IMAGENOLOGIA EM

UROLOGIA Dr. Fernando Ide Yamauchi

CONTEÚDO

1. Litíase urinária

2. Hematúria

3. Neoplasia de próstata

CONTEÚDO

1. Litíase urinária

2. Hematúria

3. Neoplasia de próstata

acr.org (2011)

S96% E98%

100% 75%

50% 25%

Dual Energy

650UH

550UH

CONTEÚDO

1. Litíase urinária

2. Hematúria

3. Neoplasia de próstata

CONTEÚDO

1. Litíase urinária

2. Hematúria

3. Neoplasia de próstata

Albani JM. Journal of Urology, Feb 2007

Wang L. Journal of Urology, Feb 2009

Chlapoutakis K. European Journal of Radiology, 2010

Sens.= 96%

Espec.= 99%

Pré Nefrográfica Excretora

Protocolo Urotomografia

Matsuki M. European Radiology, Jan 2007

Abou-El-Ghar ME. Radiology, May 2009

RM-T2 RM-difusão

High-grade bladder cancer: Association of ADC with Metastatic disease: Preliminary results

Rosenkrantz, Journal of Magnetic Resonance Imaging, 2012

CONTEÚDO

1. Litíase urinária

2. Hematúria

3. Neoplasia de próstata

CONTEÚDO

1. Litíase urinária

2. Hematúria

3. Neoplasia de próstata

2015 - 200

2001 - 20

Detecção

1.Bx Negativa

2.Vigilância Ativa

RM-sagital

RM-axial

RM-axial

1.Não detectar

significante

2.Detectar

insignificante

3.Subgraduado

T2WI DWI ADC

PSA 8,7; 3BX-

PI-RADS 5

Gleason 4+5

T2WI DWI ADC

PSA 8,2; 1BX-

DCE

PSA 8,2; 1BX-

PI-RADS 5 Gleason 4+3

Hambrock T. Magnetic Resonance Imaging Guided Prostate Biopsy in Men With Repeat Negative

Biopsies and Increased Prostate Specific Antigen

J Urol 2010

15%

x

60%

Detecção

1.Bx Negativa

2.Vigilância Ativa

T2WI DWI ADC

PSA 4,7; BX+ G6, AS

DCE

PSA 4,7; BX+ G6, AS

Gleason 4+3

Margel D. J Urol. 2012 Apr;187(4):1247-52.

8% 80%

Hambrock, T. Radiology, 2011

Hambrock, T. Relationship between Apparent Diffusion Coefficients at 3.0-T MR Imaging and

Gleason Grade in Peripheral Zone Prostate Cancer

Radiology, 2011

Gleason

ADC

"Unfortunately, and sadly to say, surely not. MRI is

still seen by many urologists as costly and difficult

and change will take more time".

fernando.yamauchi@hc.fm.usp.br

fernando.yamauchi@einstein.br