CARLOS AUGUSTO VENTURA PINTO
Projetos de Pesquisa
Unidades Organizacionais
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Can contrast-enhanced ultrasound with second-generation contrast agents replace computed tomography angiography for distinguishing between occlusion and pseudo-occlusion of the internal carotid artery?(2015) VENTURA, Carlos Augusto Pinto; SILVA, Erasmo Simao da; CERRI, Giovanni Guido; LEAO, Pedro Puech; TACHIBANA, Adriano; CHAMMAS, Maria CristinaOBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. RESULTS: Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for which occlusion was confirmed by contrast-enhanced ultrasound (p>0.5 vs. computed tomography angiography). Comparing contrast-enhanced ultrasound with Doppler ultrasound, we found that the proportion of cervical internal carotid arteries classified as occluded was 24.4% higher when the latter was used (p<0.001). CONCLUSIONS: We conclude that, in making the differential diagnosis between occlusion and pseudo-occlusion of the cervical internal carotid artery, contrast-enhanced ultrasound with a second-generation contrast agent is significantly more effective than conventional Doppler ultrasound and is equally as effective as the gold standard (computed tomography angiography). Our findings suggest that contrast-enhanced ultrasound could replace computed tomography angiography in this regard.
- Analysis of risk factors and diseases associated with atherosclerosis in the progression of carotid artery stenosis(2016) BATAGINI, Nayara Cioffi; SILVA, Erasmo Simao da; PINTO, Carlos A. V.; PUECH-LEAO, Pedro; LUCCIA, Nelson deObjective The objective of this study was to analyze the roles of demographic, clinical, and laboratory factors on the progression of atherosclerotic stenosis in carotid bifurcation. It was based on prospective information from records entered on a specific application form for follow-up outpatients at a tertiary university service. Methods Consecutive symptomatic and asymptomatic patients (n=210) who had undergone more than one carotid duplex scan but no surgical intervention were selected for the analysis. The patients were divided into two groups: patients whose duplex scans did not show bilateral progression of carotid stenosis and patients with carotid stenosis progression of <50%, 50%-69%, or >70%. Clinical and demographic parameters were compared between groups. Results Group II levels of plasma urea (51.627.8mg/dl) and fibrinogen (493.2 +/- 113.3mg/dl) were higher than the Group I levels (43.0 +/- 14.9mg/dl and 441.3 +/- 106.7mg/dl, respectively) with statistical significance (p urea=0.013 and p fibrinogen=0.018). Paradoxically, the mean body mass index was higher in Group I (26.4 +/- 4.6kg/m(2)) than in Group II (24.6 +/- 3.9kg/m(2); p=0.02). Conclusions Traditional risk factors for the development of atherosclerosis in a carotid bifurcation are important but not unique. Metabolic and inflammatory factors can contribute to disease progression.
- Volumetry and biomechanical parameters detected by 3D and 2D ultrasound in patients with and without an abdominal aortic aneurysm(2016) BATAGINI, Nayara Cioffi; VENTURA, Carlos Augusto Pinto; RAGHAVAN, Madhavan L.; CHAMMAS, Maria Cristina; TACHIBANA, Adriano; SILVA, Erasmo Simao daThe objective was to demonstrate the ability of ultrasound (US) with 3D properties to evaluate volumetry and biomechanical parameters of the aorta in patients with and without abdominal aortic aneurysm (AAA). Thirty-one patients with normal aortas (group 1), 46 patients with AAA measuring 3.0-5.5 cm (group 2) and 31 patients with AAA 5.5 cm (group 3) underwent a 2D/3D-US examination of the infra-renal aorta, and the images were post-processed prior to being analyzed. In the maximum diameter, the global circumferential strain and the global maximum rotation assessed by 2D speckle-tracking algorithms were compared among the three groups. The volumetry data obtained using 3D-US from 40 AAA patients were compared with the volumetry data obtained by a contemporary computed tomography (CT) scan. The median global circumferential strain was 2.0% (interquartile range (IR): 1.0-3.0), 1.0% (IR: 1.0-2.0) and 1.0% (IR: 1.0-1.75) in groups 1, 2 and 3, respectively (p < 0.001). The median global maximum rotation decreased progressively from group 1 to group 3 (1.38o (IR: 0.77-2.13), 0.80o (IR: 0.57-1.0) and 0.50o (IR: 0.31-0.75), p < 0.001). AAA volume estimations by 3D-US correlated well with CT (R-2 = 0.76). In conclusion, US with 3D properties is non-invasive and has the potential to evaluate volumetry and biomechanical characteristics of AAA.