GIOVANNI GUIDO CERRI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
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bookPart Prefácio(2014) CERRI, Giovanni GuidoconferenceObject SUBTLE IMPAIRMENT OF RIGHT VENTRICULAR FUNCTION IN SYSTEMIC SCLEROSIS WITH LUNG FIBROSIS DETECTED BY TISSUE DOPPLER(2014) SAMPAIO-BARROS, P.; RODRIGUES, A. C.; ROQUE, M.; ARRUDA, A. L.; BECKER, D.; BARROS, S.; KAY, F.; EMMERICH, T.; CERRI, G.- Low-carbohydrate diet versus euglycemic hyperinsulinemic clamp for the assessment of myocardial viability with F-18-fluorodeoxyglucose-PET: a pilot study(2014) SOARES JR., Jose; RODRIGUES FILHO, Filadelfo; IZAKI, Marisa; GIORGI, Maria Clementina P.; CATAPIRRA, Rosa M. A.; ABE, Rubens; VINAGRE, Carmen G. C. M.; CERRI, Giovanni G.; MENEGHETTI, Jose ClaudioPositron emission tomography with F-18-fluorodeoxyglucose (FDG-PET) is considered the gold standard for myocardial viability. A pilot study was undertaken to compare FDG-PET using euglycemic hyperinsulinemic clamp before F-18-fluorodeoxyglucose (F-18-FDG) administration (PET-CLAMP) with a new proposed technique consisting of a 24-h low-carbohydrate diet before F-18-FDG injection (PET-DIET), for the assessment of hypoperfused but viable myocardium (hibernating myocardium). Thirty patients with previous myocardial infarction were subjected to rest Tc-99m-sestamibi-SPECT and two F-18-FDG studies (PET-CLAMP and PET-DIET). Myocardial tracer uptake was visually scored using a 5-point scale in a 17-segment model. Hibernating myocardium was defined as normal or mildly reduced metabolism (F-18-FDG uptake) in areas with reduced perfusion (Tc-99m-sestamibi uptake) since F-18-FDG uptake was higher than the degree of hypoperfusion-perfusion/metabolism mismatch indicating a larger flow defect. PET-DIET identified 79 segments and PET-CLAMP 71 as hibernating myocardium. Both methods agreed in 61 segments (agreement = 94.5 %, kappa = 0.78). PET-DIET identified 230 segments and PET-CLAMP 238 as nonviable. None of the patients had hypoglycemia after DIET, while 20 % had it during CLAMP. PET-DIET compared with PET-CLAMP had a good correlation for the assessment of hibernating myocardium. To our knowledge, these data provide the first evidence of the possibility of myocardial viability assessment with this technique.
- Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?(2014) STANZANI, Daniela; CHALA, Luciano F.; BARROS, Nestor de; CERRI, Giovanni G.; CHAMMAS, Maria CristinaOBJECTIVES: Despite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification. METHODS: Seventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results. RESULTS: Percutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)> 0.73 before contrast injection, and an RI > 0.75 after contrast injection were significantly predictive of malignancy (p < 0.001). CONCLUSION: The combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers.
- MRI Findings After Prostatic Artery Embolization for Treatment of Benign Hyperplasia(2014) FRENK, Nathan E.; BARONI, Ronaldo H.; CARNEVALE, Francisco C.; GONCALVES, Octavio M. G.; ANTUNES, Alberto A.; SROUGI, Miguel; CERRI, Giovanni G.OBJECTIVE. The purpose of this article is to assess and describe the MRI findings after prostatic artery embolization for treatment of benign prostatic hyperplasia. MATERIALS AND METHODS. We retrospectively evaluated 17 patients who underwent prostatic artery embolization as part of different prospective studies to evaluate this alternative treatment of benign prostatic hyperplasia. Clinical results were evaluated by assessment of urinary catheterization and International Prostate Symptom Score (IPSS). Serial MRI examinations were performed, and the prostatic central gland and peripheral zone were evaluated for signal intensity changes and the presence and characteristics of infarcted areas. Statistical analysis was performed with ANOVA for repeated measures and Student t test. RESULTS. All patients had clinical success, as defined by the removal of indwelling urinary catheter or decreased IPSS after embolization. Infarcts were seen in 70.6% of the subjects, exclusively in the central gland, were almost always characterized by hyperintensity on T1-weighted images and predominant hypointensity on T2-weighted images, and became smaller (mean reduction, p < 0.001) and isointense to the remaining of the central gland over time. Volume reduction of the prostate after embolization was significant (averaging 32.0% after 12-18 months; p < 0.001) only in patients with infarcts. No statistically significant association was seen between the development of infarcts and IPSS. CONCLUSION. MRI can be used for assessing the development of infarcts and volume reduction in the prostate after embolization. Further studies are needed to correlate these findings to clinical outcome.
- Effects of Low-Level Laser Therapy on the Serum TGF-beta 1 Concentrations in Individuals with Autoimmune Thyroiditis(2014) HOEFLING, Danilo B.; CHAVANTES, Maria Cristina; ACENCIO, Milena M. P.; CERRI, Giovanni G.; MARUI, Suemi; YOSHIMURA, Elisabeth M.; CHAMMAS, Maria CristinaObjective: The objective of this study was to evaluate the serum concentration of transforming growth factor-beta 1 (TGF-beta 1) after low-level laser therapy (LLLT) in patients with hypothyroidism resulting from chronic autoimmune thyroiditis (CAT). Background data: Certain data indicate that LLLT is effective in patients with hypothyroidism caused by CAT; however, the mechanisms of action of LLLT in thyroid tissue are unknown. Cytokines could play a role in the response to LLLT. Methods: A randomized, placebo-controlled trial included 43 patients with a history of levothyroxine therapy for CAT-induced hypothyroidism. The patients were randomly assigned to receive either 10 sessions of LLLT (830 nm, 50 mW output power, and 707 J/cm(2) fluence; L group, n = 23) or 10 sessions of a placebo treatment (P group, n = 20) twice a week. Levothyroxine was maintained at the same dose during the entire study period. TGF-beta 1 was measured both pre-intervention and 30 days post-intervention in both groups. The differences were calculated between the TGF-beta 1 values observed 30 days post-intervention and the pre-intervention TGF-beta 1 values for each group (intragroup). Results: Comparing the differences in TGF-beta 1 levels between the L group (874.9 +/- 541.7 pg/mL) and the P group (-128.4 +/- 832.8 pg/mL) revealed that there was a statistically significant increase in TGF-beta 1 levels 30 days post-intervention in group L compared with the placebo group (p = 0.0379). Conclusions: This finding suggested that the significant increase in serum TGF-beta 1 levels in patients with CAT-induced hypothyroidism was associated with the thyroid LLLT procedure. Future studies of the effect of LLLT on TGF-beta 1 gene expression in thyroid tissue are necessary to confirm these findings.