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Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2021.tde-07012022-113542
Document
Author
Full name
Ellen Pierre de Oliveira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Barbas, Carmen Silvia Valente (President)
Jardim, Carlos Viana Poyares
Pereira, Rosa Maria Rodrigues
Santana, Alfredo Nicodemos da Cruz
Title in Portuguese
Estudo da cintilografia de inalação e perfusão pulmonar em granulomatose com poliangeíte em remissão
Keywords in Portuguese
Cintilografia de ventilação/perfusão
Granulomatose com poliangeíte
Tomografia computadorizada por raios X
Vasculite
Abstract in Portuguese
Embora a literatura médica relate eventos tromboembólicos em pacientes com Granulomatose com Poliangeíte (GPA), as diversas alterações parenquimatosas pulmonares e vasculares da doença ainda são pouco conhecidas. Este estudo consistiu em uma análise prospectiva de pacientes com diagnóstico de Granulomatose com Poliangeíte acompanhados no ambulatório de vasculites da Disciplina de Pneumologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, em fase de remissão da doença. Os pacientes realizaram exame de cintilografia de inalação e perfusão pulmonar e tomografia computadorizada de tórax de alta resolução, para verificação de possíveis alterações de ventilação e perfusão pulmonar nos lobos e segmentos e a correlação com alterações parenquimatosas da tomografia torácica. Dezessete de 38 pacientes (44%) apresentaram alterações perfusionais demonstrado pelo exame de cintilografia de perfusão. Entre os dezessete pacientes com alteração de perfusão, seis (35.3%) não possuíam alteração em cintilografia de inalação (grupo mismatch) caracterizando uma alteração vascular isolada, neste grupo o segmento mais acometido foi o segmento apico-posterior do lobo superior esquerdo (X2 [2] = 3.996; p= 0.046). Onze dos dezessete pacientes com alteração de perfusão pulmonar (64.7%) possuíam concomitantemente alteração na fase de inalação pulmonar (grupo match). Este grupo apresentou maior número de alterações parenquimatosas pulmonares em relação ao grupo mismatch (U = 82,000; p = 0.046), e as alterações do grupo match foram detectadas principalmente no lobo superior direito (X2 [2] =4.898; p = 0.027)
Title in English
Pulmonary scintigraphy inhalation and perfusion study in patients with granulomatosis with poliangiitis in remission phase
Keywords in English
Granulomatosis with polyangiitis
Tomography X-ray computed
Vasculitis
Ventilation-perfusion scan
Abstract in English
Athough the medical literature reports thromboembolic events in Granulomatous with polyangiitis (GPA) patients, pulmonary parenchymal and vascular alterations of the disease are still poorly understand. This study consisted of a prospective analysis of patients diagnosed with Granulomatosis with Polyangiitis, in the remission phase of the Disease, followed at the vasculitis outpatient clinic of the Pulmonology Department of the Hospital das Clínicas of the Medical School of the University of São Paulo. Patients underwent pulmonary inhalation and perfusion scintigraphy and high-resolution chest tomography to identify possible alterations in ventilation and pulmonary perfusion in the pulmonary lobes and segments, as well as the correlation with parenchymal changes in the chest tomography. Seventeen out of 38 patients (44%) presented perfusion alterations demonstrated by the perfusion scintigraphy exam. Among the seventeen patients with perfusion alteration, six (35.3%) had no alteration in inhalation scintigraphy (mismatch group) characterizing an isolated vascular alteration. In this group, the most affected segment was the apico-posterior segment of the left upper lobe (X2 [2] = 3,996; p = 0.046). Eleven of the seventeen patients with altered pulmonary perfusion (64.7%) had concomitant alterations in the pulmonary inhalation phase (match group). This group had a higher number of pulmonary parenchymal sequelae comparing to the mismatch group (U = 82,000; p = 0.046), and the findings in the match group were detected mainly in the right upper lobe (X2 [2] = 4,898; p = 0.027)
 
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Publishing Date
2022-01-17
 
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