment in selected patients with osteoid osteomas. (E-mail: marcos.menezes@hc.fm.usp.br) (C) 2016World Federation for Ultrasound in Medicine & Biology.
- Using Contrast-Enhanced Ultrasound for Brain Tumor Surgery(2015) OLIVEIRA, Marcelo de Lima; PICARELLI, Helder; MENEZES, Marcos R.; TEIXEIRA, Manoel J.; BOR-SENG-SHU, Edson