Rafael Kretzer Carneiro

Prof. Rafael Kretzer Carneiro


Research Focus & Metrics

Academic Career Length

7Years (2020-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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2 October 2023 in BMC Veterinary Research
Verified
Journal Article
Open access
PDF file
RCRafael Kretzer Carneiro
Rafael Kretzer Carneiro
ICIgor Cezar Kniphoff da Cruz
Igor Cezar Kniphoff da Cruz
BGBeatriz Gasser
Beatriz Gasser
BLBruna Lima
Bruna Lima
LALuiz Paulo Nogueira Aires
Luiz Paulo Nogueira Aires
MFMarcus Antônio Rossi Feliciano
Marcus Antônio Rossi Feliciano
Background: Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia.Methods: Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months.Results: It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA.Conclusions: ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.

1 June 2022 in Arquivo Brasileiro de Medicina Veterinária e Zootecnia
Verified
Journal Article
Open access
MMM.C. Maronezi
M.C. Maronezi
ASA.P.R. Simões
A.P.R. Simões
RURicardo Andrés Ramirez Uscategui
Ricardo Andrés Ramirez Uscategui
RCRafael Kretzer Carneiro
Rafael Kretzer Carneiro
BGB. Gasser
B. Gasser
MFMarcus Antônio Rossi Feliciano
Marcus Antônio Rossi Feliciano
In women, high-definition ultrasonography provides high-quality images of normal and diseased tissues throughout pregnancy, however there are no veterinary studies describing the use of this technology in pregnant dogs. The objective was to evaluate pregnant female dogs daily, using high-definition ultrasonography (HD) in brachycephalic, documenting daily findings of maternal-fetal structures. Twelve healthy brachycephalic females were evaluated daily by HD ultrasound until delivery. It was possible to identify and categorize all maternal, embryonic, and fetal structures and their development, including some fetal tissues not yet described in the literature. The HD exam is an excellent method to monitor the pregnancy of female dogs and identify structures early, providing safe and complete information regarding fetal development.

23 January 2020 in Acta Scientiae Veterinariae
Verified
Journal Article
Open access
PDF file
RCRafael Kretzer Carneiro
Rafael Kretzer Carneiro
MSMariana De Jesus De Souza
Mariana De Jesus De Souza
RBRafaela Scheer Bing
Rafaela Scheer Bing
MAMarcelo Meller Alievi
Marcelo Meller Alievi
MFMarcus Antônio Rossi Feliciano
Marcus Antônio Rossi Feliciano
MFMarcio Poletto Ferreira
Marcio Poletto Ferreira
Background: Patellar luxation is an alteration of bone development for which the indicated treatment is surgery. Failure to correct it may result in clinical worsening. The most commonly used surgical approach is the transposition of the tibial crest with trochleoplasty, which aims to accommodate 50% of the patella in the trochlea. The femoral groove and trochlea can be evaluated radiographically by tangential projection, tomography, or ultrasonography; however, all these methodologies have limitations. The objective of this study was to evaluate the depth of the trochlear groove in three regions and to compare it with the patellar diameter on simple mediolateral radiographic images. Materials, Methods & Results: Fifty non-paired pelvic limbs of adult dogs of a specific breed, weighing less than 40 kg and without orthopedic changes, were used. In the mediolateral radiographic projection, three evaluators measured the femoral trochlear sulcus at three different points and the patellar diameter. After imaging examinations, all limbs were skeletonized, and the trochlea and patella were measured with a digital caliper in the same regions as that of the radiographic measurements. All post-skeletonization calculations were performed by an evaluator. The highest mean radiographic and ex vivo trochlear depth was 3.4 ± 1.2 mm and 2.7 ± 0.8 mm, respectively. The lowest mean radiographic and ex vivo patellar diameter was 7.7 ± 1.7 mm and 7.9 ± 1.6 mm, respectively. The average relationship between the trochlear depth and patellar diameter was less than 50% in all animals, with the highest radiographically determined ratio being 44.15% and that determined ex vivo as 34.17%. The mean patellar diameter calculated radiographically was similar among the animals. Discussion: Radiographic images made it possible to assess the patella and bone surface regions of the femoral condyles. A wide arthrotomy is necessary to perform sulcoplasty, and a simple preoperative planning examination, which can facilitate the measurement of the trochlear sulcus, is important to correctly determine the procedure. The fragments evaluated after skeletonization and radiographic evaluations showed an average relationship between the trochlear depth and patellar diameter of less than 50%, thus indicating that sulcoplasty may not be necessary in animals with a ratio less than 50%. The radiographic measurements in this study used specific reference points that became more difficult to reproduce after skeletonization reducing the reliability of ex vivo data. A large variation in results was noted in each area of the measured groove, thus indicating that the trochlear measurements should be breed-specific and that it is necessary to reduce the amplitude and standardize the values. The depths in the postskeletonization limbs resulted in lower means than that obtained radiographically. Notably, articular cartilage cannot be measured using radiology; thus, image-based measurements can overestimate the trochlear parameters. Developing histopathological evaluations, determining cartilage thickness by race, and evaluating the association with measurements using imaging techniques can enhance the accuracy of the results. The methodology for measuring the diameter of the patella was radiographically reliable; however, the mean value obtained cannot be extrapolated to all animals. We thus recommend that this evaluation be standardized based on race and on a case-by-case basis. Based on the results obtained, there is wide variation in the depth of the trochlear groove in dogs. Trochleoplasty is important; however, it is essential that the surgeon determines whether this surgical trauma is necessary.

23 November 2022 in Acta Scientiae Veterinariae
Verified
Journal Article
Open access
PDF file
RCRafael Kretzer Carneiro
Rafael Kretzer Carneiro
ICIgor Cezar Kniphoff Da Cruz
Igor Cezar Kniphoff Da Cruz
BLBruna Lima
Bruna Lima
JNJosé Aloizio Gançalves Neto
José Aloizio Gançalves Neto
BGBeatriz Gasser
Beatriz Gasser
MFMarcus Antônio Rossi Feliciano
Marcus Antônio Rossi Feliciano
Background: Pelvic limb claudication is a common problem in dogs. However, determining the location of the lesion can be challenging. Diagnostic imaging is essential for identifying and evaluating muscle injuries. Ultrasonographic evaluation is frequently performed to identify muscle injuries. Although some muscle changes have already been described as ultrasonography findings in veterinary studies, little is known about the standardization of these muscle structures, especially in hip muscles. The objective of this study was to describe the normal ultrasound anatomy of the lateral and medial muscles of the pelvic limb and establish an unprecedented protocol for the evaluation of these structures.Materials, Methods & Results: A total of 4 lateral and 4 medial musculatures of the pelvic limb of dogs were evaluated using ultrasound. An initial ex vivo study (1st phase) was performed to delineate anatomical and ultrasonographic assessments. The 2nd experimental phase proceeded with the application of in vivo scanning. The same operator performed all anatomical and ultrasonographic assessments. The gluteus medius, vastus lateralis, tensor fasciae latae, sartorius, pectineus, gracilis, adductor, and rectus femoris muscles were evaluated in longitudinal and transverse planes. Ten paired hips from 5 cadavers consisting of 3 females (60%) and 2 males (40%) were evaluated during the ex vivo phase. The average age and weight of the dogs were 3.6 ± 0.87 years and 21.9 ± 5.2 kg, respectively. The in vivo study included 4 females (40%) and 6 males (60%), for a total of 10 healthy animals consisting of 20 hips; the mean weight was 30.11 ± 7.45 kg and the average age was 4.5 ± 2.75 years. All muscles maintained the same ultrasound pattern when compared with each other and between different groups in the in vivo study. The longitudinal section presented a hypoechoic structure permeated by thin hyperechoic longitudinal striations. The hypoechoic aspect was maintained, with striae identified as hyperechogenic points in the cross-sectional view.Discussion: B-mode ultrasonographic evaluation with a high-frequency transducer has facilitated the identification of the lateral and medial muscles of the pelvic limbs of medium and large dogs ex vivo and in vivo. This approach is an effective and safe way to access these muscles, and aids in the establishment of an unprecedented protocol for ultrasound evaluation of this region. Understanding the normal ultrasonographic anatomy is essential to identify muscle injuries such as contractures, tumors, ruptures, and stretch, which can lead to loss of muscle echogenicity and echotexture. Furthermore, ultrasound standardization reduces inter-observer error, facilitates technique reproducibility, assists in a more assertive assessment, and directs the patient's most appropriate therapy. In addition, anatomical dissection with the aid of acoustic gel injection into the evaluated musculature is essential to guide the examination because it allows the confirmation of the structures. In this study, the ultrasound scans of 6 fundamental muscles (gluteus medius, tensor fasciae latae, gracilis, adductor, pectineus, and rectus femoris) for hip mobility and 2 knee muscles (sartorius and vastus lateralis) were standardized. Ex vivo evaluations facilitated the application of in vivo techniques, and no difficulties were found during these evaluations. Keywords: canine, fundamental muscles, imaging, diagnosis, ultrasound, neoplasm.

30 August 2024 in Veterinary Research Communications
Verified
Journal Article
Closed access
PDF file
RCRafael Kretzer Carneiro
Rafael Kretzer Carneiro
AMAna Sofia Matos
Ana Sofia Matos
RGRafaela Della Giustina
Rafaela Della Giustina
KSKaio Augusto dos Santos
Kaio Augusto dos Santos
BRBárbara Corbellini Rovaris
Bárbara Corbellini Rovaris
AMAury Nunes de Moraes
Aury Nunes de Moraes

4 May 2022 in Acta Scientiae Veterinariae
Verified
Journal Article
Open access
GMGabriela Morais Madruga
Gabriela Morais Madruga
ICIgor Cezar Kniphoff da Cruz
Igor Cezar Kniphoff da Cruz
RCRafael Kretzer Carneiro
Rafael Kretzer Carneiro
MFMarcus Antônio Rossi Feliciano
Marcus Antônio Rossi Feliciano
MMMarjury Cristina Maronez
Marjury Cristina Maronez
EPEduardo Perlmann
Eduardo Perlmann
Background: Ocular lymphoma can affect the iris, conjunctiva, choroid, and retina and is mostly associated with multicentric disease. Elastography is an ultrasound technique that provides noninvasive, pain-free assessment of tissue stiffness. It has the ability to assess subtle changes throughout the organ as well as focal lesions. Microbubble contrast ultrasound enables the detection of incipient vascular flows, which are difficult to detect using traditional ultrasound methods. This study aimed to describe acoustic radiation force impulse (ARFI) elastography and microbubble contrast ultrasound findings in the eyes of two dogs diagnosed with intraocular T-cell lymphoma. Cases: Case 1. Physical examination revealed an exophytic mass in the left eye. Schirmer test revealed a secretion of 22 mm/min. Negative threat reflex, glare, direct pupillary light reflex, and consensual response were also noted. Biomicroscopy revealed hyperplasia of the third eyelid, overlapping with the affected eye. When the membrane was removed, moderate conjunctival hyperemia, mucoid secretion, and buphthalmia were observed. In addition, significant corneal edema was present, making it impossible to visualize the anterior chamber and perform fundus examination. The intraocular pressure, as measured with a rebound tonometer, was 39 mmHg. B-mode ultrasonography identified amorphous, hyperechoic, and heterogeneous structures throughout the anterior chamber, iris, and ciliary body. The elastogram showed that the mass had greenish tones and intermediate stiffness, and the mean SWV of the ciliary body and iris was 2 m/s. Contrast-enhanced ultrasound (CEUS) revealed vascularization of the neoformation region, with wash-in, peak, and wash-out values of 9.89 s, 24.56 s, and 107.87 s, respectively. Case 2. On physical examination, a change in the shape of the right pupil was observed. Schirmer test revealed a secretion of 20 mm/min, with negative threat, glare, and pupillary reflexes to direct and consensual light. Biomicroscopy revealed neoformation from 7 am to 11 am in the sclera, retina, and choroid complex, concomitant with dyscoria and conjunctival hyperemia. The intraocular pressure, as measured by rebound tonometry, was 33 mmHg. Fundoscopy revealed a mass in the temporal region and focal retinal detachment. No changes were observed in the contralateral eye. B-mode ultrasound revealed an increase in volume in the temporal region of the iris, ciliary body, and choroid with diffuse heterogeneity and partial retinal detachment. Elastographic examination revealed shades of green and yellow compatible with increased tissue stiffness. On quantitative examination, the mean SWVs of the ciliary body and iris were 3.14 m/s. On CEUS, the neoformation region presented wash-in, peak, and wash-out values of 8.67 s, 22.33 s, and 80.20 s. Discussion: B-mode ultrasonography established the tumor extent and evaluated echogenicity, verifying the involved ocular structures. The examination played an important role in the diagnosis as well as clinical management. ARFI elastography can detect small tissue changes, helping to define nodules and masses more reliably, in addition to allowing the verification of tissue stiffness. In both dogs, it was possible to verify that the masses presented greater rigidity than the adjacent tissues both qualitatively and quantitatively. In previous studies, it was found that cutaneous and breast lymphomas in humans were more rigid than adjacent tissues on elastography. This increase in rigidity and heterogeneity observed on elastograms can be explained by the extramedullary interactions of the matrix in T-cell lymphomas. Tumor growth is dependent on the blood supply, which was evaluated using CEUS in these cases. Furthermore, the ciliary body contrast filling times were longer than those described in normal dogs. Keywords: eye, surgery, diagnostic imaging, pain, veterinary ophthalmology, neoplasia. Título: Linfoma intraocular em cães - achados da ultrassonografia contrastada e elastografia ARFI Descritores: olho, cirurgia, diagnóstico por imagem, dor, oftlamologia veterinária, neoplasia.