CESAR HIGA NOMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder
8 resultados
Resultados de Busca
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- Is there a consistent association between coronary heart disease and ischemic stroke caused by intracranial atherosclerosis?(2013) CONFORTO, Adriana B.; LEITE, Claudia da Costa; NOMURA, Cesar H.; BOR-SENG-SHU, Edson; SANTOS, Raul D.Coronary heart disease and ischemic stroke are frequent coexistent conditions that share risk factors and pose major burdens to global health. Even though a clear relation has been established between extracranial internal carotid artery atherosclerosis and symptomatic or asymptomatic coronary heart disease, there is a gap in knowledge about the association between intracranial atherosclerosis and coronary heart disease. Intracranial atherosclerosis is associated with high risks of stroke recurrence and vascular death. More research and clinical trials are needed to answer whether early diagnosis of asymptomatic coronary heart disease and aggressive treatment can decrease the risk of vascular death in patients with ischemic stroke caused by intracranial atherosclerosis.
- Endovascular Removal of Intravascular Foreign Bodies: A Single-Center Experience and Literature Review(2022) LEITE, Tulio Fabiano de Oliveira; PAZINATO, Lucas Vatanabe; BORTOLINI, Edgar; PEREIRA, Osvaldo Ignacio; NOMURA, Cesar Higa; LEAL FILHO, Joaquim Mauricio da MottaObjective: To describe causes, clinical signs, experience and endovascular techniques for extraction of intravenous foreign bodies (IFB) and literature review. Methods: This retrospective study was based on data collected from the medical records of 51 consecutive patients (26 women and 25 men) treated from July 2007 to May 2020 at a single quaternary center in Brazil and case series with data, published in the literature since 2000 on IFB removal, of at least 5 patients. The average patient age was 43.54 years (range, 2 months to 84 years). The different retrieval method using the following was used in the procedure: gooseneck snare, guidewire, balloon, and custom snares. Results: The retrieval process rate was 100%. Thirty-one port-a-caths, 6 guidewires, 4 double lumens, 3 permcaths, 3 Shiley (R) catheters, 1 intra cath, 2 peripherally inserted central catheters, and one stent were extracted. The locations where the IFBs were most frequently trapped were the right atrium (39.2%), the pulmonary artery (17.64%), the superior vena cava (13.72%), and the right ventricle (16.12%). Single venous access was used in 67.07% of the patients. Femoral access, which was the most commonly used approach, was used in 85.71% of the patients. The loop was used in 64.70% of the patients. A fractured catheter was the main IFB in 60.76% of the cases (31 patients). Only one complication related to the extraction of an IFB was noted in a single patient who suffered from atrial fibrillation (1.96%). The 30 day mortality rate was zero. Conclusion: Percutaneous IFB removal should be considered as an alternative for the treatment and retrieval of IFBs because it is a minimally invasive procedure that is relatively simple, safe, and has low complication rates.
- Thoracic tomographic manifestations in symptomatic respiratory patients with COVID-19(2020) FARIAS, Lucas de Pádua Gomes de; STRABELLI, Daniel Giunchetti; FONSECA, Eduardo Kaiser Ururahy Nunes; LOUREIRO, Bruna Melo Coelho; NOMURA, Cesar Higa; SAWAMURA, Márcio Valente YamadaAbstract China was the epicenter for the novel coronavirus disease (COVID-19), which quickly spread to other Asian countries and later to Western countries; subsequently, COVID-19 was categorized as a pandemic by the World Health Organization. Diagnosis primarily depends on viral detection in respiratory samples; however, available kits are limited, lack high sensitivity, and have a long turnaround time for providing results. In this scenario, computed tomography has emerged as an efficient and available high-sensitivity method, allowing radiologists to readily recognize findings related to COVID-19. The objective of this article is to demonstrate the main tomographic findings in symptomatic respiratory patients with COVID-19 to assist medical professionals during this critical moment.
- The Role of Radiomics in Rectal Cancer(2023) MIRANDA, Joao; HORVAT, Natally; ARAUJO-FILHO, Jose A. B.; ALBUQUERQUE, Kamila S. S.; CHARBEL, Charlotte; TRINDADE, Bruno M. C.; CARDOSO, Daniel L. L.; FARIAS, Lucas de Padua Gomes de; CHAKRABORTY, Jayasree; NOMURA, Cesar HigaPurposeRadiomics is a promising method for advancing imaging assessment in rectal cancer. This review aims to describe the emerging role of radiomics in the imaging assessment of rectal cancer, including various applications of radiomics based on CT, MRI, or PET/CT.MethodsWe conducted a literature review to highlight the progress of radiomic research to date and the challenges that need to be addressed before radiomics can be implemented clinically.ResultsThe results suggest that radiomics has the potential to provide valuable information for clinical decision-making in rectal cancer. However, there are still challenges in terms of standardization of imaging protocols, feature extraction, and validation of radiomic models. Despite these challenges, radiomics holds great promise for personalized medicine in rectal cancer, with the potential to improve diagnosis, prognosis, and treatment planning. Further research is needed to validate the clinical utility of radiomics and to establish its role in routine clinical practice.ConclusionOverall, radiomics has emerged as a powerful tool for improving the imaging assessment of rectal cancer, and its potential benefits should not be underestimated.
- Cardiovascular Imaging and Interventional Procedures in Patients with Novel Coronavirus Infection(2020) COSTA, Isabela Bispo Santos da Silva; ROCHITTE, Carlos Eduardo; CAMPOS, Carlos M.; BARBERATO, Silvio Henrique; OLIVEIRA, Glaucia Maria Moraes de; LOPES, Marcelo Antonio Cartaxo Queiroga; NOMURA, Cesar Higa; ABIZAID, Alexandre A.; CERRI, Giovanni; KALIL FILHO, Roberto; HAJJAR, Ludhmila AbrahaoThe coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.
- Current status and future perspectives of radiomics in hepatocellular carcinoma(2023) MIRANDA, Joao; HORVAT, Natally; FONSECA, Gilton Marques; ARAUJO-FILHO, Jose de Arimateia Batista; FERNANDES, Maria Clara; CHARBEL, Charlotte; CHAKRABORTY, Jayasree; COELHO, Fabricio Ferreira; NOMURA, Cesar Higa; HERMAN, PauloGiven the frequent co-existence of an aggressive tumor and underlying chronic liver disease, the management of hepatocellular carcinoma (HCC) patients requires experienced multidisciplinary team discussion. Moreover, imaging plays a key role in the diagnosis, staging, restaging, and surveillance of HCC. Currently, imaging assessment of HCC entails the assessment of qualitative characteristics which are prone to inter-reader variability. Radiomics is an emerging field that extracts high-dimensional mineable quantitative features that cannot be assessed visually with the naked eye from medical imaging. The main potential applications of radiomic models in HCC are to predict histology, response to treatment, genetic signature, recurrence, and survival. Despite the encouraging results to date, there are challenges and limitations that need to be overcome before radiomics implementation in clinical practice. The purpose of this article is to review the main concepts and challenges pertaining to radiomics, and to review recent studies and potential applications of radiomics in HCC.
- Percutaneous retrieval of intravascular foreign body in children: a case series and review(2022) PAZINATO, Lucas Vatanabe; LEITE, Tulio Fabiano de Oliveira; BORTOLINI, Edgar; PEREIRA, Osvaldo Ignacio; NOMURA, Cesar Higa; MOTTA-LEAL-FILHO, Joaquim Mauricio daBackground Percutaneous retrieval of intravascular foreign bodies has recently increased as a treatment option. Purpose To report our single-center experience of the percutaneous retrieval of 14 intravascular embolized catheter fragments in children and to conduct a literature review. Material and Methods MEDLINE databases were searched for case reports and series including children and iatrogenic catheter fragments or guidewires retrieved through percutaneous techniques. We also conducted a retrospective analysis of 14 cases from our institution over a 14-year period. A total of 27 studies were selected comprising 74 children, plus our 14 unpublished cases. Statistical analyses were performed using Microsoft Excel version 2016. Results Port catheter fragments and peripherally inserted central catheters (PICCs) were the most embolized foreign bodies and the pulmonary artery was the most common site of embolization in 44.1% of cases. Analysis of the retrieval technique demonstrated a preference for extraction through the femoral vein (81.7%) and using snare techniques (93.5%). The success rate of percutaneous retrieval was 96.6% with only 1.1% of procedure-related complications. Patients were asymptomatic in 77.2% of cases, presented septic complications in 2.3%, and no deaths were reported. Median fluoroscopy time was 10 min (range = 1.7-80 min) and median procedure length was 60 min (range = 35-208 min). Conclusion Percutaneous retrieval of intravascular foreign bodies is a feasible, safe, and efficient technique in children and should be considered the preferred treatment option.
- Imaging findings in COVID-19 pneumonia(2020) FARIAS, Lucas de Padua Gomes de; FONSECA, Eduardo Kaiser Ururahy Nunes; STRABELLI, Daniel Giunchetti; LOUREIRO, Bruna Melo Coelho; NEVES, Yuri Costa Sarno; RODRIGUES, Thiago Potrich; CHATE, Rodrigo Caruso; NOMURA, Cesar Higa; SAWAMURA, Marcio Valente Yamada; CERRI, Giovanni GuidoThe coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan city and was declared a pandemic in March 2020. Although the virus is not restricted to the lung parenchyma, the use of chest imaging in COVID-19 can be especially useful for patients with moderate to severe symptoms or comorbidities. This article aimed to demonstrate the chest imaging findings of COVID-19 on different modalities: chest radiography, computed tomography, and ultrasonography. In addition, it intended to review recommendations on imaging assessment of COVID-19 and to discuss the use of a structured chest computed tomography report. Chest radiography, despite being a low-cost and easily available method, has low sensitivity for screening patients. It can be useful in monitoring hospitalized patients, especially for the evaluation of complications such as pneumothorax and pleural effusion. Chest computed tomography, despite being highly sensitive, has a low specificity, and hence cannot replace the reference diagnostic test (reverse transcription polymerase chain reaction). To facilitate the confection and reduce the variability of radiological reports, some standardizations with structured reports have been proposed. Among the available classifications, it is possible to divide the radiological findings into typical, indeterminate, atypical, and negative findings. The structured report can also contain an estimate of the extent of lung involvement (e.g., more or less than 50% of the lung parenchyma). Pulmonary ultrasonography can also be an auxiliary method, especially for monitoring hospitalized patients in intensive care units, where transfer to a tomography scanner is difficult.