MANOEL DE SOUZA ROCHA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
17 resultados
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Agora exibindo 1 - 10 de 17
- I BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 2: APPROACH TO RESECTABLE METASTASES(2016) RIBEIRO, Heber Salvador de Castro; TORRES, Orlando Jorge Martins; MARQUES, Marcio Carmona; HERMAN, Paulo; KALIL, Antonio Nocchi; FERNANDES, Eduardo de Souza Martins; OLIVEIRA, Fabio Ferreira de; CASTRO, Leonaldson dos Santos; HANRIOT, Rodrigo; OLIVEIRA, Suilane Coelho Ribeiro; BOFF, Marcio Fernando; COSTA JR., Wilson Luiz da; GIL, Roberto de Almeida; PFIFFER, Tulio Eduardo Flesch; MAKDISSI, Fabio Ferrari; ROCHA, Manoel de Souza; AMARAL, Paulo Cezar Galvao do; COSTA, Leonardo Atem Goncalves de Arujo; ALOIA, Tomas A.; D'ALBUQUERQUE, Augusto Carneiro; COIMBRA, Felipe Jose FernandezBackground: Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients. Aim: In the second module of this consensus, management of resectable liver metastases was discussed. Method: Concept of synchronous and metachronous metastases was determined, and both scenarius were discussed separately according its prognostic and therapeutic peculiarities. Results: Special attention was given to the missing metastases due to systemic preoperative treatment response, with emphasis in strategies to avoid its reccurrence and how to manage disappeared lesions. Conclusion: Were presented validated ressectional strategies, to be taken into account in clinical practice.
- HEPATOSPLENIC SCHISTOSOMIASIS-ASSOCIATED CHRONIC PORTAL VEIN THROMBOSIS: RISK FACTOR FOR HEPATOCELLULAR CARCINOMA?(2023) DARCE, George Felipe Bezerra; MAKDISSI, Fabio Ferrari; ANDO, Sabrina de Mello; FONSECA, Gilton Marques; KRUGER, Jaime Arthur Pirola; COELHO, Fabricio Ferreira; ROCHA, Manoel de Souza; HERMAN, PauloBACKGROUND: Hepatosplenic schistosomiasis is an endemic disease prevalent in tropical countries and is associated with a high incidence of portal vein thrombosis. Inflammatory changes caused by both parasitic infection and portal thrombosis can lead to the development of chronic liver disease with potential carcinogenesis. AIMS: To assess the incidence of portal vein thrombosis and hepatocellular carcinoma in patients with schistosomiasis during long-term follow-up. METHODS: A retrospective study was conducted involving patients with schistosomiasis followed up at our institution between 1990 and 2021. RESULTS: A total of 126 patients with schistosomiasis were evaluated in the study. The mean follow-up time was 16 years (range 5-31). Of the total, 73 (57.9%) patients presented portal vein thrombosis during follow-up. Six (8.1%) of them were diagnosed with hepatocellular carcinoma, all with portal vein thrombosis diagnosed more than ten years before. CONCLUSIONS: The incidence of hepatocellular carcinoma in patients with schistosomiasis and chronic portal vein thrombosis highlights the importance of a systematic long-term follow-up in this group of patients.
- Inter-and intraobserver agreement in computed tomography enterography in inflammatory bowel disease(2016) HORVAT, Natally; TAVARES, Camila Carlos; ANDRADE, Adriana Ribas; CABRAL, Julia Campos Simoes; LEAO-FILHO, Hilton Muniz; CAIADO, Angela Hissae Motoyama; UEDA, Serli Kiyomi Nakao; LEITE, Andre Zonetti Arruda; SIPAHI, Aytan Miranda; ROCHA, Manoel SouzaAIM To evaluate intra-and interobserver agreement in imaging features in inflammatory bowel disease and comparison with fecal calprotectin (FC) levels. METHODS Our institutional computed tomography enterography (CTE) database was retrospectively queried to identify patients who underwent CTE from January 2014 to June 2015. Patient inclusion criteria were confirmed inflammatory bowel disease (IBD) and FC collected < 4 mo after CTE without any change in clinical treatment or surgical treatment during this interval. The exclusion criterion was poor image quality. Two blinded abdominal radiologists, with 12 and 3 years of experience analyzed the CTE regarding localization (small bowel, colonic, both, or no disease detected); type of IBD (inflammatory, stenosing, fistulizing, > 1 pattern, or normal); and signs of active disease (present or absent). In 42 of 44 patients evaluated, routine CTE reports were made by one of the readers who reevaluated the CTEs >= 6 mo later, to determine the intraobserver agreement. FC was considered a sign of disease activity when it was higher than 250 mu g/g. RESULTS Forty-four patients with IBD (38 with Crohn's disease and 6 with ulcerative colitis) were included. There was a moderate interobserver agreement regarding localization of IBD (kappa = 0.540), type of disease (kappa = 0.410) and the presence of active signs in CTE (kappa = 0.419). There was almost perfect intraobserver agreement regarding localization, type and signs of active disease in IBD. The kappa values were 0.902, 0.937 and 0.830, respectively. After a consensus between both radiologists regarding inflammatory activity in CTE, we found that 24 (85.7%) of 28 patients who were classified with active disease had elevated FC, and six (37.5%) of 16 patients without inflammatory activity in CTE had elevated FC (P = 0.003). The correlation between elevated FC and the presence of active disease in CTE was significant (kappa = 0.495, P = 0.001). CONCLUSION We found almost perfect intraobserver and moderate interobserver agreement in the signs of active disease in CTE with concurrence of high FC levels.
conferenceObject Hepatic iron overload analysis bymagnetic resonance imaging in a non-alcoholic fatty liver disease population(2017) FILHO, H. M. L.; FABREGA, P.; CHUA-ANUSORN, W.; OLIVEIRA, C. P.; CARRILHO, F. J.; LIMA, F.; CERCATO, C.; CLARK, P.; ROCHA, M.- Spectrum of abdominal imaging findings in histiocytic disorders(2015) HORVAT, Natally de Souza Maciel Rocha; COELHO, Clovis Rego; ROZA, Larissa Cardoso; SOUZA, Rodrigo Canellas de; COSTA, Yves Bohrer; OLIVEIRA, Ebe Christie de; ROCHA, Manoel de Souza; BARONI, Ronaldo HuebThe present article provides an overview of the spectrum of abdominal findings of histiocytic disorders that may be observed in multimodality imaging illustrated by clinical cases from our Imaging Center. We will review abdominal findings of Langerhans cell histiocytosis, Rosai-Dorfman disease, Erdheim-Chester disease, and hemophagocytic syndrome illustrated by clinical cases from our imaging department with histologic correlation. Abdominal involvement of histiocytic disorders is rare and may occur in the liver, biliary tract, kidney, retroperitoneum, kidney, gastrointestinal tract, and lymph nodes. Histiocytic disorders encompass a group of rare diseases with a wide range of manifestations in which the abdominal involvement is quite infrequent. The role of the radiologist is to report the major imaging findings and the differential diagnosis; however, the imaging features are unspecific and biopsy usually is necessary to establish the definitive diagnosis.
article Serous Cystadenocarcinoma of the Pancreas Presenting with Liver Metastases: Case Report and Literature Review(2016) PERINI, Marcos Vinicius; LIMA, Fabiana Roberto; FRENK, Nathan Elie; LEDO FILHO, Hilton Muniz; COELHO, Fabricio Ferreira; KRUGER, Jaime Arthur; ROCHA, Manoel de Souza; HERMAN, PauloSerous cystic neoplasms of the pancreas are usually benign. Malignant serous cystic neoplasm is a rare clinical entity. We report a case of a 45-year-old man presenting with metastatic liver lesions on ultrasound. Computed tomography scan showed a hypervascular solid lesion arising in the pancreatic body and invading the celiac axis and portal vein with liver metastases. Ultrasound-guided liver biopsy diagnosed a serous cystic neoplasm, indistinguishable from serous cystadenoma. Based on clinical, radiological and pathological correlation, the diagnosis of cystadenocarcinoma was established. There are few reported cases of malignant serous cystic neoplasms in which malignancy was confirmed. Although rare in males, cystadenocarcinoma should be considered in the differential diagnosis of patients presenting with a pancreatic mass and liver metastasis.- BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF HEPATOCELLULAR CARCINOMA(2020) CHAGAS, Aline Lopes; MATTOS, Angelo Alves de; CARRILHO, Flair José; BITTENCOURT, Paulo Lisboa; VEZOZZO, Denise Cerqueira Paranaguá; HORVAT, Natally; ROCHA, Manoel de Souza; ALVES, Venâncio Avancini Ferreira; CORAL, Gabriela Perdomo; ALVARES-DA-SILVA, Mario Reis; BARROS, Fabio Marinho do Rego; MENEZES, Marcos Roberto; MONSIGNORE, Lucas Moretti; COELHO, Fabricio Ferreira; SILVA, Renato Ferreira da; SILVA, Rita de Cássia Martins Alves; BOIN, Ilka de Fatima Santana Ferreira; D`ALBUQUERQUE, Luiz Augusto Carneiro; GARCIA, José Huygens Parente; FELGA, Guilherme Eduardo Gonçalves; MOREIRA, Airton Mota; BRAGHIROLI, Maria Ignez Freitas Melro; HOFF, Paulo Marcelo Gehm; MELLO, Vivianne Barretto de; DOTTORI, Mariana Fonseca; BRANCO, Tiago Pugliese; SCHIAVON, Leonardo de Lucca; COSTA, Thaisa de Fátima AlmeidaABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.
- Biliary tract schwannoma: A rare cause of obstructive jaundice in a young patient(2012) FONSECA, Gilton Marques; MONTAGNINI, Andre Luis; ROCHA, Manoel de Souza; PATZINA, Rosely Antunes; BERNARDES, Mario Vinicius Angelete Alvarez; CECCONELLO, Ivan; JUKEMURA, JoseSchwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastrointestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumor did not recur in any of the resected cases.
conferenceObject TUMOR RESPONSE EVALUATION ACCORDING TO MRECIST CRITERIA IN PATIENTS WITH HEPATOCELLULAR CARCINOMA TREATED WITH TACE-DRUG ELUTING BEADS(2012) CHAGAS, A. L.; KIKUCHI, L.; FREITAS, N. S.; SANTOS, A. C. B.; ALENCAR, R. S. S. M.; TANI, C. M.; MOREIRA, A. M.; ROCHA, M. S.; D'ALBUQUERQUE, L. A. C.; CARNEVALE, F. C.; CARRILHO, F. J.Introduction: Transarterial chemoembolization (TACE) is efficient in reduce tumoral growth and increase survival in patients with hepatocellular carcinoma (HCC). Drug eluting beads (DEB) is an embolizing device that slowly releases chemotherapy to decrease systemic toxicity during TACE. Initial studies showed that TACE-DEB is superior to conventional TACE regarding tumor response and toxicity. There is no study in our population that evaluate HCC response to TACE-DEB, according to mRECIST criteria. Objective: The aim of this study is to evaluate tumor response according to mRECIST criteria in patients with HCC treated with TACE-DEB. Methods: In the period of the study, 53 patients with HCC were treated with 65 sessions of TACE-DEB loadeD with doxorubicin 50mg. Tumor response was evaluated one month after the procedure with CT or MRI according to mRECIST criteria. Results: Median age was 62 years and 74% were male. The majority of the patients were cirrhotic (89% – CHILD A 65% and CHILD B 35%). Etilogy of liver disease was HCV in 27/53 (51%), HBV in 8/53 (15%), alcohol in 10/53 (19%) and NASH in 3/53 (6%). According to BCLC staging system, 51% was BCLC A and 49% was BCLC B. Most patients had one nodule (66%). No patient presented with extrahepatic metastasis or macroscopic vascular invasion. Tumor response according to mRECIST was possible after 60 procedures. Complete response was reached in 12/60 (20%), partial response in 31/60 (52%), stable disease in 4/60 (6.5%) and progressive disease in 13/60 (21.5%). Conclusion: In patients with compensated liver cirrhosis and HCC, TACE-DEB was efficient in induce tumor response according to mRECIST criteria, and in our study objective response (complete response + partial response) was reached in 72% os cases. Further studies are necessary to evaluate survival and predictors factors of response.- Hepatic Epithelioid Hemangioendothelioma: An Unusual Lesion of the Liver(2012) LUPINACCI, Renato Micelli; ROCHA, Manoel de Souza; HERMAN, Paulo