Hepatocyte-specific contrast agent-enhanced magnetic resonance cholangiography: perioperative evaluation of the biliary tree

<div><p>Abstract A large number of gadolinium chelates have recently been tested in clinical trials. Some of those have already been approved for clinical use in the United States and Europe. Thus, new diagnostic perspectives have been incorporated into magnetic resonance imaging studies. Among such gadolinium chelates are hepatobiliary-specific contrast agents (HSCAs), which, due to their property of being selectively taken up by hepatocytes and excreted by the biliary ducts, have been widely used for the detection and characterization of focal hepatic lesions. In comparison with conventional magnetic resonance cholangiography (MRC), HSCA-enhanced MRC provides additional information, with higher spatial resolution and better anatomic evaluation of a non-dilated biliary tree. A thorough anatomic assessment of the biliary tree is crucial in various hepatic surgical procedures, such as complex resection in patients with colorectal cancer and living-donor liver transplantation. However, the use of HSCA-enhanced MRC is still limited, because of a lack of data in the literature and the poor familiarity of radiologists regarding its main indications. This pictorial essay aims to demonstrate the use of HSCA-enhanced MRC, with particular emphasis on anatomical analysis of the biliary tree, clinical applications, and the most important imaging findings.</p></div

Inovação gerencial em municípios: análise exploratória das práticas de gestão do plano estratégico de Juiz de Fora

Este artigo procura discutir as práticas de gestão associadas ao plano estratégico do município mineiro de Juiz de Fora (PlanoJF). Para tanto, recupera algumas características da intervenção estatal entre as décadas de 1930 e 1980 no Brasil. Detalha, ainda, alguns fatos que, a partir dos anos 1990, alteraram a natureza desse processo. A reflexão sobre referências teóricas e as evidências coletadas por meio de entrevistas pessoais, da observação não-participante e da análise documental possibilitam, ao final do artigo, a descrição do plano, a análise dos mecanismos de gestão conduzidos por seu comitê executivo e a exposição de algumas constatações