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Tuesday, November 27, 2012

"Brazil Presents" Spotlights the Latest MR Imaging Techniques

Pedro Daltro, M.D.
Pedro Daltro, M.D.

Radiology remains integral to the growth of healthcare in Brazil, according to presenters who offered the latest state-of-the-art in MR imaging to a packed room during Monday's "Brazil Presents" session.

"The purpose of these 'Country Presents' sessions is to highlight the achievements of other countries around the world and share knowledge between our countries," said RSNA President George S. Bisset, III, M.D., in his introductory remarks, "And I can't think of any greater pleasure for me than to have 'Brazil Presents' today."

Brazil, which offers universal health coverage that is utilized by 75 percent of the public, is now the fifth-largest buyer of MR imaging devices in the world, according to moderator Pedro Daltro, M.D., who outlined the country's healthcare expenditures including medical diagnostics.

Douglas Racy, M.D., whose presentation focused on factors that can influence the quality of MR imaging, was among the Brazilian presenters who demonstrated highly advanced techniques in a variety of MR applications.

"There are tradeoffs for MR imaging parameters," Dr. Racy explained. "Often we cannot gain advantage in one parameter without sacrificing another." He outlined techniques to ensure the appropriate tradeoffs for various clinical indications, emphasizing the best quality in the shortest acquisition time.

"As the number and complexity of identified midbrain-hindbrain malformations has increased, neuroradiologists must be prepared to study and discuss with neurologists and geneticists the embryological events and genetic mutations," said Leonardo Vedolin, M.D., Ph.D., noting that the current pattern-recognition approach to MR imaging has limitations and identified

developmentally-based classification methods for congenital posterior fossa malformations.

Emerson Gasparetto, M.D., Ph.D., demonstrated advanced MR techniques including images acquired at 7T for distinguishing demyelinating diseases from tumors, infection, vascular disease and other demyelinating diseases.

"The most common reason for falsely attributing a patient's symptoms to multiple sclerosis is faulty interpretation of MR imaging," said Dr. Gasparetto, who also demonstrated the role of advanced MR in assessing treatment response, progression and prognosis.

In characterizing hypervascular lesions in the cirrhotic liver, MR imaging tools can help narrow the differential diagnosis, said Antonio Eiras de Araujo, M.D., who outlined diagnostic approaches and management techniques for challenging cases.

"Hypervascular lesions are common in the cirrhotic liver and differentiating them is a relevant responsibility of the radiologist," Dr. Eiras de Araujo said.

Dr. Daltro concluded with a visually engaging presentation of advances in fetal MR imaging technology, demonstrating how 3D simulation videos can be created to demonstrate a virtual path through anatomical structures and demonstrate how, for example, a facial mass can obstruct the airway. He also showed how imaging can guide molds for physical models of the fetus and internal structures.

Such innovative research is key to the strong partnership RSNA has forged with Brazilian radiologists and professional societies to encourage growth and learning in both regions. Also hailing from Brazil is this year's Honorary Member Giovanni G. Cerri, M.D., Ph.D., of São Paulo.

"Brazil is a country where world-class radiology is practiced by world-class radiologists," said Dr. Bisset. "This is an opportunity for us to learn from you."

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