Publications by authors named "Aldo Maurici Araújo Alves"

4 Publications

  • Page 1 of 1

Bosniak classification of cystic renal masses version 2019 does not increase the interobserver agreement or the proportion of masses categorized into lower Bosniak classes for non-subspecialized readers on CT or MR.

Eur J Radiol 2020 Oct 15;131:109270. Epub 2020 Sep 15.

Hospital Sao Paulo, Universidade Federal de Sao Paulo (UNIFESP) - R. Botucatu, 740 - Vila Clementino, São Paulo, SP, 04023-062, Brazil; Grupo Fleury - R. Cincinato Braga, 282 - Bela Vista, São Paulo, SP, 01333-910 Brazil.

Purpose: In a condition so prevalent as renal cysts, classifications should display satisfactory reproducibility not only among subspecialized readers. We aimed to compare the interobserver agreement of the Bosniak classification version 2019 (BC19) and current Bosniak classification (CBC) for non-subspecialized readers on CT and MRI and to verify whether BC19 leads to a downgrade of renal cystic masses when compared to CBC.

Methods: We evaluated 50 renal cystic masses in 47 patients on MR and CT (25 per method). Eighteen readers (nine third-year radiology residents and nine abdominal imaging fellows) assessed the images using BC19 and CBC with an eight-week interval. Kappa statistic was used to assess agreement. An average score of Bosniak categories across all raters evaluated if there was downgrading of lesions on BC19.

Results: The highest values of Kappa were found for fellows on CBC-MR (κ = 0.51), and the lowest values were found for residents on CBC-MR and fellows on BC19-MR (both κ = 0.36). On CBC, interobserver agreement was moderate for MR and CT (κ = 0.42 and 0.43, respectively), whereas on BC19, it was fair (κ = 0.38 and 0.40, respectively). The best agreements were in categories I (κ = 0.49-0.69) and IV (κ = 0.45-0.51). The poorest agreements occurred at IIF (κ = 0.18 on BC19-CT). There was a moderate median increase from CBC to BC19 in terms of Bosniak categories for both methods (MR [Z=-2.058, p = 0.040] and CT [Z=-2.509, p = 0.012]).

Conclusion: BC19, when compared to CBC, did not improve interobserver agreement nor diminished the proportion of masses categorized into lower Bosniak classes among non-subspecialized readers.
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http://dx.doi.org/10.1016/j.ejrad.2020.109270DOI Listing
October 2020

Evaluating inflammatory activity in Crohn's disease by cross-sectional imaging techniques.

Radiol Bras 2020 Jan-Feb;53(1):38-46

Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.

The evaluation of inflammatory bowel activity in patients with Crohn's disease has traditionally been a challenge, mainly because of the difficulty in gaining endoscopic access to the small bowel. Historically, barium-based contrast studies were the only option for the evaluation of inflammatory activity in Crohn's disease. They were gradually replaced by cross-sectional imaging techniques, computed tomography enterography (CTE) and magnetic resonance enterography (MRE) now being the modalities of choice for such evaluations. Those two imaging methods have provided important information regarding intestinal wall involvement and extra-intestinal manifestations of Crohn's disease, not only assessing lesion characteristics and complications but also quantifying inflammatory bowel activity. The objective of this article is to review the main technical aspects of CTE and MRE, together with their indications, contraindications, and limitations, as well as the CTE and MRE imaging characteristics of inflammatory activity in Crohn's disease.
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http://dx.doi.org/10.1590/0100-3984.2018.0096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159043PMC
April 2020

The role of gadoxetic acid-enhanced magnetic resonance cholangiography in the evaluation of postoperative bile duct injury: pictorial essay.

Radiol Bras 2019 Nov-Dec;52(6):403-407

Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.

Iatrogenic lesion of the bile ducts is a relatively common occurrence during liver surgery, increasing morbidity and mortality rates. T2-weighted magnetic resonance cholangiography and gadoxetic acid-enhanced functional magnetic resonance cholangiography (fMRC) with administration of hepatobiliary-specific contrast medium (gadoxetic acid) are fundamental to the diagnostic imaging approach in patients with such lesions. Here, we present a review of the literature and suggest an imaging approach to biliary tract injury, focusing on clinical cases in which fMRC had an impact on the decision-making process for the management of the affected patients.
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http://dx.doi.org/10.1590/0100-3984.2018.0089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007050PMC
February 2020

The many faces of primary and secondary hepatic lymphoma: imaging manifestations and diagnostic approach.

Radiol Bras 2019 Sep-Oct;52(5):325-330

Department of Diagnostic Imaging, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.

Hepatic lymphoma can be divided into its primary and secondary forms. To be classified as primary hepatic lymphoma, the disease should be limited to the liver and hilar lymph nodes, with no distant involvement (to the bone marrow or other sites). Primary hepatic lymphoma is quite rare, accounting for less than 1% of all cases of non-Hodgkin lymphoma, whereas secondary hepatic lymphoma affects nearly half of such cases. Familiarity with the imaging features of hepatic lymphoma is important for its early diagnosis and appropriate management. In this essay, we aim to review the roles of computed tomography and magnetic resonance imaging in identifying and monitoring hepatic lymphomas, using sample cases to describe and illustrate the wide spectrum of imaging findings in the primary and secondary forms of this disorder.
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http://dx.doi.org/10.1590/0100-3984.2018.0013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808615PMC
October 2019