OBJECTIVE: To identify the students' profile and their motivation to attend the Course of Post-Graduation in Medicine (Radiology) at the School of Medicine of Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil, as well as to quantitative and qualitatively evaluate their scientific production. MATERIALS AND METHODS: A questionnaire comprised of both open and closed questions was sent to 183 post-graduates, and 148 returned with answers. Expectations, professional destiny and scientific production were evaluated. RESULTS: Technical and scientific improvement (39.08%) and docent career progression (26.82%) were the primary motivating factors for students to attend the post-graduation course. The changes resulting from the conclusion of the course were: improvement of technical knowledge (33.33%) and higher confidence in their professional performance (17.83%). This survey has demonstrated that 60.42% of the respondents work in higher education institutions and 39.58% do not, and that 84.93% of the scientific papers about themes of theses/dissertations were published. CONCLUSION: The course has met the essential requirements for researchers and docents education. Also, the survey has demonstrated the necessity of a more effective performance of the program docents besides curricular changes with the introduction of a discipline dedicated to the preparation of scientific papers.

Keywords: Post-graduates, Profile, Post-graduation, Radiology, UFRJ

The authors perform a revisional and iconographic study of the lacrimal system by means of radiological methods, namely, conventional radiography, linear tomography, computed tomography and magnetic resonance imaging. Image methods are essential to define diagnosis and therapy, considering that besides demonstrating alterations of the lacrimal system, they may indicate the patients with better prognosis associated with the surgical approach. Considering the lower cost, lower radiation dose, low rate of complications, and level of information that can be obtained dacryocystography by means of linear tomography is recommended as the initial investigation method.

Keywords: Dacryocystography, Lacrimal system, Obstruction of the lacrimal system

OBJECTIVE: The present study was aimed at evaluating the possibility of a radiological study of the lumbar spine determining the correct identification of an individual despite the changes associated with aging. MATERIALS AND METHODS: The study sample included 60 pairs of lumbar spine radiographic images of both male and female, adult patients of different ages, acquired at different times, at three-year minimum intervals. The pairs of images were mixed up so two experienced radiologists could put them back together. The vertebrae of each pair were compared for similarities and differences in anatomical details. Pairing criteria adopted were finding a specific anatomical variation or detail, or finding two or more similarities among anatomical details, with no point of divergence. RESULTS: Correct pairing of radiographs of the whole sample was achieved by both observers, who presented countless coincidence points in their analyses. The statistical analysis demonstrated a good-to-perfect interobserver agreement. CONCLUSION: Comparison between radiographic images of lumbar spine can determine a correct identification of individuals, despite changes associated with aging. Therefore, radiography represents a potential tool to be utilized in forensic identification studies.

Keywords: Radiographic comparison, Identification, Forensic anthropology

OBJECTIVE: To evaluate the consequences of incomplete necropsy reports of gunshot victims, in cases in which radiological methods were not used to locate the firearm projectiles. MATERIALS AND METHODS: A total of 8,185 necropsy reports of "Instituto Médico-Legal Afrânio Peixoto", Rio de Janeiro, Brazil, were reviewed. This corresponds to the total number of corpses of the period from January to December 2001, and 3,122 of these consisted of autopsies of gunshot victims. RESULTS: Out of these 3,122, 309 bodies were buried with the firearm projectiles in its interior, which may lead to legal investigations in the future. In the same period 23 exhumations were requested, 12 of them with the purpose of collecting projectiles. The expenses related to the performance of necropsy exams of gunshot victims were calculated in about U$ 344 whereas the expenses related to the exhumations for the purpose of collecting firearm projectiles were calculated in about U$ 399. These calculations were performed to show the total amount that could be saved and otherwise spent, if legal-medical investigations of gunshot victims were successfully performed at first examination. In conclusion, necropsy examinations of gunshot victims must follow specific protocols, since incomplete necropsies will require posterior exhumations, with unnecessary additional costs.

Keywords: Radiology, Forensic Medicine, Radioscopy, Necropsy, Bullets

OBJECTIVE: To use skeletal scintigraphy to detect mandibular growth through the analysis of bone metabolism in individuals with normal craniofacial growth, and to compare the findings with those seen in individuals with excessive craniofacial growth. MATERIALS AND METHODS: Forty-seven male and female patients between 18 to 28 years of age were divided in two groups - class I, control (n = 13), and class III, case (n = 34). Images were obtained two hours after intravenous injection of 99mTc-MDP (200 µCi/kg). Right and left side views of the mandible were obtained as well as a posterior view of the lumbar spine. The count rate was determined by the mean values of the count of the condyles and of the fourth lumbar vertebra, using a total of 300,000 counts. RESULTS: No asymmetrical condyle uptake was observed in both groups, and in spite of the absence of statistically significant differences, the mean condylar uptake values were higher in class III group. CONCLUSION: The increased mean uptake indicated higher condylar bone metabolism in class III individuals suggesting residual mandibular growth. Further studies are presently ongoing to increase our sample size.

Keywords: Bone scintigraphy, Mandibular condyle, Mandibular growth, Temporomandibular joint

Renal allograft acute rejection must be promptly diagnosed since its reversibility is related to the readiness in which treatment is initiated. The aim of this study was: 1) to establish a quantitative method to evaluate kidney rejection and acute tubular necrosis (ATN); 2) to assess the potential role of 99mTc-mononuclear leukocytes scintigraphy in the diagnosis of renal rejection and differential diagnosis of ATN. One hundred and sixty studies were performed in 80 renal transplant patients at the first and fifth day after transplantation. Autologous cells were used for labeling. Images were obtained at 30 minutes, 3 hours and 24 hours after intravenous administration of 444 MBq (12 mCi) of labeled cells. There was abnormal labeled cells uptake in 27 of 31 cases of rejection and in 6 of 8 cases of ATN. The results of each patient were compared with clinical findings. Doppler scanning detected 18 of 31 cases of rejection. Rejection diagnosis sensitivity and specificity rates using scintigraphy were 87.1% and 100%, respectively, and 58.1% and 100%, respectively using ultrasound. Renal biopsy was performed in eight patients which demonstrated seven cases of rejection and one case of ATN. These results suggest that 99mTc-mononuclear leukocytes imaging may be useful in the early diagnosis of rejection and in the differential diagnosis of ATN.

Keywords: 99mTc-mononuclear leukocytes, Renal allograft, Rejection, Diagnosis

The aim of this study was to identify the sentinel node by periareolar injection of the radiopharmaceutical in four points, regardless of tumor topography. The sentinel node biopsy reduces morbidity in axillary staging. Fifty-seven sentinel node biopsies were prospectively performed in two groups: group A (25 patients) and group B (32 patients). The peritumoral injection technique was used in group A and the new injection technique in four points was used in group B. The sentinel node biopsies were studied by imprint cytology and hematoxilin and eosin staining followed by axillary lymph node dissection in all patients of group A and only in the positive cases of group B. In group A, 88% (22/25) of the sentinel nodes were identified. There was no false negative case; the sensibility and specificity were of 100%. In group B, 96% (31/32) of sentinel nodes were identified and the status of the axillary lymph nodes showed a predictive positive value of 100%. The number of sentinel nodes varied from 1 to 7, mode of 1 and median of 2.7. The hotspot area was 10 to 100 times the background radiation. The periareolar injection in four points seems to be a good lymphatic mapping method for identification of the sentinel node. We suggest the standardization of this site for injections to identify the sentinel node, although further studies to confirm these findings are necessary.

Keywords: Breast cancer, Sentinel node, Lymphoscintigraphy

Dynamic renal scintigraphy allows the diagnosis of complications in patients submitted to organ transplantation, such as perfusion abnormalities, acute tubular necrosis and rejection. In this study we employed 99mTc-DTPA scintigraphy to study patients submitted to kidney transplantation. The results obtained and the clinical findings were conjunctly analyzed in order to detect graft rejection or other complications. The type of immunosuppressive scheme used was also correlated with the observed complications. Fifty-five patients submitted to kidney transplantation from 1989 to 1999 were evaluated. All patients with nephrotoxicity received a 3-drug immunosuppressive scheme. In this study, acute rejection was the most frequent complication (40.4%) observed following transplantation. Thirteen of 15 recipients of cadaveric kidney grafts presented acute tubular necrosis. Only one false-positive case was observed when scintigraphy and clinical findings were not concordant. We suggest carrying out renal scintigraphy to follow-up post-transplantation patients.

Keywords: Dynamic renal scintigraphy, 99mTc-DTPA, Kidney transplantation, Immunosuppression

Objective: To assess the performance of morphometric parameters calculated from breast lesion contours at ultrasonography, in the quantification of morphological features and in the distinction among BI-RADS categories 2, 3, 4 and 5. Materials and Methods: The present casuistry included 40 cases, with orthogonal imaging of patients submitted to surgery. Based on the lesions segmentation, the following five morphometric parameters were calculated: area ratio, overlap ratio, normalized residual value, circularity and depth-to-width ratio. Linear discriminant analysis was applied to select the best parameters, and ROC curve was utilized as figure of merit. Results: Overlap ratio was able to statistically distinguish breast lesions classified as BI-RADS 3 from others classified as BI-RADS 4 (α = 5%; p = 0.015). Additionally, such parameter presented the best performance in the differentiation between malignant and benign breast lesions. Conclusion: These results indicate that morphometric analysis of breast lesions at ultrasonography seems to be helpful in distinguishing patients who should undergo biopsy from those to be followed-up only with imaging methods.

Keywords: Breast ultrasonography; BI-RADS; Computer-assisted image processing; Computer-assisted image interpretation.

Mammography is the best method for early detection of breast cancer. Nevertheless, approximately 10% to 30% of breast lesions are missed at screening due to limitations of human observers. Computer-aided detection (CAD) is a relatively new technology that has been implemented in some mammography services to allow a double reading of mammograms. Clinical studies have demonstrated that CAD increases the sensitivity by up to 21% in the detection of breast cancer by radiologists. A CAD system is useful in situations where there is a high interobserver variability, lack of trained observers, or impossibility to perform the double reading with two or more radiologists. The objective of the present review is based on the need to get the medical community acquainted with this tool as an auxiliary, quantitative and non-operator-dependent method, to improve the diagnosis of breast cancer.

Keywords: Breast cancer; CAD; Double reading.