OBJETIVO: Comparar o desempenho das sequências T1, T2, STIR e DWIBS (difusão de corpo inteiro com supressão do sinal de fundo) na identificação de sítios caracterizados como acometidos pelo linfoma de Hodgkin nas cadeias linfonodais, órgãos parenquimatosos e medula óssea, e avaliar a concordância entre os examinadores. MATERIAIS E MÉTODOS: Foram estudados 12 pacientes com diagnóstico confirmado de linfoma de Hodgkin. Os pacientes foram encaminhados para o exame de ressonância magnética, sendo realizadas as sequências ponderadas em T1, T2, STIR e DWIBS. RESULTADOS: O número de sítios linfonodais caracterizados como acometidos nas sequências ponderadas em T1 e T2 apresentaram resultados semelhantes (8 sítios), mas inferiores às sequências STIR e DWIBS (11 e 12 sítios, respectivamente). Quanto ao acometimento da medula óssea, observaram-se os mesmos valores para as sequências T1, T2 e DWIBS (17 lesões), superiores ao valor encontrado na sequência STIR (13 lesões). Quando realizada a comparação entre os examinadores, nota-se que há alta concordância entre as quatro sequências. CONCLUSÃO: As sequências STIR e DWIBS detectaram maior número de linfonodos caracterizados como acometidos. Todas as sequências apresentaram resultados semelhantes na avaliação dos órgãos parenquimatosos e medula óssea. Em todas as sequências analisadas houve alta concordância entre os examinadores.

OBJETIVO: Avaliar, por meio da ressonância magnética, uma série de fetos com diagnóstico ultra-sonográfico de malformação, a fim de estabelecer os benefícios e limites diagnósticos proporcionados pela técnica de ressonância magnética fetal, em comparação com a ultra-sonografia. MATERIAIS E MÉTODOS: Foram estudadas 40 mulheres entre 15-35 semanas de gestação com diagnóstico de anomalia fetal durante o exame de ultra-sonografia. As pacientes foram encaminhadas para o estudo complementar com ressonância magnética. As indicações para o estudo da ressonância magnética fetal foram: anomalias do sistema nervoso central, do tórax, do abdome, renais, esqueléticas e tumores. A avaliação pós-natal incluiu a revisão das imagens de ultra-sonografia e ressonância magnética, o acompanhamento do nascimento, exames laboratoriais, radiológicos e necropsia. RESULTADOS: Os resultados mostraram que os estudos complementares com ressonância magnética fetal trouxeram informações adicionais em 60% dos casos estudados. Os benefícios da ressonância magnética fetal foram: ampliação da avaliação global, aumento do campo de avaliação, maior resolução tecidual pelo uso de seqüências, e avaliação em pacientes obesas e com oligoidrâmnio. Os limites da ressonância magnética fetal foram: evitar exame no primeiro trimestre, avaliação do fluxo sanguíneo, movimentação fetal, claustrofobia materna, estudo do coração fetal e esqueleto. CONCLUSÃO: A ressonância magnética fetal pode ser utilizada como método complementar para a avaliação das malformações fetais.

Purpose: To evaluate the efficiency of transvaginal ultrasound in the early diagnosis of ovarian cancer. Methods: Screening transvaginal ultrasound has been annually performed during the last 2 years in asymptomatic women without familial history of ovarian cancer. When abnormalities were detected, the procedure was repeated after 4-6 weeks. If the findings disappeared, the study was repeated after 1 year. If the abnormality persisted, study was complemented with tumor markers, computed tomography and laparoscopic surgery. The findings were compared with a control group of women in whom ovarian transvaginal ultrasonography was formally indicated. Results: A total of 26007 transvaginal ultrasound were performed: 8813 (33.8%) belonged to the screening group and 17194 (66.2%) to the control group. In 14 patients of the screening group, a malignant tumor was diagnosed and histologically confirmed. The mean age of these patients was 45 years old (SD 12). Eleven of these tumors were stage I (seven Ia, and four Ic), two stage IIIc and one was a metastatic melanoma in both ovaries. Six lesions were borderline tumors (five serous and one mucinous). In the control group, 27 ovarian cancers were diagnosed in patients with a mean age of 48 years (SD 17). In this group, 11 tumors were in stage I, and six were borderline. Conclusions: Although consensus about the benefits of using transvaginal ultrasound as a screening procedure is not conclusive, our data reveals that tumors detected in patients screened with transvaginal ultrasound are in earlier stages when compared with those diagnosed in the control group. No differences were found in age and number of borderline tumors between both groups. Additional studies are needed to support this preliminary findings. P02Endometrial sampling during sonohysterography (SHGes) E. Ferrazzi, C. Lanzani, N. Ciminera & V. Conserva Purpose: To assess the diagnostic accuracy of sonohysterography (SHG) and endometrial sampling during SHG (SHGes) compared to traditional hysteroscopy and biopsy. Methods: Seventy-two consecutive patients with irregular bleeding and/or intracavitary abnormalities underwent transvaginal sonography (TVS) and SHG. SHG was performed with a 4.7-mm intrauterine catheter. In all patients, an endometrial biopsy was performed by a syringe vacuum aspiration at the end of SHG. Procedure-related pain was assessed. Sonographic findings at SHG were defined as normal, focal lesions or diffuse endometrial abnormality. In patients with diffuse endometrial abnormality, hysteroscopy and hysteroscopic guided biopsy were performed. In patients with focal lesions, an operative hysteroscopy was performed. Pathologic report was the gold standard. Results: Mean age was 48 years (interquartile range 38-54). At SHG, no pain, mild, and severe discomfort was reported by 75, 18 and 7% of patients, respectively. Fifty patients underwent hysteroscopic guided biopsy, 22 operative hysteroscopy. Hysteroscopic findings were compared to SHG-SHGes finding. (A) Benign lesions: in 56 cases SHG and SHG...

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Objectives: Cases of ventricumegaly were evaluate fetal MRI to establish the contribution of the MRI regarding aetiological diagnosis, additional findings and management. Methods: We evaluate 91 cases of ventriculomegaly (VM) between 20-28 gestational weeks (range 23.4 weeks). All cases of VM were screened by ultrasound (US) using the atrial width classified as normal when atrial width < 10.0 mm, as mild VM an atrial width between 10.0-15.0 mm, and severe when atrial width > 15.0 mm. All MRI studies were performed up to 7 days after the US diagnosis. All cases were followed by US every 4 weeks and a 2 nd MRI was performed between 32-36 weeks. Results: There was 68 cases of mild VM (74.2%) and 25.1% cases of severe VM. Fetal MRI brings additional information regarding the size of the 4 th ventricule, evaluating the walls and surface of the ventricules, the position of the fornix, analyses of the germinal zone, posterior fossa (cerebellar herniation), gyration process and evaluation of ventricular symetry or asymetry. The 2 nd MRI allow us to understand the progression of different aetilogical processes of VM. Conclusions: Fetal MRI should be used in cases of VM as a complementary method to evaluate intracranial additional findings that could contribute to a more refined aetilogical diagnosis of ventriculomegaly. OP20.05Fetal volume measurement at gestational age of 11+0-13+6 weeks by three-dimensional ultrasound N. Smeets 1 , F. van Deursen 2 , S. Oei 2,31 Obstetrics and Gynecology, Atrium Medical Centre Parkstad, Merkelbeek, Netherlands; 2 Obstetrics and Gynaecology Department, Atrium Medical Centre Parkstad, Heerlen, Netherlands; 3 Obstetrics and Gynaecology Department, Maxima Medical Centre, Veldhoven-Eindhoven, Netherlands Objectives: The aim of this study was to measure fetal volume at a gestational age of 11+0-13+6 weeks in singleton pregnancies by using three-dimensional ultrasound. Methods: Three-dimensional ultrasound volume scans were acquired during nuchal translucency measurements by an ultrasound expert in 438 consecutive singleton pregnancies at 11+0-13+6 weeks of gestation. The Virtual Organ Computer-aided AnaLysis (VOCAL) technique is used to measure fetal volumes by rotational steps of 9 • in the A(xial)-plane (manual mode). Linear regression analysis was used to determine the association between fetal volume and gestational age in days. Results: The image quality of 424 of 436 cases was sufficient to measure fetal volume (97%). Fetal volume increased with gestational age from a mean of 11.8 cm 3 at 11+0 weeks to 31.4 cm 3 at 13+6 weeks. The correlation between fetal volume and gestational age was 0.69 (P < 0.01). The regression equation was, fetal volume = −67.490 + 1.002 × gestational age in days (r 2 = 0.47). Conclusions: This study shows that fetal volume measurement during the first trimester of pregnancy is feasible. OP20.06Contribution of fetal magnetic resonance imaging in the evaluation of fetal craniofacial anomalies Objectives: To evaluate the impact of fetal magnetic reson...