O tratamento das fraturas de mandíbulas edêntulas é motivo de controvérsias na literatura e um dos fatores que tornam seu tratamento complexo é o suprimento sanguíneo reduzido. Nesse contexto, o ultra-som Doppler consiste em exame nãoinvasivo o qual pode ser utilizado na análise de alterações da vascularização de diversos segmentos corpóreos e influenciar decisões clínicas. Este trabalho teve como objetivo avaliar a vascularização mandibular de pacientes edêntulos que foram submetidos a tratamento de fratura de mandíbula (grupo experimental), por meio de ultra-som doppler colorido. Possíveis correlações entre os dados clínicos, radiográficos e a vascularização mandibular foram analisadas. O fluxo arterial de vasos, como carótida externa, maxilar, facial, mentual, submentual e sublingual, após o tratamento, foi comparado ao fluxo arterial dos mesmos vasos em um grupo controle composto por pacientes edêntulos livres de fratura. Com o emprego do transdutor linear, de maneira extra-oral, foram obtidos velocidade pico-sistólica (VPS), velocidade diastólica final (VDF), índice de resistência (IR), índice de pulsatilidade (IP) e aceleração, de cada artéria. Além disso, foram obtidos detalhes do tratamento por meio de avaliação clínica e radiográfica, assim como da avaliação dos prontuários. Houve diferenças estatisticamente significantes para os valores de IR da artéria mentual, IP da artéria maxilar, VPS, IP e aceleração da artéria submentual. Além disso, na pesquisa de fatores vasculares locais obstrutivos, de acordo com a artéria e os fatores estudados, houve diferenças estatisticamente significantes para o VPS, VDF e IP da artéria facial, IR da artéria sublingual, os quais apresentaram valores menores quando da presença desses fatores. Os grupos experimental e controle foram semelhantes quanto à ocorrência de variações de sentido de fluxo. Na análise das correlações entre os fatores estudados e o grau de atrofia alveolar, foram observadas diferenças estatisticamente significantes para os valores de VPS e VDF da artéria submentual, maiores no grupo não-atrófico. O exame de ultra-som doppler colorido foi capaz de demonstrar alterações em algumas artérias que suprem a mandíbula de pacientes edêntulos submetidos a tratamento de fratura, havendo poucas correlações com o grau de atrofia alveolar. / The treatment of edentulous mandibular fractures is motive of controversies in literature and one of the factors that make this treatment complex is the reduced blood supply. In this context, the doppler ultrasound is a non-invasive method that can be used in the analysis of changes in the vascularization of several corporeous segments and influence clinical decisions. The purpose of this study is to assess the vascular supply of edentulous patients, that have been treated of mandibluar fracture (experimental group), using the colored Doppler ultrasound. Possible correlations between the alveolar atrophy degree and the mandibular blood supply were analyzed. The arterial flow of vessels like external carotid, maxilar, facial, mentual, submentual and sublingual, after treatment, was compared with the arterial flow of the same vessels in a control group, consisting of edentulous fracture-free patients. With the use of linear probe extra-orally, the systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI) and acceleration of each artery, was obtained. Also, treatment details were obtained through clinical, radiological investigations, and hospital notes assessments. There was significant statistic differences to the values mentual artery RI, maxilar artery PI, submentual artery SPV, PI and acceleration. Also, in the analysis of the presence of obstructive vascular local factors, according to the artery and studied factors, statistically significant differences were observed to facial artery SPV, FDV and PI, sublingual artery RI, that present lower values when these factors were present. The experimental and control groups were similar in respect to variations in flow direction occurrence. In the analysis of the correlations between the studied factors and alveolar atrophy degree, statistically significant differences were observed to the submentual artery SPV and FDV, higher in non-atrophic group. The color doppler sonography was able to show changes in some arteries that supply the mandible of edentulous patients submitted to fracture treatment, with few correlations with the alveolar atrophy degree.

Tomographic MR (Magnetic Resonance) and sonographic biosignal processing are important non-invasive diagnostic methods used in a medicine. A noise added into processed data by an amplifier of tomograph receiving part and by circuits of sonograph is resulting in a body organ diagnosis degradation. Image data are stored in a standardized DICOM medical file format. Methods using wavelet analysis for noise suppression in image data have been designed and their comparation with classical methods has been made in this work. The MATLAB was utilized for data processing and data rewriting back to the DICOM format.

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Auf der Grundlage pränatal-sonographischer Befunde werden bei schweren, nichttherapierbaren Fehlbildungen vorzeitige Schwangerschaftsbeendigungen durchgeführt. Vor diesem Hintergrund ist es unbedingt erforderlich, Qualitätskontrollen der pränatal-sonographischen Diagnostik und der Fetalpathologie vorzunehmen. Dabei liegt der Schwerpunkt in der Aufdeckung möglicher Fehlerursachen differenter Befunde zwischen der pränatal-sonographischen Diagnostik und der Fetalpathologie und deren Beseitigung. Mögliche Fehlerursachen für Fehldiagnosen werden dargestellt und kategorisiert sowie die Fehldiagnosen einer Fallgruppe nach ihren Ursachen analysiert. Anschließend werden Vorschläge zur Reduktion vermeidbarer Fehler gemacht. In der vorliegenden Arbeit wurden 119 Autopsiefälle, davon 77 % induzierte Aborte, 9 % Spontanaborte und 11 % Totgeborene an der Frauenklinik der Charité Berlin aus dem Jahr 2000 ausgewertet. Es wurden alle pränatalen sonographischen und postmortalen pathologischen Befunde der betrachteten Fälle miteinander verglichen und auf Übereinstimmung überprüft. Insgesamt wurden 801 Einzeldiagnosen untersucht, deren Auswertung in 38,75 % identische Befunde ergab. Bei 8 % dieser Befunde mit bestätigten klinisch-pränatalen Diagnosen wurden durch die Fetalautopsie wesentliche Zusatzbefunde mit möglichen Auswirkungen auf das Schwangerschaftsmanagement oder das Wiederholungsrisiko erhoben. Der Anteil an falsch-negativen Diagnosen betrug 24 % aller Befunde. Der Anteil an falsch-positiven Diagnosen belief sich auf 25 % aller Befunde. 12 % der pränatal-sonographisch erhobenen Diagnosen konnten nicht mehr durch die pathologische Untersuchung verifiziert werden. Bei 0,25 % waren die Befunde inkomplett und ließen sich ebenfalls nicht in der pathologischen Untersuchung bestätigen. Im Gegensatz zu den Ergebnissen aller Einzelbefunde war die Zuverlässigkeit der sonographischen Hauptdiagnosen der betrachteten Fälle bedeutend besser. So waren unter den Totgeburten 90 % der pränatal-sonographischen Hauptdiagnosen korrekt, 5 % waren falsch-positiv und 5 % falsch-negativ. In der Gruppe der Spontanaborte und weiteren Abbrüche waren es 100 % identische Hauptdiagnosen. Bei den induzierten Aborten gab es 89 % korrekte sonographische Hauptdiagnosen, 4,3 % falsch-positive und 6,7 % nicht-verifizierbare Hauptdiagnosen. Durch die zusätzliche Einbeziehung genetischer Diagnostik zeigte sich, dass der Anteil an korrekt erhobenen Diagnosen zur Beendigung der Schwangerschaft an der Charité Berlin im Jahr 2000 sogar bei 94 % lag. Häufigste Ursachen der Fehldiagnosen: - Kleinheit des Objekts: 32 % - Frühe Schwangerschaftswoche: 7,2 % - Artifizielle Befunde durch Autolyse: 7,1 % - Mangelnde topographische Zuordnung: 6,8 % - Austrocknung: 5 % - Schäden bei Passage des Geburtskanals: 4,8 % - Sonstiges: 37,1 % In dieser Arbeit wurden erstmalig Häufigkeiten von Fehlerursachen herausgearbeitet, die es ermöglichen, konkrete Verbesserungen einzuführen. Diese wurden im Abschnitt 5.3.2 erläutert und hier kurz zusammengefasst. - Möglichst frühzeitige Sektion des Feten - Bessere und kürzere Lagerung und Transport des Feten - Einsatz schonender Abbruchverfahren - Intensive Ausbildung sicherstellen - Konsultation durch erfahrene Kollegen ermöglichen - Bei Oligohydramnie Fruchtwasser-Instillation, Drehung des Kindes, Umlagerung der Patientin - Bei maternaler Adipositas: erfahrene Untersucher, intensive Untersuchung - Bei Schallauslöschung Wendung des Kindes, Umlagerung der Patientin - Vermehrt Verwendung von Vierkammerblick, cw-Doppler, Videosequenzen - Kenntnis der verwendeten Ultraschalltechnik, Wartung - Bei früher SSW Wiederbestellung der Patientin in späterer SSW / Introduction: The significance of the ultrasound screening lies in prognosis and predication for the management of the pregnancy and further pregnancies. With respect to incurable malformations sometimes a termination of the pregnancy is necessary. After the termination of such a pregnancy an autopsy of the fetus is performed to verify the prenatal diagnosis. Sometimes remain differences between the prenatal and the postmortal examination. The sources for different diagnoses are analysed in the view to make suggestions for the reduction of avoidable mistakes. Material and methods: The here presented study offers a systematic analysis of the differences between prenatal and postmortal examination. We divided the sources of the differences into fetal, maternal, temporal, arteficial, technical and subjective factors. We examined all fetal autopsies at the institute of pathology of the Charité Berlin of the year 2000 to test the feasibility of the method. Within the retrospective study we analysed 119 autopsies of fetuses. The gestational age varied between the 13th and 36th week. For the characterisation of the results of the comparison we defined the following score values: id: identical, idz: identical, but additional diagnosis, f-p: false positive ultrasound diagnoses, f-n: false negative ultrasound diagnoses, n-v: not validatable morphological correlate - due to damages, ik: incomplete diagnoses, VD: ultrasound suspicion diagnosis Results: For all diagnoses: For all of the 119 autopsies 801 separate diagnoses and 67 suspicious diagnoses have been recorded (Tab1). We found in 38,75% of the diagnoses identical and in 8% additional diagnoses. The amount of prenatal-sonographic false-negative diagnoses was 24% and the amount of false-positive diagnoses was 25%. About 12% of the prenatal sonographic diagnoses couldn't be verified during autopsy. Main diagnoses: For the induced abortions had been 89% correct sonographic main diagnoses, 4,3% had been false-positive and 6,7% couldn't be verified. The results are listed with the number of diagnoses and the percentual frequence in (%) and the number of suspicous diagnoses and the percentual frequence in(%). - identical (id): 239 (30,75%); 25 (38%) - Additional (idz): 66 (8%); 9 (13%) - false-positive (f-p): 203 (25%); 23 (34%) - false-negative (f-n): 196 (24%); 4 (6%) - not validatable (n-v): 95 (12%); 6 (9%) - Incomplete (ik): 2 (0,25%); 0 (0%) - Total: 801 (100%); 67 (100%) In our study it was possible to analyse the dependency of differences between prenatal and post mortal examination with respect to the influencing error categories like the followings. Sources and Frequence of different diagnoses and the percentual frequence in (%): - Smallness of the object: 32 % - Early gestational age: 7,2 % - Artificial diagnoses by autolysis: 7,1 % - Lack of topographic relations: 6,8 % - Withering of extremities: 5 % - Destruction by abortion: 4,8 % - Others: 37,1 % Conclusion: The aim of the presented study was to investigate the reasons for differences between prenatal and post mortal examination and to analyse the specific influence of the different error categories. - Suggestions to reduce the perinatal management - Early autopsy of the fetus - Better and shorter transport and storage of the fetus - Use of mild methods of abortion - Guarantee of intensive education - Consultation of experienced colleagues - Oligohydramnia: instillation of amniotic fluid, rotation of baby, rotation of mother - Maternal obesity: experienced examiner - Sonographic artefacts: rotation of the baby, rotation of the mother - Use of four-chamber-view, cw-Doppler, video sequences - Knowledge of the used sonographic technologies - In early gestational age new examination in later gestational age

Die vorliegende medizinische Dissertation untersucht nicht-invasive bildgebende Verfahren wie die konventionelle Sonographie, die Acoustic radiation force impulse (ARFI)-Elastographie sowie die Transiente Elastographie (TE) zur Detektion von Komplikationen in der Frühphase nach allogener Stammzelltransplantation. Dem kurativen Therapieansatz der Stammzelltransplantation steht ein hohes Komplikationspotential gegenüber. Besonders hepatobiliär treten Graft-versus-host Erkrankungen (GvHD) sowie Gefäßkomplikationen (VOD) auf. Der bisherige diagnostische Goldstandard, die Leberbiopsie, ist als invasives Verfahren mit einer hohen Intra- und Inter-Untersucher-Variabilität sowie der geringen Repräsentativität als Screeningmethode ungeeignet. Die Elastographieverfahren ARFI und TE als nicht-invasive Alternativen ermitteln die Lebergewebesteifigkeit als Surrogatparameter fibrotischer Veränderungen und wurden bereits in zahlreichen Studien als geeignete Diagnoseverfahren für Leberfibrose und -zirrhose unterschiedlicher Ätiologie definiert. Ziel dieser prospektiven Pilotstudie war die Evaluation der genannten Methoden zur Detektion von Frühkomplikationen nach allogener Stammzelltransplantation. Die Ergebnisse der Studie zeigen, dass sowohl die konventionelle Sonographie als auch die Transiente Elastographie pathologische Organveränderungen vor allem des hepatobiliären Systems detektieren können. Allerdings erscheinen diese Veränderungen unspezifisch. Es bestehen keine signifikanten Unterschiede zwischen Patienten mit und ohne Komplikationen. Anders bei der ARFI-Elastographie. Hier zeigten die Messwerte im linken Leberlappen signifikant höhere Werte bei Patienten mit Komplikationen. Zusammenfassend ist die ARFI-Elastographie zur Prädiktion möglicher Komplikationen nach allogener Stammzelltransplantation geeignet, sollte allerdings mit anderen diagnostischen Verfahren ergänzt werden.

Introdução: A doença aterosclerótica intracraniana é uma das principais causas de acidente vascular cerebral isquêmico (AVCI) no mundo, porém sua prevalência parece estar subestimada na população brasileira pela carência de estudos na área. O objetivo principal deste estudo foi descrever a frequência e gravidade da estenose intracraniana nos pacientes com AVCI ou ataque isquêmico transitório (AIT), utilizando a ultrassonografia transcraniana colorida (UTC). O objetivo secundário foi correlacionar os achados deste exame com a angiotomografia de crânio (AngioTC). Métodos: estudo observacional e prospectivo, onde foram avaliados pacientes consecutivos com o diagnóstico de AVCI ou AIT admitidos no período de fevereiro de 2014 a dezembro de 2014. A avaliação inicial consistiu na coleta de dados demográficos, epidemiológicos e clínicos e em seguida os pacientes foram submetidos ao exame de UTC através das janelas transtemporais e suboccipital, com o intuito de avaliar a presença de estenose intracraniana. Estenose intracraniana foi graduada em moderada (50- 70%), grave (70-99%) e suboclusão/oclusão (>= 99%). Foram considerados sintomáticos os casos em que houve uma associação entre os novos sinais e sintomas e uma nova área de infarto ao exame de neuroimagem no território da artéria envolvida ou quando o quadro neurológico correspondeu ao território da artéria envolvida. Os pacientes que possuíam UTC e AngioTC em sua avaliação foram comparados de forma cega quanto ao grau de estenose intracraniana seguindo a mesma classificação. Resultados: Foram avaliados 271 pacientes com o diagnóstico de AVCI ou AIT agudos (149 homens, com média de idade de 65,8 ± 12,5), 263 (97%) foram submetidos a exame de circulação intracraniana, sendo a ultrassonografia transcraniana colorida realizada em 168 casos (61,9%). Apenas 25 indivíduos (14,9%) foram excluídos devido a janela transtemporal insuficiente. Dentre os 143 pacientes que puderam ser avaliados adequadamente pela ultrassonografia transcraniana, a prevalência de estenose arterial intracraniana foi de 38,5% (55 casos); sendo sintomática em 25,2% dos casos. A média de idade dos pacientes era de 64 ± 11 anos, 26,9 % eram brancos e 29,4% hipertensos. Os pacientes com estenose intracraniana apresentaram maior pontuação na escala do NIH: 10 (IQ 4 - 19) vs 6 (IQ 3 - 13), maiores níveis de pressão arterial sistólica na admissão: 160 (IQ 145-170) vs 140 (IQ 130 - 155) e menores taxas de HDL: 32 (IQ 27 - 39) vs 36 (IQ 30 - 45). Após análise multivariada, o fator de risco independentemente associado à estenose intracraniana foi a hipertesão arterial sistêmica na admissão (p=0,006). Nos 100 pacientes com ambos os exames, a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da UTC comparada a AngioTC para detecção de estenoses intracranianas moderadas-graves foi de 60%, 73%, 73% e 60%, respectivamente. Conclusões: Encontramos alta frequência de estenose arterial intracraniana entre os pacientes com AVCI agudo e AIT na nossa população, especialmente entre indivíduos portadores de hipertensão arterial sistêmica. A UTC é uma ferramenta não-invasiva que pode ser utilizada para investigação da doença moderada-grave com acurácia moderada quando comparada a AngioTC / Background: Intracranial atherosclerotic disease is a major cause of ischemic stroke in the world, but its prevalence seems to be underestimated in our population by the lack of studies in the area. The aim of this study was to describe the frequency and severity of intracranial stenosis in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA), using the transcranial color-coded sonography (TCCS). The secondary objective was to correlate the TCCS test results with the findings on CT angiography on the same patients. Methods: Prospective observational study that evaluated consecutive patients admitted with a diagnosis of ischemic stroke or TIA during the period February 2014 to December 2014. The initial evaluation consisted of collection of demographic, epidemiological and clinical data and then the patients underwent the examination TCCS through transtemporal and suboccipital windows, in order to assess the presence of intracranial stenosis. Intracranial stenosis was graded moderate (50-70%), severe (70-99%) and subocclusion/occlusion (>= 99%). The cases were considered symptomatic when there was an association between new symptoms and signs and a new infarct area on neuroimaging in the territory of the stenotic artery or when the neurological status corresponded to the territory of that artery. Patients who had TCCS and intracranial angiography in their assessment were blindly compared for the degree of intracranial stenosis following the same classification. Results: We evaluated 271 patients with diagnosis of acute ischemic stroke and TIA (149 men, mean age 65.8 ± 12.5), 263 (97%) underwent examination of intracranial circulation, with the TCCS held in 168 cases (61.9%). Only 25 individuals (14.9%) were excluded due to insufficient transtemporal window. Among the 143 patients who could be evaluated properly by transcranial ultrasound, the prevalence of intracranial arterial stenosis was 38.5% (55 cases); with 25,2% symptomatic cases. The average age of patients was 64 ± 11 years, 26.9% were white and 29.4% hypertensive. Patients with intracranial stenosis had higher scores on the NIHSS: 10 (IR 4-19) vs 6 (IR 3- 13), higher levels of systolic blood pressure at entry: 160 (IR 145-170) vs 140 (IR 130 - 155) and lower HDL rates: 32 (IR 27-39) vs 36 (IR 30-45). After multivariate analysis, the risk factor independently associated with intracranial stenosis was systemic arterial hypertension at admission (p = 0.006). In the 83 patients with both tests, the sensitivity, specificity, positive predictive value and negative predictive value of TCCS compared to CT angiography for detection of intracranial stenosis moderate-severe was 60%, 73%, 73% e 60%, respectively, Conclusions: We found a high frequency of intracranial artery stenosis in patients with acute ischemic stroke and TIA in our population, especially among individuals with hypertension. TCCS is a non-invasive tool that can be used to study moderate-severe disease with moderate accuracy compared to CT angiography

Introdução:O Forame Oval Patente (FOP) é a comunicação direita-esquerda (CDE) ou shunt direita-esquerda (SDE) mais comum e frequentemente encontrada em adultos jovens com Acidente Vascular Cerebral (AVC) relacionado ao mecanismo de embolia paradoxal. A Ecocardiografia Transesofágia (ETE) é considerada o padrão para visualização direta do FOP. O Doppler Transcraniano com o teste de microbolhas é frequentemente usado para detectar CDE com boa correlação com o ETE para o diagnóstico de FOP. Mais recentemente, a Ultrassonografia Transcraniana Colorida (TCCS) com inclusão do modo-B e fluxo de cor tem superado o DTC (que é realizado \"as cegas\") em muitas aplicações clínicas mas a acurácia do TCCS para a detecção de CDE e FOP não tem sido sistematicamente avaliada. Objetivo: Determinar se o TCCS é uma ferramenta acurada para identificar tanto FOP quanto CDE. Métodos: Foram recrutados 106 pacientes prospectivamente com Acidente Vascular Cerebral Isquêmico menores de 55 anos admitidos na Unidade de Emergência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP). Os pacientes foram submetidos aos exames de ETE, DTC e TCCS e todos os exames incluíram a técnica do teste de microbolhas. Os examinadores foram cegos para os resultados desses exames e foi calculado a concordância Kappa de Cohen inter-examinadores para o TCCS e DTC. A acurácia para o TCCS foi calculada em comparação ao ETE. Resultados: Foram detectados CDE em 54 (50.9%) dos pacientes (idade média 43.9 ± 8.2 anos) com Kappa de Cohen de 0.92 (IC 95% 0.78-1.0) quando realizados TCCS e TCD. TEE e TCSS foram positivos em 23/98 (23.4%) e ETE negative em 20/98 (20.4%). Em 30 (28.3%) o ETE revelou FOP. O TCSS teve uma sensibilidade de 88.4%(IC 95% 0.68-0.97) e especificidade de 72.2%(IC 95% 0.60-0.81) e uma razão de verossimilhança positive de 3.18 (IC 95% 2.14-4.73) para o diagnóstico de FOP. Conclusão: TCCS e DTC tiveram excelente concordância. TCCS tem uma boa acurácia para a detecção de FOP e CDE em pacientes jovens com Acidente Vascular Isquêmico / Introduction: Patent Foramen Ovale (PFO) is the most common right-to-left shunt (RLS) and is often found in young patients with stroke related to paradoxical embolism. ContrastEnhanced Transesophageal Echocardiography (TEE) is considered a gold standard to visualize PFO. Transcranial Doppler (TCD) with bubble test is often used to detect RLS with good correlation to TEE for the diagnostic of PFO. More recently, Transcranial Color Coded Sonography (TCCS) which included B-mode and color coded imaging has overcome blind TCD in many clinical applications but the accuracy of TCCS for detection of RLS and PFO has not been systematically evaluated. Hypothesis: To determine if the TCCS is an accurate tool to identify both PFO and RLS. Methods: We investigate 106 patients with ischemic stroke under 55 years-old admitted from 2012 to 2014 in a tertiary academic hospital. Patients were evaluated with TEE, TCD and TCCS, and all exams included a saline bubble test. The examiners were blinded for the other tests results. Kappa agreement was calculated inter-examiners for TCCS and TCD. Accuracy of TCCS was calculated in comparison to TEE. Results: We detected a RLS in 54 (50.9%) patients (age mean 43.9 ± 8.2) with kappa agreement 0.92 (95%CI 0.78-1.0) when performed TCCS and TCD. TEE and TCSS were positive in 23/98 (23.4%) and TEE did not reveal contrast in 20/98 (20.4%). In 30 (28.3%) patients only TEE revealed a PFO. TCSS had a sensitivity of 88.4% (95%CI 0.68-0.97), specificity of 72.2% (95%CI 0.60-0.81) and positive likelihood ratio of 3.18 (2.14-4.73) of the diagnosis of PFO. Conclusion: TCCS and TCD had an excellent agreement. TCCS has a good accuracy for the detection of PFO and RLS in young patients with stroke

A doença cardiovascular aterosclerótica é a principal causa de morte no hemisfério ocidental, portanto também no Brasil. A detecção não invasiva da aterosclerose é fundamental para prevenção. Objetivos: Correlacionar os fatores de risco (escore de Framingham), o perfil lipídico, a PCR-us, a espessura da íntima-média da carótida, a função endotelial, o índice tornozelo-braquial e o escore de cálcio pela tomografia computadorizada, com a extensão da doença coronariana determinada pelo índice de Friesinger, na cinecoronariografia. Casuística e métodos: Foram estudados 100 pacientes de ambos os sexos, com idade de 55,1±10,7 sendo 55% homens e 45% mulheres. Não foram incluídos pacientes com síndrome coronariana aguda, insuficiência renal dialítica, doença do colágeno e câncer. Todos se submeteram a avaliação clínica, laboratorial (glicemia, perfil lipídico e PCR-us), função endotelial da artéria braquial e ultrasonografia da artéria carótida por ultra-som de alta resolução, índice tornozelo-braquial e tomografia computadorizada coronária para determinação do escore de cálcio. Foram calculados o colesterol não HDL-c e a relação TG/HDL-c. Todos os pacientes foram submetidos à cinecoronariografia por indicação do médico assistente. Foram considerados normais pacientes sem lesão obstrutiva na cinecoronariografia. Resultados: Pela análise univariada, escore de cálcio (529,5 ± 930,9) um HDL-c (45,9±15,5), relação TG/HDL (5,5±9,2) e IMT (0,77±0,22) mostraram correlação significativa com o índice de Friesinger. Já por análise multivariada somente o escore de cálcio, relação TG/HDL-c aumentada e HDL-c baixo correlacionaram-se significativamente com a extensão da DAC. A PCR-s (3,4±3,5), LDL-c (122,8±51,5) e DMF (4,8±5,7) não se correlacionaram com o índice de Friensinger. Conclusão: Assim, é possível ter uma idéia aproximada da presença/extensão da DAC usando métodos não invasivos, especialmente escore de cálcio, relação TG/HDL-c e HDL-c baixo. / Background: Atherosclerotic cardiovascular disease is the leading cause of death in the western hemisphere including Brazil. Non-invasive detection of atherosclerosis is critical to prevention. Objectives: We correlated the risk factors (score of Framingham), lipid profile, PCR-us, carotid intima-media thickness, endothelial function, ankle-brachial index and calcium score by computed tomography with the extent of coronary disease determined by the Friesinger index, by coronary angiography. Methods: We studied 100 patients of both sexes, aged from 55.1 ± 10.7, 55% men and 45% women. Patients with acute coronary syndrome, renal dialitic, collagen disease and cancer were not included. All were submitted to clinical evaluation, laboratory (blood glucose, lipid profile and hs-CRP), endothelial function of brachial artery and ultra-sonography of carotid artery by high-resolution ultra-sound, ankle-brachial index and computed tomography for coronary determination of calcium score. We calculated the cholesterol not HDL-c and TG/HDL-c ratio. All patients were submitted to coronary angiography for indication by attending physician. We considered normal patients without obstructive lesion in coronary angiography. Results: By univariate analysis, calcium score, HDL-c, TG/HDL ratio and IMT showed significant correlation with Friesinger index. However, multivariate analysis only calcium score, increased TG/HDL-c and low HDL-c correlated significantly with the extension of the CAD. The hs-CRP, LDL-c and FMD, did not correlate Friensinger index. Conclusion: Thus, it is possible to have an approximate idea of the presence/extension of CAD by non-invasive methods, especially calcium score, TG/HDL-C ratio and HDL-c.