OBJECTIVE: The present study was aimed at evaluating the BI-RADS® classification accuracy in mammography. Additionally, the frequency of different findings was described and the interobserver agreement was evaluated. MATERIALS AND METHODS: Mammographic images of 115 patients were independently and blindly reviewed by two specialists in compliance with BI-RADS recommendations, and later compared with histological data. The BI-RADS accuracy in mammography was evaluated. The interobserver agreement was analyzed with the Cohen's kappa (κ) test, and the differences between groups were evaluated with the chi-squared test. RESULTS: The present study demonstrated that the mammographic accuracy ranged from 75% to 62% in the differentiation between benign and malignant lesions with the utilization of the BI-RADS classification. Statistically significant interobserver agreement was observed in the description of masses margins (κ= 0.66). A low agreement rate was identified in the description of masses borders (shape) (κ= 0.40) and calcifications, both in relation to their distribution (κ= 0.24) and morphology (κ= 0.36). CONCLUSION: The present study demonstrated the BI-RADS accuracy in the differentiation between benign and malignant lesions. The interobserver agreement was poor in the analysis of calcifications morphology and distribution, but a progressive increase in the positive predictive values was observed in the subcategory 4.

Keywords: Breast cancer, Mammography, Histopathology, Accuracy, BI-RADS, Ultrasonography

OBJECTIVE: The main purpose of the present study is to evaluate the accuracy of ultrasonography (BI-RADS) in the diagnosis of breast cancer whereas the additional specific objectives are to describe the frequency of different sonographic findings and evaluating interobserver agreement. MATERIALS AND METHODS: Images of 110 patients who had been referred for biopsy with previous diagnosis of breast nodules were independently reviewed by two specialists according to the BI-RADS classification. Histological findings were utilized as a gold-standard. The accuracy of findings was determined. The chi-squared test for categorical variables was utilized in the analysis of the differences resulting from the groups comparison, and the interobserver agreement was calculated with kappa () statistics. RESULTS: Among 110 breast masses evaluated by ultrasonography, 76 (69%) were benign and 34 (30.9%) were malignant. According to the radiologists, the sensitivity ranged from 70.5% to 82.3%, negative predictive value, from 81.1% to 87.5%, positive predictive value, from 42.1% to 45.1%, specificity from 56.58% to 55.2%, and accuracy from 60.9% to 63.6%. The global interobserver agreement was considered as moderate ( = 0.50). CONCLUSION: The fourth edition of BI-RADS provides radiologists with an accurate clinical decision support system for the diagnosis and management of breast disease.

Keywords: Breast cancer, Ultrasonography, BI-RADS, Anatomopathological, Accuracy

Erdheim-Chester disease is a rare non-Langerhans cell histiocytosis of unknown etiology, affecting multiple organ system, involving bones, central nervous system, eyes, lungs, mediastinum, kidneys and retroperitoneum. The authors report two cases that progressed with the typical presentation of the disease. Radiological findings were in agreement with literature and guided the diagnosis, confirmed by immunohistochemistry.

Keywords: Erdheim-Chester disease, Radiography, Computed tomography

Bronchial atresia is a rare congenital abnormality that usually shows a juxta-hilar mass with distal radiolucency on conventional x-ray films. Most patients are young and have no symptoms. Computed tomography usually confirms the diagnosis, allowing conservative management of the asymptomatic cases. The authors report three cases of bronchial obstruction. One of the patients was of particular importance and interest, a 45-year-old female patient with symptoms of respiratory infection, due to the association with a bulky bronchocele. The diagnosis was made by analyzing the findings of conventional x-ray films and computed tomography, and the comparison with previous conventional x-ray films and linear tomography, which had already demonstrated abnormalities. A literature review on the clinical and radiological findings of this pulmonary malformation is presented.

Keywords: Bronchial atresia, Bronchocele, Bronchial mucocele

The authors report the case of a 56-year-old male patient complaining of dysphagia for solids and food impaction, submitted to videofluoroscopic swallowing study that demonstrated the presence of two esophageal diverticula. The videofluoroscopic swallowing study was critical in the identification and diagnosis of the diverticula, an esophageal cause of dysphagia.

Keywords: Deglutition disorders; Diverticulum.

Heterotaxy syndrome is defined as an abnormal arrangement of some organs and vessels in association with dysmorphism. The authors describe the case of a patient with heterotaxy syndrome with poliesplenia incidentally diagnosed during imaging evaluation (computed tomography and small bowel barium study) of unrelated pathological condition.

Keywords: Heterotaxy syndrome; Polysplenia; Disorders of intestinal rotation; Partial inferior vena cava agenesis; Dorsal pancreas agenesis.

The authors report the case of an elderly woman assessed for dyspnea and right costal margin pain, whose chest radiography demonstrated opacity simulating pulmonary lesion, and computed tomography revealed the vascular origin of the condition. Acute aortic syndrome due to ruptured atheromatous plaque penetrating through the elastic lamina in association with aortic hematoma and aneurysm is a relevant differential diagnosis to be considered in these cases.

Keywords: Aorta; Aortic arch; Computed tomography.