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Biomedical subjects

M Funari

Publications and source records attributed to M Funari.

6 recordsLinked to original sources

Chronic pulmonary paracoccidioidomycosis (South American blastomycosis): high-resolution CT findings in 41 patients.

OBJECTIVE: To assess the pulmonary parenchymal findings on high-resolution CT in 41 patients with the chronic form of paracoccidioidomycosis (South American blastomycosis). SUBJECTS AND METHODS: The study included 41 consecutive patients in whom chronic paracoccidioidomycosis had been proven. All patients underwent high-resolution CT (1-mm collimation, high-spatial-frequency reconstruction algorithm) at 12 equally spaced intervals through the chest. The images were analyzed by two radiologists, and each final decision was reached by consensus. RESULTS: Thirty-eight (93%) of the 41 patients had CT scans with abnormal findings. The findings included interlobular septal thickening in 36 patients (88%), 1-25 mm diameter nodules in 34 (83%), peribronchovascular interstitial thickening in 32 (78%), centrilobular opacities in 26 (63%), intralobular lines in 24 (59%), ground-glass opacities in 14 (34%), cavitation in seven (17%), air-space consolidation in five (12%), traction bronchiectasis in 34 (83%), and paracicatricial emphysema in 28 (68%). In approximately 90% of patients, the abnormalities were bilateral and symmetrical and involved all lung zones. CONCLUSION: High-resolution CT findings of paracoccidioidomycosis consist predominantly of interstitial abnormalities and nodules associated with traction bronchiectasis and paracicatricial emphysema in a bilaterally symmetrical distribution.

Adult↗

Magnetic resonance imaging in acute and subacute mediastinal bleeding.

The appearance of intracranial hematoma on magnetic resonance (MR) images has been described. However, the appearance of hematoma on ECG-gated spin-echo images, which are used for cardiac imaging, has not been described previously. Accordingly a retrospective analysis of nine consecutive patients with acute and subacute mediastinal bleeding imaged with ECG-gated spin-echo MR images was done. The time interval between the incipient event and the date of the MR study was determined, and the signal appearance of the hemorrhage was evaluated relative to striated muscle and fat. MR findings were corroborated by other imaging modalities and surgical findings. Acute hematomas showed medium to high signal intensity, whereas subacute hematomas had areas of high signal intensity on images acquired with ECG gating to every heart beat (repetition time = R-R interval) and a short echo time (30 msec). The characteristic signal intensities of blood on ECG-gated MR images are usually distinct in comparison to other pericardial and mediastinal fluid collections. The ability of MR to specifically identify blood within the first few hours after hemorrhage was not tested in this study.

Acute Disease↗

Detection of aortic arch thrombus using MR imaging.

Three patients with peripheral embolization and negative echocardiographic examinations were studied with MR imaging. Magnetic resonance imaging detected aortic arch thrombi in the absence of aortic aneurysm, dissection, or ulcerated plaques. By combining spin echo and cine MR sequences, MR enabled us to characterize and contrast intravascular mural thrombi reliably without application of contrast media. Thus we are assisted in the identification of patients at risk for embolization from an often overlooked source: the thoracic aorta.

Aged↗

MRI and ultrasound detection of asymptomatic thyroid nodules in hyperparathyroidism.

A retrospective MRI and ultrasound (US) study of 50 patients with hyperparathyroidism and no history of thyroid disease was done. The purpose was to compare the sensitivity of both methods in the detection of asymptomatic thyroid nodules, as well as to determine the prevalence of thyroid abnormalities in patients with hyperparathyroidism. All the patients underwent MR and 33 were also studied by high-resolution US. Magnetic resonance imaging was performed on a 1.5 T unit, using T1-(500-700/20) and T2-(2,000/20 and 70) weighted images. Axial sections (5 mm with a 1 mm interval between them) were obtained along the neck. Ultrasonography was performed using a 10 MHz linear array transducer. The prevalence of thyroid nodules was 46% in the 50 patients studied by MR imaging. In the subgroup of patients studied by both methods, US depicted nodules in 48% of patients, and MR depicted nodules in 45%. Magnetic resonance imaging and US detected a high frequency of thyroid nodules in patients with hyperparathyroidism. This high frequency makes the detection of an intrathyroidal parathyroid adenoma problematic.

Adult↗

Cardiac tumors: assessment with Gd-DTPA enhanced MR imaging.

Previous studies have shown the value of MR imaging for the identification of cardiac masses. The distinction of intramural tumors from normal myocardium may be equivocal because of the similarity of signal intensity between tumor and normal myocardium on ECG-gated SE images. The purpose of this study was to assess the role of Gd-DTPA for improving the contrast between cardiac tumors and myocardium. Four patients with established or suspected cardiac tumors were imaged with a 1.5 T imager. The T1-weighted images (TR = RR interval, TE = 20-30 ms) were obtained before and immediately after the intravenous injection of Gd-DTPA, at a dosage of 0.1 mmol/kg. Tumors were identified in three patients. All tumors were isointense to the myocardium in precontrast images but demonstrated differential enhancement relative to myocardium after the administration of Gd-DTPA. Two tumors were hyperintense relative to myocardium, and the third was mostly hypointense, surrounded by a hyperintense rim. In the remaining case, no tumor was found and the myocardium was homogeneously enhanced on postgadolinium images. Gadolinium DTPA can produce differential enhancement of tumor from normal myocardium and therefore demonstrate intramural masses.

Aged↗

Calcification in primary lung non-Hodgkin lymphoma.

Calcification in lymphoma before treatment or after chemotherapy is extremely rare. There have been scarse reports of calcified masses due to Hodgkin and non-Hodgkin lymphomas, originating in the main lymphatic chains of the mediastinum and retroperitoneum. We report a case of primarily extra-nodal (pulmonary) non-Hodgkin lymphoma with calcification prior to current treatment.

Calcinosis↗