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Lassoued Ferjani H, Kharrat L, Ben Nessib D, Kaffel D, Maatallah K, Hamdi W. Does sacroiliitis is a mandatory criterion for enthesitis-related arthritis diagnosis? Reumatol Clin (Engl Ed) 2024; 20:187-192. [PMID: 38644029 DOI: 10.1016/j.reumae.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 04/23/2024]
Abstract
INTRODUCTION AND OBJECTIVES Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA). We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients. MATERIALS AND METHODS We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype. RESULTS ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1=16 versus G2=3, p=0.005). Sacroiliac joints MRI's sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68-28.09; p=0.006). CONCLUSION Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.
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Affiliation(s)
- Hanene Lassoued Ferjani
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia; Research Unit UR17SP04, Ksar Saïd, 2010 Tunis, Tunisia
| | - Lobna Kharrat
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia.
| | - Dorra Ben Nessib
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia; Research Unit UR17SP04, Ksar Saïd, 2010 Tunis, Tunisia
| | - Dhia Kaffel
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia; Research Unit UR17SP04, Ksar Saïd, 2010 Tunis, Tunisia
| | - Kaouther Maatallah
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia; Research Unit UR17SP04, Ksar Saïd, 2010 Tunis, Tunisia
| | - Wafa Hamdi
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia; Research Unit UR17SP04, Ksar Saïd, 2010 Tunis, Tunisia
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Merino-Rueda LR, Casas-Ramos P, Honrado-Franco E, Izquierdo-García FM, Ramos-Pascua LR. [Translated article] Comparative study of deep lipomas and atypical lipomatous tumours: Malignancy risk factors. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024:S1888-4415(24)00067-5. [PMID: 38508379 DOI: 10.1016/j.recot.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD Observational, longitudinal and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0mm was used as a predictor of malignancy. CONCLUSIONS Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.
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Affiliation(s)
- L R Merino-Rueda
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz, Madrid, Spain.
| | - P Casas-Ramos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de León, León, Spain
| | - E Honrado-Franco
- Servicio de Anatomía Patológica, Hospital Universitario de León, León, Spain
| | | | - L R Ramos-Pascua
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Mayo-Juanatey A, García-Ferrer L, Ballester-Suárez A, Valls-Pascual E, Vázquez-Gómez I, Alegre-Sancho JJ. Ischiofemoral impingement syndrome: A five-case series report. Reumatol Clin (Engl Ed) 2024; 20:162-165. [PMID: 38443229 DOI: 10.1016/j.reumae.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/21/2023] [Indexed: 03/07/2024]
Abstract
Gluteal pain is a frequent cause of medical attention in the daily clinical practice. It can be caused by multiple pathologies, being ischiofemoral impingement syndrome among those included in its differential diagnosis. Encompassed within the deep gluteal syndromes, this entity occurs as a consequence of the entrapment of the neuromuscular structures between the lesser femoral trochanter and the ischial tuberosity, causing pain in the root of the lower limb, with irradiation towards the thigh or the gluteal region and poor tolerance to deambulation and sedestation. The magnetic resonance imaging of the hip is fundamental for its diagnosis, and its management consists on medical treatment at onset. Despite not being a frequent diagnosis in the clinical practice in Rheumatology, keeping it in mind helps improving its prognosis by establishing an early and adequate treatment.
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Affiliation(s)
| | - Luís García-Ferrer
- Servicio de Radiodiagnóstico, Hospital Universitari Doctor Peset. Valencia. Spain
| | | | - Elia Valls-Pascual
- Servicio de Reumatología, Hospital Universitari Doctor Peset. Valencia, Spain
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4
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Ortiz de Mendivil A, Martín-Medina P, García-Cañamaque L, Jiménez-Munarriz B, Ciérvide R, Diamantopoulos J. Challenges in radiological evaluation of brain metastases, beyond progression. Radiologia (Engl Ed) 2024; 66:166-180. [PMID: 38614532 DOI: 10.1016/j.rxeng.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/02/2023] [Indexed: 04/15/2024]
Abstract
MRI is the cornerstone in the evaluation of brain metastases. The clinical challenges lie in discriminating metastases from mimickers such as infections or primary tumors and in evaluating the response to treatment. The latter sometimes leads to growth, which must be framed as pseudo-progression or radionecrosis, both inflammatory phenomena attributable to treatment, or be considered as recurrence. To meet these needs, imaging techniques are the subject of constant research. However, an exponential growth after radiotherapy must be interpreted with caution, even in the presence of results suspicious of tumor progression by advanced techniques, because it may be due to inflammatory changes. The aim of this paper is to familiarize the reader with inflammatory phenomena of brain metastases treated with radiotherapy and to describe two related radiological signs: "the inflammatory cloud" and "incomplete ring enhancement", in order to adopt a conservative management with close follow-up.
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Affiliation(s)
- A Ortiz de Mendivil
- Servicio de Radiodiagnóstico, Sección de Neurorradiología, Hospital Universitario HM Sanchinarro, Madrid, Spain.
| | - P Martín-Medina
- Servicio de Radiodiagnóstico, Sección de Neurorradiología, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | | | - B Jiménez-Munarriz
- Servicio de Oncología Médica, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - R Ciérvide
- Servicio de Oncología Radioterápica, Hospital Universitario HM Sanchinarro, Madrid, Spain
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5
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Merino-Rueda LR, Casas-Ramos P, Honrado-Franco E, Izquierdo-García FM, Ramos-Pascua LR. Comparative study of deep lipomas and atypical lipomatous tumours: Malignancy risk factors. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024:S1888-4415(24)00026-2. [PMID: 38199434 DOI: 10.1016/j.recot.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD Observational, longitudinal, and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0 mm was used as a predictor of malignancy. CONCLUSIONS Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.
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Affiliation(s)
- L R Merino-Rueda
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz, León, Madrid, España.
| | - P Casas-Ramos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de León, León, España
| | - E Honrado-Franco
- Servicio de Anatomía Patológica, Hospital Universitario de León, León, España
| | | | - L R Ramos-Pascua
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
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Miranda Bautista J, Garrido Morro I, Fernández García P, Herrera Herrera I. FLAIR hyperintensity in the subarachnoid space: Main differentials. Radiologia (Engl Ed) 2024; 66:78-89. [PMID: 38365357 DOI: 10.1016/j.rxeng.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/21/2022] [Indexed: 02/18/2024]
Abstract
The fluid-attenuated inversion recovery (FLAIR) sequence forms part of the vast majority of current diagnostic protocols for brain MRI. This sequence enables the suppression of the signal from cerebrospinal fluid, facilitating the detection of disease involving the subarachnoid space. The causes of hyperintensity in the arachnoid space in this sequence can be divided into two main categories: hyperintensity due to disease and hyperintensity due to artifacts. Hyperintensity due to tumors, inflammation, vascular disease, or hypercellularity of the cerebrospinal fluid or hematic contents is well known. However, numerous other non-pathological conditions, mainly due to artifacts, that are also associated with this finding are a potential source of diagnostic errors.
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Affiliation(s)
| | - I Garrido Morro
- Servicio de Radiodiagnóstico, HGU Gregorio Marañón, Madrid, Spain
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7
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Mora-Boga R, Díaz Recarey ME, Salvador de la Barrera S, Ferreiro Velasco ME, Rodríguez Sotillo A, Montoto Marqués A. [Neurological evolution in traumatic spinal cord injury according to the size of the intraparenchymal hemorrhage]. Rehabilitacion (Madr) 2024; 58:100819. [PMID: 37862776 DOI: 10.1016/j.rh.2023.100819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION AND OBJECTIVES The presence of spinal cord hemorrhage is considered as a poor prognostic factor in traumatic spinal cord injury (SCI). However, it has been suggested in published works that the prognosis of small hemorrhages is not so negative. The aim of this paper is to assess the neurological evolution in individuals with intraparenchymal hemorrhage according to its size. MATERIAL AND METHODS Retrospective observational study. Selected all the patients admitted for acute traumatic SCI between 2010 and 2018 with early magnetic resonance study and spinal cord hemorrhage. Two groups were established depending on the size of the bleeding: microhemorrhages (less than 4mm) and macrohemorrhages (greater than 4mm). The neurological examination at admission and discharge was compared according to the AIS grade and the motor score (MS). RESULTS Forty-six cases collected, 17 microhemorrhages and 29 macrohemorrhages. 70.6% of the microhemorrhages were AIS A while among macrohemorrhages the percentage was 89.6%. At the time of discharge, an improvement in the AIS grade was observed in 40.0% of the microhemorrhages compared to 4.0% of the macrohemorrhages (P=.008). Initial MS was similar, 45.2±22.2 in the microhemorrhages and 40.9±20.4 in the macrohemorrhages (P=.459), but at discharge it was higher in the first group: 60.4±20.5 for 42.7±22.8 (P=.033). Eight patients (17.4%) died during admission. CONCLUSIONS There is a relationship between the size of the intraparenchymal hemorrhage and the neurological prognosis of SCI, with hemorrhages smaller than 4mm presenting a better evolution.
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Affiliation(s)
- R Mora-Boga
- Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España.
| | - M E Díaz Recarey
- Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España
| | - S Salvador de la Barrera
- Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España
| | - M E Ferreiro Velasco
- Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España
| | - A Rodríguez Sotillo
- Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España; Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidad de A Coruña, A Coruña, España
| | - A Montoto Marqués
- Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España; Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidad de A Coruña, A Coruña, España
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García de Andoin Sojo C, Gómez Muga JJ, Aza Martínez I, Antón Méndez L, Fornell Pérez R. Inflammatory lesions of the brainstem: Keys for the diagnosis by MRI. Radiologia (Engl Ed) 2024; 66:32-46. [PMID: 38365353 DOI: 10.1016/j.rxeng.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/15/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To describe the magnetic resonance imaging (MRI) findings for the most common inflammatory and immune-mediated diseases that involve the brainstem. CONCLUSION Inflammatory lesions involving the brainstem are associated with a wide range of autoimmune, infectious, and paraneoplastic syndromes, making the differential diagnosis complex. Being familiar with these entities, their clinical characteristics, and their manifestations on MRI, especially the number of lesions, their shape and extension, and their appearance in different sequences, is useful for orienting the radiological diagnosis.
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Affiliation(s)
| | - J J Gómez Muga
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Spain
| | - I Aza Martínez
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Spain
| | - L Antón Méndez
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Spain
| | - R Fornell Pérez
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Spain
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Reddy Bursapalle M, Valakkadaa J, Ayappan A. Role of intravoxel incoherent motion (IVIM) imaging in response assessment of hepatocellular carcinoma after transarterial chemoembolization (TACE) - A prospective study. Radiologia (Engl Ed) 2024; 66:23-31. [PMID: 38365352 DOI: 10.1016/j.rxeng.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 07/13/2022] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Response evaluation of hepatocellular carcinoma (HCC) currently is based on arterial phase enhancement which doesn't take into microstructural changes in the tumor after trans-arterial chemoembolization (TACE). AIM This prospective study was conducted to assess the feasibility and efficacy of intravascular incoherent motion imaging (IVIM) in response evaluation of HCC after TACE. 39 cirrhotic patients with 48 HCC underwent MR imaging 1 week within and 6weeks after TACE. IVIM parameters like Dslow (true diffusion), Dfast (pseudodiffusion), perfusion fraction and ADC were measured prior to and postTACE. The pre and post TACE values in LR-TR (LIRADS - treatment response) nonviable and viable lesions were compared using paired t-tests. ROC curve analysis was done to calculate sensitivity and specificity and propose cut-off values. RESULT Non-viable lesions showed a significant increase in Dslow (1.208 ± 0.581 vs 1.560 ± 0.494, P-value -.0207) and ADC (1.37 ± 0.53 vs 1.65 ± 0.4287, P value .016) after TACE. There was also significant decrease in Dfast (33.7 ± 10.4 vs 23.75 ± 12.13, P value .0005) and f (19.92 ± 10.54 vs 12.9 ± 10.41, P value .012) values after TACE in non-viable lesions compared to viable lesions. The change in true diffusion had the highest AUC (0.741) among IVIM parameters with greater than 0.075 increase between preTACE and postTACE values having a sensitivity and specificity of 81.8% and 60% respectively for complete response. CONCLUSION IVIM imaging is feasible to assess the response in HCC after TACE. True diffusion is more sensitive and specific than apparent diffusion in evaluating the response.
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Affiliation(s)
- M Reddy Bursapalle
- Departamento de Ciencias de la Imagen y Radiología Intervencionista, Instituto Sreechitra de Ciencias Médicas y Tecnología, Trivandrum, India
| | - J Valakkadaa
- Departamento de Ciencias de la Imagen y Radiología Intervencionista, Instituto Sreechitra de Ciencias Médicas y Tecnología, Trivandrum, India.
| | - A Ayappan
- Departamento de Ciencias de la Imagen y Radiología Intervencionista, Instituto Sreechitra de Ciencias Médicas y Tecnología, Trivandrum, India
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Moradi B, Azadbakht J, Sarmadi S, Gity M, Shirali E, Azadbakht M. Placenta accreta spectrum in early and late pregnancy from an imaging perspective. A scoping review. Radiologia (Engl Ed) 2023; 65:531-545. [PMID: 38049252 DOI: 10.1016/j.rxeng.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/11/2023] [Indexed: 12/06/2023]
Abstract
Placenta accreta spectrum (PAS) disorders (with increasing order of the depth of invasion: accreta, increta, percreta) are quite challenging for the purpose of diagnosis and treatment. Pathological examination or imaging evaluation are not very dependable when considered as stand-alone diagnostic tools. On the other hand, timely diagnosis is of great importance, as maternal and fetal mortality drastically increases if patient goes through the third phase of delivery in a not well-suited facility. A multidisciplinary approach for diagnosis (incorporating clinical, imaging, and pathological evaluation) is mandatory, particularly in complicated cases. For imaging evaluation, the diagnostic modality of choice in most scenarios is ultrasound (US) exam; patients are referred for MRI when US is equivocal, inconclusive, or not visualizing placenta properly. Herewith, we review the reported US and MRI features of PAS disorders (mainly focusing on MRI), going over the normal placental imaging and imaging pitfalls in each section, and lastly, covering the imaging findings of PAS disorders in the first trimester and cesarean section pregnancy (CSP).
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Affiliation(s)
- B Moradi
- Departamento de Radiología, Hospital General Yas, Universidad de Ciencias Médicas de Teherán, Teheran, Iran; Departamento de Radiología, Centro de Investigación de Diagnóstico Avanzado y Radiología Intervencionista (ADIR), Centro de Imagen Médica, Complejo Hospitalario Imán Jomeini, Universidad de Ciencias Médicas de Teherán, Teheran, Iran
| | - J Azadbakht
- Departamento de Radiología, Facultad de Medicina, Universidad de Ciencias Médicas de Kashan, Kashan, Iran.
| | - S Sarmadi
- Departamento de Patología, Hospital General Yas, Universidad de Ciencias Médicas de Teherán, Teheran, Iran
| | - M Gity
- Departamento de Radiología, Hospital General Yas, Universidad de Ciencias Médicas de Teherán, Teheran, Iran; Departamento de Radiología, Centro de Investigación de Diagnóstico Avanzado y Radiología Intervencionista (ADIR), Centro de Imagen Médica, Complejo Hospitalario Imán Jomeini, Universidad de Ciencias Médicas de Teherán, Teheran, Iran
| | - E Shirali
- Departamento de Oncología Ginecológica, Hospital General Yas, Universidad de Ciencias Médicas de Teherán, Teheran, Iran
| | - M Azadbakht
- Escuela de Farmacología, Universidad de Ciencias Médicas de Shiraz, Shiraz, Iran
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Montoya-Bordón J, Elvira-Ruiz P, Carriazo-Jiménez B, Robles-Blanco C, Pereiro-Montbrun F, Rodríguez-Fernández C. Imaging diagnosis of vertebral metastasis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:511-522. [PMID: 37209915 DOI: 10.1016/j.recot.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 05/22/2023] Open
Abstract
The spine is the third most frequent location for metastatic disease, after the lung and liver. On the other hand, the most frequent bone tumors are metastases and the spine is the main location. A review of the different imaging techniques available, both radiological and nuclear medicine, and the morphological appearance of spinal metastases in each of them is performed. Magnetic resonance imaging is the best imaging modality for detection of spinal metastases. It is important to make the differential diagnosis between vertebral fracture of osteoporotic and pathological cause. Spinal cord compression is a serious complication of metastatic disease and its assessment by imaging through objective scales is decisive for estimating spinal stability and therefore establishing treatment. Lastly, percutaneous intervention techniques are briefly discussed.
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Affiliation(s)
- J Montoya-Bordón
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
| | - P Elvira-Ruiz
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - B Carriazo-Jiménez
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - C Robles-Blanco
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - F Pereiro-Montbrun
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - C Rodríguez-Fernández
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
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12
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Montoya-Bordón J, Elvira-Ruiz P, Carriazo-Jiménez B, Robles-Blanco C, Pereiro-Montbrun F, Rodríguez-Fernández C. [Translated article] Imaging diagnosis of vertebral metastasis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:S511-S522. [PMID: 37541345 DOI: 10.1016/j.recot.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/12/2023] [Indexed: 08/06/2023] Open
Abstract
The spine is the third most frequent location for metastatic disease, after the lung and liver. On the other hand, the most frequent bone tumours are metastases and the spine is the main location. A review of the different imaging techniques available, both radiological and nuclear medicine, and the morphological appearance of spinal metastases in each of them is performed. Magnetic resonance imaging is the best imaging modality for detection of spinal metastases. It is important to make the differential diagnosis between vertebral fracture of osteoporotic and pathological cause. Spinal cord compression is a serious complication of metastatic disease and its assessment by imaging through objective scales is decisive for estimating spinal stability and therefore establishing treatment. Lastly, percutaneous intervention techniques are briefly discussed.
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Affiliation(s)
- J Montoya-Bordón
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
| | - P Elvira-Ruiz
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - B Carriazo-Jiménez
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - C Robles-Blanco
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - F Pereiro-Montbrun
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - C Rodríguez-Fernández
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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13
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López-Gómez J, Sacristán Enciso B, Caro Miró MA, Querol Pascual MR. Clinically isolated syndrome: Diagnosis and risk of developing clinically definite multiple sclerosis. Neurologia 2023; 38:663-670. [PMID: 37858891 DOI: 10.1016/j.nrleng.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/01/2021] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION In most cases, multiple sclerosis (MS) initially presents as clinically isolated syndrome (CIS). Differentiating CIS from other acute or subacute neurological diseases and estimating the risk of progression to clinically definite MS is essential since presenting a second episode in a short time is associated with poorer long-term prognosis. DEVELOPMENT We conducted a literature review to evaluate the usefulness of different variables in improving diagnostic accuracy and predicting progression from CIS to MS, including magnetic resonance imaging (MRI) and such biofluid markers as oligoclonal IgG and IgM bands, lipid-specific oligoclonal IgM bands in the CSF, CSF kappa free light-chain (KFLC) index, neurofilament light chain (NfL) in the CSF and serum, and chitinase 3-like protein 1 (CHI3L1) in the CSF and serum. CONCLUSIONS Codetection of oligoclonal IgG bands and MRI lesions reduces diagnostic delays and suggests a high risk of CIS progression to MS. A KFLC index > 10.6 and CSF NfL concentrations > 1150 ng/L indicate that CIS is more likely to progress to MS within one year (40%-50%); 90% of patients with CIS and serum CHI3L1 levels > 33 ng/mL and 100% of those with lipid-specific oligoclonal IgM bands present MS within one year of CIS onset.
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Affiliation(s)
- J López-Gómez
- Unidad de Proteínas, Servicio de Análisis Clínicos, Hospital Universitario de Badajoz, Badajoz, Spain.
| | - B Sacristán Enciso
- Sección de Proteínas y Autoinmunidad, Servicio de Análisis Clínicos, Hospital de Mérida, Badajoz, Spain
| | - M A Caro Miró
- Servicio de Análisis Clínicos, Hospital Universitario de Badajoz, Badajoz, Spain
| | - M R Querol Pascual
- Servicio de Neurología, Hospital Universitario de Badajoz, Badajoz, Spain
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14
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Karsenty C, Alattar Y, Mousseaux E, Marcilhacy G, Gencer U, Craiem D, Iserin L, Ladouceur M, Legendre A, Laredo M, Bonnet D, Malekzadeh-Milani S, Soulat G. 4D flow magnetic resonance imaging to assess right ventricular outflow tract in patients undergoing transcatheter pulmonary valve replacement. Rev Esp Cardiol (Engl Ed) 2023; 76:793-802. [PMID: 36921915 DOI: 10.1016/j.rec.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES Magnetic resonance imaging (MRI) including 4D flow is used before percutaneous pulmonary valve implantation (PPVI). As PPVI is limited by the size of the right ventricular outflow tract (RVOT), accurate sizing is needed to plan the intervention. The aim of this study was to compare different MRI modalities and invasive angiography to balloon sizing of RVOT. METHODS Single-center prospective study of patients who underwent PPVI for isolated pulmonary regurgitation assessed by 4D flow MRI, 3D steady-state free precession/gradient echo (3D SSFP/GRE) and contrast magnetic resonance angiography. Balloon sizing was considered as the reference. RESULTS A total of 23 adults were included (mean age, 38.4±12.5 years). Eighteen patients underwent successful primary PPVI. The average of the narrowest RVOT diameter was 25.4±4.3 mm by balloon sizing. Compared to balloon sizing, RVOT diameters were better correlated when estimated by systolic 4D flow MRI (r=0.89, P<.001) than by diastolic 4D flow MRI (r=0.71, P <.001), 3D contrast magnetic resonance angiography (r=0.73; P <.001) and 3D SSFP/GRE (r=0.50; P=.04) and was not significantly correlated when estimated by 2D in diastole and systole. The mean difference between systolic 4D flow MRI and balloon sizing was 0.2 mm (95%CI, -3.5 to 3.9 mm), whereas it was wider with other techniques. CONCLUSIONS Beyond the quantification of pulmonary valve regurgitation, 4D flow allows accurate estimation of RVOT diameters, especially in systole, which is fundamental before planning PPVI.
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Affiliation(s)
- Clément Karsenty
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Pediatric and Congenital Cardiology, Children's Hospital, CHU Toulouse, Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Toulouse, France; Adult Congenital Cardiology Department, Clinique Pasteur, Toulouse, France.
| | - Yousef Alattar
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Elie Mousseaux
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Gabrielle Marcilhacy
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Umit Gencer
- Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Damian Craiem
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Laurence Iserin
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Magalie Ladouceur
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Antoine Legendre
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Mikael Laredo
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Institut de Cardiologie, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Damien Bonnet
- Pediatric and Congenital Department, M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France; Institut IMAGINE, Université de Paris, Paris, France
| | - Sophie Malekzadeh-Milani
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Pediatric and Congenital Department, M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France
| | - Gilles Soulat
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
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15
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Serra Del Carpio G, Tapia Viñé M, Torena N, Bernabeu Taboada D. Chronic expanding hematoma. Radiologia (Engl Ed) 2023; 65 Suppl 2:S78-S82. [PMID: 37858357 DOI: 10.1016/j.rxeng.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/06/2022] [Indexed: 10/21/2023]
Abstract
Chronic expansive hematoma (CEH) is a rare lesion, characterized by the persistence and increase in size of an hematoma for a period greater than one month since the initial hemorrhage. The clinical importance of this pathology is due to the fact that it can simulate malignant soft tissue neoplasms, both clinically as a result of its progressive growth and radiologically for its findings in imaging studies. This article will review three cases of CEH in different scenarios, explaining the radiological findings in different imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and PET-CT.
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Affiliation(s)
| | - M Tapia Viñé
- Servicio de Radiología, Hospital Universitario La Paz, Madrid, Spain
| | - N Torena
- Servicio de Radiología, Hospital Universitario La Paz, Madrid, Spain
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16
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Vieira E Brito D, Fereira A, Pereira J, Pereira-Lourenço M, Godinho R, Pereira B, Peralta P, Conceiçao P, Reis Mario A, Paula Rabaça C. Prior MRI-imaging impact of patients submitted to brachytherapy for prostate cancer. Actas Urol Esp 2023; 47:503-508. [PMID: 37086843 DOI: 10.1016/j.acuroe.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 04/24/2023]
Abstract
INTRODUCTION Brachytherapy for the treatment of prostate cancer is a well-established option. Use of Multiparametric Magnetic Resonance Imaging (mpMRI) for staging and diagnosis of prostate cancer has come to change the current paradigm. In this study we aim to assess the impact of performing mpMRI to evaluate the presence of extracapsular lesions before brachytherapy in patients with prostate cancer concerning biochemical recurrence and time to nadir. METHODS Review data from 73 patients submitted to brachytherapy. The following factors were evaluated: age, initial PSA, MRI local staging results, ISUP, nadir, time to nadir, PSA at one-year, biochemical recurrence, and time to recurrence. RESULTS Median age was 68 years (51-72) and median follow-up 53 months (30-72). Concerning imaging modality 30,1% (n = 22) patients performed mpMRI. In the mpMRI group, 90.9% (n = 20) had at least one suspect lesion on mpMRI. Time to nadir was 27 months (3-64) in patients where mpMRI was not performed and 23.5 months (2-48) in patients submitted to mpMRI (P = .244). The median value of nadir was 0.42 ng/mL (<0.001-2) in patients submitted to mpMRI and vs 0.28 ng/mL (<0.001-4) in patients without MRI (P = .062) Recurrence utilizing Phoenix criteria was 9% (n = 2) in patients with MRI and 9.2% (n = 5) without mpMRI (P = .456), median follow-up of 43 months (12-72) for the MRI group with 58 months (30-78) for the non-mpMRI group. Both groups were statistically similar. CONCLUSION Our results allow us to conclude that in our series MRI did not influence biochemical recurrence, time to nadir, or nadir value.
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Affiliation(s)
- D Vieira E Brito
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal.
| | - A Fereira
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - J Pereira
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - M Pereira-Lourenço
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - R Godinho
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - B Pereira
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - P Peralta
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - P Conceiçao
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
| | - A Reis Mario
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal; Servicio de Radioterapia, Instituto Portugués de Oncología, Coimbra, Portugal
| | - C Paula Rabaça
- Servicio de Urología, Instituto Portugués de Oncología, Coimbra, Portugal
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17
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Encinas Tobajas VM, Almeida González C, Marcilla D, Vallejo M, Cano Rodríguez A, Reina Sánchez de Movellán JI, Morales Pérez JM. Myxoid liposarcoma: MRI features with histological correlation. Radiologia (Engl Ed) 2023; 65 Suppl 2:S23-S32. [PMID: 37858349 DOI: 10.1016/j.rxeng.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 01/30/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Myxoid liposarcoma is classified in the group of sarcomas with adipose differentiation, which is the second most common group of sarcomas. However, myxoid liposarcoma is not a homogeneous entity, because the behavior and clinical course of these tumours can vary widely. This study aimed to describe the magnetic resonance imaging (MRI) features of myxoid liposarcomas and to determine whether the MRI features are associated with the histologic grade and can differentiate between low-grade and high-grade tumours and thus help in clinical decision making. MATERIAL AND METHODS We studied 36 patients with myxoid liposarcomas treated at our centre between 2010 and 2018. We analysed clinical variables (age, sex, and tumour site) and MRI features (size, depth, borders, fatty component, myxoid component, non-fatty/non-myxoid component, apparent diffusion coefficient (ADC), and type of enhancement after the administration of intravenous contrast material). We correlated the MRI features with the histologic grade and the percentage of round cells. RESULTS In our series, patients with myxoid liposarcomas were mainly young adults (median age, 43 years). There were no differences between sexes; 97.2% were located in the lower limbs, 86.1% were deep, and 77.8% had well-defined borders. Of the 23 myxoid liposarcomas that contained no fat, 16 (69.6%) were high grade (p = 0.01). All the tumors with a myxoid component of less than 25% were high grade (p = 0.01); 83.3% of those with a non-fatty/non-myxoid component greater than 50% were high grade (p = 0.03) and 61.5% had more than 5% round cells (p = 0.01). Diffusion sequences were obtained in 14 of the 36 patients; ADC values were high (median, 2 × 10-3 mm2/s), although there were no significant associations between low-grade and high-grade tumours. Contrast-enhanced images were available for 30 (83.3%) patients; 83.3% of the tumours with heterogeneous enhancement were high grade (p = 0.01). CONCLUSIONS MRI can be useful for differentiating between high- and low-grade myxoid liposarcomas and can help in clinical decision making.
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Affiliation(s)
- V M Encinas Tobajas
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - C Almeida González
- Unidad de Bioestadística, Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - D Marcilla
- Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Vallejo
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Cano Rodríguez
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - J M Morales Pérez
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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18
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Iglesias-Hidalgo G, Lopez-Maseda A, Zaldumbide-Dueñas L, Canteli-Padilla B. Granular cell tumor of soft tissues: MR findings. Radiologia (Engl Ed) 2023; 65 Suppl 2:S83-S87. [PMID: 37858358 DOI: 10.1016/j.rxeng.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/15/2022] [Indexed: 10/21/2023]
Abstract
Granular cell tumors (GrCT) are histologically unique neoplasms that often manifest as painless solitary nodules located in the dermis or submucosal tissue. In this article we analyze the radiologic features of this type of tumor in five patients by magnetic resonance imaging (MRI), analyzing morphologic and signal characteristics. MR imaging findings were similar to other publications and we demonstrate low ADC values in our series.
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Affiliation(s)
- G Iglesias-Hidalgo
- Servicio de Radiodiagnóstico, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain.
| | - A Lopez-Maseda
- Servicio de Radiodiagnóstico, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | - L Zaldumbide-Dueñas
- Servicio de Anatomía Patológica, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | - B Canteli-Padilla
- Servicio de Radiodiagnóstico, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
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19
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Martel Villagrán J, Martínez-Sánchez RT, Cebada-Chaparro E, Bueno Horcajadas AL, Pérez-Fernández E. Diagnostic accuracy of lumbar CT and MRI in the evaluation of chronic low back pain without red flag symptoms. Radiologia (Engl Ed) 2023; 65 Suppl 2:S59-S70. [PMID: 37858354 DOI: 10.1016/j.rxeng.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/01/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Low back pain (LBP) is one of the most frequent reasons for medical consultation. Most of the patients will have nonspecific LBP, which usually are self-limited episodes. It is unclear which of the diagnostic imaging pathways is most effective and costeffective and how the imaging impacts on patient treatment. Imaging techniques are usually indicated if symptoms remain after 6 weeks. Magnetic resonance imaging (MRI) is the diagnostic imaging examination of choice in lumbar spine evaluation of low back pain; however, availability of MRI is limited. OBJECTIVES To evaluate the diagnostic accuracy of computed tomography (CT) with MRI (as standard of reference) in the evaluation of chronic low back pain (LBP) without red flags symptoms. To compare the results obtained by two radiologists with different grades of experience. MATERIALS AND METHODS Patients with chronic low back pain without red flags symptoms were retrospectively reviewed by two observers with different level of experience. Patients included had undergone a lumbar or abdominal CT and an MRI within a year. Once the radiological information was collected, it was then statistically reviewed. The aim of the statistical analysis is to identify the equivalence between both diagnostic techniques. To this end, sensitivity, specificity and validity index were calculated. In addition, intra and inter-observer reliability were measured by Cohen's kappa values and also using the McNemar test. RESULTS 340 lumbar levels were evaluated from 68 adult patients with chronic low back pain or sciatica. 63.2% of them were women, with an average age of 60.3 years (SD 14.7). CT shows high values of sensitivity and specificity (>80%) in most of the items evaluated, but sensitivity was low for the evaluation of density of the disc (40%) and for the detection of disc herniation (55%). Moreover, agreement between MRI and CT in most of these items was substantial or almost perfect (Cohen's kappa-coefficient > 0'8), excluding Modic changes (kappa = 0.497), degenerative changes (kappa0.688), signal of the disc (kappa = 0.327) and disc herniation (kappa = 0.639). Finally, agreement between both observers is mostly high (kappa > 0.8). Foraminal stenosis, canal stenosis and the grade of the canal stenosis were overdiagnosed by the inexperienced observer in the evaluation of CT images. CONCLUSIONS AND SIGNIFICANCE CT is as sensitive as lumbar MRI in the evaluation of most of the items analysed, excluding Modic changes, degenerative changes, signal of the disc and disc herniation. In addition, these results are obtained regardless the experience of the radiologist. The rising use of diagnostic medical imaging and the improvement of image quality brings the opportunity of making a second look of abdominal CT in search of causes of LBP. Thereby, inappropriate medical imaging could be avoided (2). In addition, it would allow to reduce MRI waiting list and prioritize other patients with more severe pathology than LBP.
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Affiliation(s)
- J Martel Villagrán
- Radiología musculoesquelética, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - E Cebada-Chaparro
- Radiología musculoesquelética, Hospital Universitario de Cáceres, Cáceres, Spain
| | - A L Bueno Horcajadas
- Radiología musculoesquelética, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - E Pérez-Fernández
- Metodología de la Investigación, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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20
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Alemán Millares R, Santos Armentia E, Del Campo Estepar S, Novoa Ferro M. Medication-related osteonecrosis of the jaw: the radiologist's role. Radiologia (Engl Ed) 2023; 65:473-480. [PMID: 37758337 DOI: 10.1016/j.rxeng.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 10/18/2021] [Indexed: 10/03/2023]
Abstract
In recent decades, the dreaded adverse effect of bisphosphonates, osteonecrosis of the jaw, has been widely reported and described in detail. Osteonecrosis of the jaw consists of the destruction of part of the maxilla as a consequence of these antiresorptive drugs. In recent years, new drugs that can also cause osteonecrosis of the jaw (e.g., some monoclonal antibodies or antiangiogenic drugs) have come on the market. For this reason, the term "bisphosphonate-related osteonecrosis of the jaw" has been replaced with "medication-related osteonecrosis of the jaw (MRONJ). This review aims to describe the radiologic characteristics of MRONJ that, although nonspecific, radiologists need to recognize in the appropriate clinical context.
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Affiliation(s)
- R Alemán Millares
- Departamento de Radiología, Hospital Ribera Povisa, Vigo, Pontevedra, Spain.
| | - E Santos Armentia
- Departamento de Radiología, Hospital Ribera Povisa, Vigo, Pontevedra, Spain
| | | | - M Novoa Ferro
- Departamento de Radiología, Hospital Ribera Povisa, Vigo, Pontevedra, Spain
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21
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Vilanova JC, Catalá-Sventzetzky V, Hernández-Mancera J. MRI for detection, staging, and follow-up of prostate cancer: Synthesis of the PI-RADS v2.1, MET-RADS, PRECISE, and PI-RR guidelines. Radiologia (Engl Ed) 2023; 65:431-446. [PMID: 37758334 DOI: 10.1016/j.rxeng.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/19/2022] [Indexed: 10/03/2023]
Abstract
Prostate cancer is very common among men. Radiology, mainly through MRI, plays a key role in the different stages of prostate cancer: diagnosis, staging and treatment assessment. The correct management of MRI requires knowledge and proper use of the different guidelines developed for the acquisition, interpretation and reporting of MRI in diagnosis (PI-RADS guide), whole body staging (MET-RADS guide), active surveillance (PRECISE guide) and local recurrence (PI-RR guide) in prostate cancer. The objective of this article is to show an update and synthesis of the most relevant aspects of these MRI guidelines for an optimal use and thus providing a more effective management of prostate cancer.
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Affiliation(s)
- J C Vilanova
- Departamento Radiología, Clínica Girona, Institut de Diagnòstic per la Imatge (IDI), Hospital Dr. J. Trueta/Hospital Sta. Caterina, Departamento de Ciencias Médicas, Facultad de Medicina, Universitat de Girona, Girona, Spain.
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Llufriu S, Agüera E, Costa-Frossard L, Galán V, Landete L, Lourido D, Meca-Lallana JE, Moral E, Bravo-Rodríguez F, Koren L, Labiano A, León A, Martín P, Monedero MD, Requeni L, Zubizarreta I, Rovira À. Recommendations for the coordination of Neurology and Neuroradiology Departments in the management of patients with multiple sclerosis. Neurologia 2023; 38:453-462. [PMID: 37120107 DOI: 10.1016/j.nrleng.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/01/2021] [Indexed: 05/01/2023] Open
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is widely used for the diagnosis and follow-up of patients with multiple sclerosis (MS). Coordination between neurology and neuroradiology departments is crucial for performing and interpreting radiological studies as efficiently and as accurately as possible. However, improvements can be made in the communication between these departments in many Spanish hospitals. METHODS A panel of 17 neurologists and neuroradiologists from 8 Spanish hospitals held in-person and online meetings to draft a series of good practice guidelines for the coordinated management of MS. The drafting process included 4 phases: 1) establishing the scope of the guidelines and the methodology of the study; 2) literature review on good practices or recommendations on the use of MRI in MS; 3) discussion and consensus between experts; and 4) validation of the contents. RESULTS The expert panel agreed a total of 9 recommendations for improving coordination between neurology and neuroradiology departments. The recommendations revolve around 4 main pillars: 1) standardising the process for requesting and scheduling MRI studies and reports; 2) designing common protocols for MRI studies; 3) establishing multidisciplinary committees and coordination meetings; and 4) creating formal communication channels between both departments. CONCLUSIONS These consensus recommendations are intended to optimise coordination between neurologists and neuroradiologists, with the ultimate goal of improving the diagnosis and follow-up of patients with MS.
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Affiliation(s)
- S Llufriu
- Servicio de Neurología, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - E Agüera
- Servicio de Neurología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - L Costa-Frossard
- Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - V Galán
- Servicio de Neurología, Hospital Virgen de la Salud, Toledo, Spain
| | - L Landete
- Servicio de Neurología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - D Lourido
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J E Meca-Lallana
- CSUR Esclerosis Múltiple y Unidad de Neuroinmunología Clínica, Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - E Moral
- Servicio de Neurología, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - F Bravo-Rodríguez
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - L Koren
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Labiano
- Servicio de Neurología, Hospital Virgen de la Salud, Toledo, Spain
| | - A León
- Sección de Neurorradiología, Servicio de Radiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - P Martín
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M D Monedero
- Sección de Neurorradiología, Servicio de Radiodiagnóstico, Hospital Universitario Dr. Peset, Valencia, Spain
| | - L Requeni
- Sección de Neurorradiología, Servicio de Radiodiagnóstico, Hospital Universitario Dr. Peset, Valencia, Spain
| | - I Zubizarreta
- Servicio de Neurología, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - À Rovira
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Martínez Camblor L, Peña Suárez JM, Martínez-Cachero García M, Santamarta Liébana E, Rodríguez Castro J, Saiz Ayala A. Cerebral microbleeds. Utility of SWI sequences. Radiologia (Engl Ed) 2023; 65:362-375. [PMID: 37516489 DOI: 10.1016/j.rxeng.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/12/2022] [Indexed: 07/31/2023]
Abstract
OBJECTIVES Define the concept of cerebral microbleeds (CMBs) and describe the most useful MRI sequences for detecting this finding. Review the entities that most frequently present with CMBs and that may benefit from the use of susceptibility-weighted imaging (SWI) sequences. CONCLUSIONS SWI is a useful MRI sequence for the detection and characterization of microhemorrhages, venous structures and other sources of susceptibility in imaging. SWI is particularly sensitive to local magnetic field inhomogeneities generated by certain substances and is superior to T2* GRE sequences for this assessment. CMBs may be seen in different neurologic conditions, in certain infrequent clinical contexts and have a key role as a biomarker status in gliomas (ITTS) and as a marker of inflammatory activity in multiple sclerosis.
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Affiliation(s)
- L Martínez Camblor
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - J M Peña Suárez
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - E Santamarta Liébana
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Rodríguez Castro
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Saiz Ayala
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
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Ospina Balaguera C, García FJ, Gutiérrez-Prieto JE, Torres Vera S, Castañeda JF. [Translated article] Relationship between low lying peroneus brevis muscle belly and peroneal tendons dislocation. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T240-T245. [PMID: 36878281 DOI: 10.1016/j.recot.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/30/2022] [Indexed: 03/07/2023] Open
Abstract
INTRODUCTION Peroneal tendon pathologies are an important cause of pain in the lateral aspect of the ankle. It has been proposed in the literature that low lying peroneus brevis muscle belly occupies more space in the retromalleolar groove and could cause laxity of the superior retinaculum which would promote tendon dislocation, tenosynovitis or ruptures. The objective of the study is to characterise the population with low lying peroneus brevis muscle belly and determine the association between the low lying peroneus brevis muscle belly found on magnetic resonance imaging and clinical peroneal tendon dislocation. METHODS A case-control study was developed with a sample of 103 patients. The cases were patients with low lying peroneus brevis muscle belly and peroneal dislocation and the controls were patients with normal implantation of the peroneus brevis muscle and peroneal tendon dislocation. RESULTS The prevalence of clinical peroneal dislocation in patients with low implantation of the peroneal brevis muscle belly was 7.64%, and the prevalence of clinical peroneal dislocation in patients with normal implantation of the peroneus brevis muscle belly was 8.88%. The OR was 0.85 (CI 0.09-7.44, p=0.88). DISCUSSION Our findings indicate that there is no statistically significant relationship between low lying peroneus brevis muscle belly and clinical dislocation of the peroneal tendons.
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Affiliation(s)
- C Ospina Balaguera
- Residente de la Unidad de Ortopedia y Traumatología, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - F J García
- Profesor de la Unidad de Ortopedia y Traumatología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - J E Gutiérrez-Prieto
- Residente de la Unidad de Ortopedia y Traumatología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - S Torres Vera
- Residente de la Unidad de Ortopedia y Traumatología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - J F Castañeda
- Profesor de la Unidad de Ortopedia y Traumatología, Universidad Nacional de Colombia, Bogotá, Colombia
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25
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Láinez Ramos-Bossini AJ, Ruiz Santiago F, Moraleda Cabrera B, López Zúñiga D, Ariza Sánchez A. Imaging of low-energy vertebral fractures. Radiologia (Engl Ed) 2023; 65:239-250. [PMID: 37268366 DOI: 10.1016/j.rxeng.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/01/2023] [Indexed: 06/04/2023]
Abstract
Low-energy vertebral fractures pose a diagnostic challenge for the radiologist due to their often-inadvertent nature and often subtle imaging semiology. However, the diagnosis of this type of fractures can be decisive, not only because it allows targeted treatment to prevent complications, but also because of the possibility of diagnosing systemic pathologies such as osteoporosis or metastatic disease. Pharmacological treatment in the first case has been shown to prevent the development of other fractures and complications, while percutaneous treatments and various oncological therapies can be an alternative in the second case. Therefore, it is necessary to know the epidemiology and typical imaging findings of this type of fractures. The objective of this work is to review the imaging diagnosis of low-energy fractures, with special emphasis on the characteristics that should be outlined in the radiological report to guide a specific diagnosis that favours and optimizes the treatment of patients suffering of low energy fractures.
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Affiliation(s)
- A J Láinez Ramos-Bossini
- Sección de Radiología Musculoesquelética, Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain; Programa de doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain; Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - F Ruiz Santiago
- Sección de Radiología Musculoesquelética, Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain; Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad de Granada, Granada, Spain.
| | - B Moraleda Cabrera
- Sección de Radiología Musculoesquelética, Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain
| | - D López Zúñiga
- Sección de Radiología Musculoesquelética, Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain
| | - A Ariza Sánchez
- Sección de Radiología Musculoesquelética, Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain
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Martínez-Cachero García M, Menéndez de Llano Ortega R, Martínez Camblor L, Carrasco Aguilera B, Rodríguez Castro J, Gómez Illán R. Extrauterine leiomyomatosis, the great mimicker. Radiologia (Engl Ed) 2023; 65:251-257. [PMID: 37268367 DOI: 10.1016/j.rxeng.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/08/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Describe the radiographic features of the different forms of extrauterine leiomyomatosis. CONCLUSIONS Leiomyomas with a rare growth pattern occur most often in women of reproductive age and with a history of hysterectomy. Extrauterine leiomyomas present a greater diagnostic challenge because they may mimic malignancies, and serious diagnostic errors may result.
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Affiliation(s)
| | | | - L Martínez Camblor
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - B Carrasco Aguilera
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Rodríguez Castro
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
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27
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Barreiro-Pérez M, Cabeza B, Calvo D, Reyes-Juárez JL, Datino T, Vañó Galván E, Maceira González AM, Delgado Sánchez-Gracián C, Prat-González S, Perea RJ, Bastarrika G, Sánchez M, Jiménez-Borreguero LJ, Fernández-Golfín Lobán C, Rodríguez Palomares JF, Tolosana JM, Hidalgo Pérez JA, Pérez-David E, Bertomeu-González V, Cuéllar H. Magnetic resonance in patients with cardiovascular devices. SEC-GT CRMTC/SEC-Heart Rhythm Association/SERAM/SEICAT consensus document. Radiologia (Engl Ed) 2023; 65:269-284. [PMID: 37268369 DOI: 10.1016/j.rxeng.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/21/2022] [Indexed: 06/04/2023]
Abstract
Magnetic resonance has become a first-line imaging modality in various clinical scenarios. The number of patients with different cardiovascular devices, including cardiac implantable electronic devices, has increased exponentially. Although there have been reports of risks associated with exposure to magnetic resonance in these patients, the clinical evidence now supports the safety of performing these studies under specific conditions and following recommendations to minimize possible risks. This document was written by the Working Group on Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomography of the Spanish Society of Cardiology (SEC-GT CRMTC), the Heart Rhythm Association of the Spanish Society of Cardiology (SEC-Heart Rhythm Association), the Spanish Society of Medical Radiology (SERAM), and the Spanish Society of Cardiothoracic Imaging (SEICAT). The document reviews the clinical evidence available in this field and establishes a series of recommendations so that patients with cardiovascular devices can safely access this diagnostic tool.
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Affiliation(s)
- M Barreiro-Pérez
- Imagen Cardiaca, Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
| | - B Cabeza
- Servicio de Diagnóstico por Imagen, Hospital Clínico San Carlos, Madrid, Spain; Servicio de Tomografía Computarizada y Resonancia Magnética, Hospital Nuestra Señora del Rosario, Madrid, Spain
| | - D Calvo
- Unidad de Arritmias, Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain; Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - J L Reyes-Juárez
- Área de Imagen Cardiovascular, Servicio de Radiodiagnóstico, Instituto de Diagnóstico por la Imagen (IDI), Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - T Datino
- Unidad de Arritmias, Departamento de Cardiología, Hospital Universitario Quirónsalud Madrid, Madrid, Spain; Unidad de Arritmias, Servicio de Cardiología, Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain; Departamento de Medicina, Universidad Europea de Madrid, Madrid, Spain
| | - E Vañó Galván
- Servicio de Tomografía Computarizada y Resonancia Magnética, Hospital Nuestra Señora del Rosario, Madrid, Spain
| | - A M Maceira González
- Unidad Cardiovascular, Grupo Biomético Ascires, Valencia, Spain; Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Valencia, Spain
| | | | - S Prat-González
- Servicio de Cardiología, Instituto Clínic Cardiovascular (ICCV), Hospital Clínic, Barcelona, Spain
| | - R J Perea
- Servicio de Radiología, Centro de Diagnóstico por la Imagen (CDI), Hospital Clínic, Barcelona, Spain
| | - G Bastarrika
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - M Sánchez
- Servicio de Radiología, Centro de Diagnóstico por la Imagen (CDI), Hospital Clínic, Barcelona, Spain
| | | | - C Fernández-Golfín Lobán
- Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - J F Rodríguez Palomares
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J M Tolosana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J A Hidalgo Pérez
- Servicio de Radiología, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain
| | - E Pérez-David
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - V Bertomeu-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - H Cuéllar
- Área de Imagen Cardiovascular, Servicio de Radiodiagnóstico, Instituto de Diagnóstico por la Imagen (IDI), Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Díaz-Fernández F, Celma A, Salazar A, Moreno O, López C, Cuadras M, Regis L, Planas J, Morote J, Trilla E. Systematic review of methods used to improve the efficacy of magnetic resonance in early detection of clinically significant prostate cancer. Actas Urol Esp 2023; 47:127-139. [PMID: 36462603 DOI: 10.1016/j.acuroe.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/28/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND OBJECTIVE Prostate cancer (PC) is the malignant neoplasm with the highest incidence after lung cancer worldwide. The objective of this study is to review the literature on the methods that improve the efficacy of the current strategy for the early diagnosis of clinically significant PC (csPC), based on the performance of magnetic resonance imaging (RM) and targeted biopsies when suspicious lesions are detected, in addition to systematic biopsy. EVIDENCE ACQUISITION A systematic literature review was performed in PubMed, Web of Science and Cochrane according to the PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), using the search terms: multiparametric magnetic resonance imaging, biparametric magnetic resonance imaging, biomarkers in prostate cancer, prostate cancer y early diagnosis. A total of 297 references were identified and, using the PICO selection criteria, 21 publications were finally selected to synthesize the evidence. EVIDENCE SYNTHESIS With the consolidation of MRI as the test of choice for the diagnosis of prostate cancer, the role of PSA density (PSAD) becomes relevant as a predictive tool included in prediction nomograms, without added cost. PSAD and diagnostic markers, combined with MRI, offer a high diagnostic power with an area under curve (AUC) above 0.7. Only the SHTLM3 model integrates markers in the creation of a nomogram. Prediction models also offer consistent efficacy with an AUC greater than 0.8 when associating MRI. CONCLUSIONS The efficacy of MRI in clinically significant prostate cancer detection can be improved with different parameters in order to generate predictive models that support decision making.
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Affiliation(s)
- F Díaz-Fernández
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - A Celma
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Salazar
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - O Moreno
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - C López
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M Cuadras
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - L Regis
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J Planas
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J Morote
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universistat Autònoma de Barcelona, Barcelona, Spain
| | - E Trilla
- Departamento de Urología y Trasplante Renal, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universistat Autònoma de Barcelona, Barcelona, Spain
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Mora-Boga R, Vázquez Muíños O, Pértega Díaz S, Meijide-Faílde RM, Rodríguez-Sotillo A, Ferreiro-Velasco ME, Salvador-de la Barrera S, Montoto-Marqués A. Prognostic value of early magnetic resonance imaging in the morbidity and mortality of traumatic spinal cord injury. Med Intensiva 2023; 47:157-164. [PMID: 36068148 DOI: 10.1016/j.medine.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/19/2021] [Accepted: 01/07/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To assess in individuals with traumatic spinal cord injury (TSCI) the relationship between mortality and need for ICU and early magnetic resonance imaging (MRI), analyzing spinal parenchymal alterations, disruption of vertebral ligaments (DVL) and spinal cord compression (SCC). DESIGN Retrospective study. SETTING Third-level hospital, Spinal Cord Injury Unit and ICU. PATIENTS Individuals with acute TSCI between 2010 and 2019. INTERVENTION Analysis of MRI performed in the first 72 h. VARIABLES OF INTEREST Admission to ICU and mortality. RESULTS 269 cases collected. The pattern that demonstrated higher mortality was cord hemorrhage (16.7%) for 12.5% of single-level edema and 6.5% of multilevel edema (p = 0.125). The same happened with ICU admissions: 69.0% in hemorrhage, 60.2% in multilevel edema and 46.3% in short edema (p = 0.018). Analyzing CCM, mortality was 13.4% with 59.2% of ICU admissions, for 2.2% and 42.2% of individuals without cord compression (p = 0.020 and p = 0.003). The figures of death and ICU admission among cord injuries with DVL were 15.0% and 67.3%, for 6.2% and 44.4% of the individuals without DLV (p < 0.001 and p = 0.013). CONCLUSIONS The presence of spinal cord hemorrhage, SCC and DVL was associated with a higher admission in ICU. A significant increase in mortality was observed in cases with SCC and DVL.
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Affiliation(s)
- Rubén Mora-Boga
- Unidad de Lesionados Medulares, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.
| | - Olalla Vázquez Muíños
- Unidad de Neurorradiología, Servicio de Radiodiagnóstico, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - Sonia Pértega Díaz
- Unidad de Estadística y Epidemiología Clínica, Spanish Clinical Research Network (SCReN). Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - Rosa María Meijide-Faílde
- Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidade de A Coruña (UDC), A Coruña, Spain
| | - Antonio Rodríguez-Sotillo
- Unidad de Lesionados Medulares, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain; Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidade de A Coruña (UDC), A Coruña, Spain
| | | | | | - Antonio Montoto-Marqués
- Unidad de Lesionados Medulares, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain; Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidade de A Coruña (UDC), A Coruña, Spain
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Gunturiz-Beltrán C, Borràs R, Alarcón F, Garre P, Figueras I Ventura RM, Benito EM, Caixal G, Althoff TF, Tolosana JM, Arbelo E, Roca-Luque I, Prat-González S, Perea RJ, Brugada J, Sitges M, Guasch E, Mont L. Quantification of right atrial fibrosis by cardiac magnetic resonance: verification of the method to standardize thresholds. Rev Esp Cardiol (Engl Ed) 2023; 76:173-182. [PMID: 35809892 DOI: 10.1016/j.rec.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) allows noninvasive detection of left atrial fibrosis in patients with atrial fibrillation (AF). However, whether the same methodology can be used in the right atrium (RA) remains unknown. Our aim was to define a standardized threshold to characterize RA fibrosis in LGE-CMR. METHODS A 3 Tesla LGE-CMR was performed in 53 individuals; the RA was segmented, and the image intensity ratio (IIR) calculated for the RA wall using 1 557 767 IIR pixels (40 994±10 693 per patient). The upper limit of normality of the IIR (mean IIR+2 standard deviations) was estimated in healthy volunteers (n=9), and patients who had undergone previous typical atrial flutter ablation (n=9) were used to establish the dense scar threshold. Paroxysmal and persistent AF patients (n=10 each) were used for validation. IIR values were correlated with a high-density bipolar voltage map in 15 patients undergoing AF ablation. RESULTS The upper normality limit (total fibrosis threshold) in healthy volunteers was set at an IIR = 1.21. In the postablation group, 60% of the maximum IIR pixel (dense fibrosis threshold) was calculated as IIR = 1.29. Endocardial bipolar voltage showed a weak but significant correlation with IIR. The overall accuracy between the electroanatomical map and LGE-CMR to characterize fibrosis was 56%. CONCLUSIONS An IIR > 1.21 was determined to be the threshold for the detection of right atrial fibrosis, while an IIR > 1.29 differentiates interstitial fibrosis from dense scar. Despite differences between the left and right atria, fibrosis could be assessed with LGE-CMR using similar thresholds in both chambers.
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Affiliation(s)
- Clara Gunturiz-Beltrán
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Roger Borràs
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Francisco Alarcón
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Paz Garre
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Eva M Benito
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gala Caixal
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Till F Althoff
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Department of Cardiology and Angiology, Charité-University Medicine Berlin, Charité Campus Mitte, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - José María Tolosana
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Arbelo
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ivo Roca-Luque
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Susanna Prat-González
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Rosario Jesús Perea
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Josep Brugada
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Sitges
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Eduard Guasch
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Lluís Mont
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
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Barreiro-Pérez M, Cabeza B, Calvo D, Reyes-Juárez JL, Datino T, Vañó Galván E, Maceira González AM, Delgado Sánchez-Gracián C, Prat-González S, Perea RJ, Bastarrika G, Sánchez M, Jiménez-Borreguero LJ, Fernández-Golfín Lobán C, Rodríguez Palomares JF, Tolosana JM, Hidalgo Pérez JA, Pérez-David E, Bertomeu-González V, Cuéllar H. Magnetic resonance in patients with cardiovascular devices. SEC-GT CRMTC/SEC-Heart Rhythm Association/SERAM/SEICAT consensus document. Rev Esp Cardiol (Engl Ed) 2023; 76:183-196. [PMID: 36539182 DOI: 10.1016/j.rec.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/21/2022] [Indexed: 12/23/2022]
Abstract
Magnetic resonance has become a first-line imaging modality in various clinical scenarios. The number of patients with different cardiovascular devices, including cardiac implantable electronic devices, has increased exponentially. Although there have been reports of risks associated with exposure to magnetic resonance in these patients, the clinical evidence now supports the safety of performing these studies under specific conditions and following recommendations to minimize possible risks. This document was written by the Working Group on Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomography of the Spanish Society of Cardiology (SEC-GT CRMTC), the Heart Rhythm Association of the Spanish Society of Cardiology (SEC-Heart Rhythm Association), the Spanish Society of Medical Radiology (SERAM), and the Spanish Society of Cardiothoracic Imaging (SEICAT). The document reviews the clinical evidence available in this field and establishes a series of recommendations so that patients with cardiovascular devices can safely access this diagnostic tool.
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Affiliation(s)
- Manuel Barreiro-Pérez
- Imagen Cardiaca, Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
| | - Beatriz Cabeza
- Servicio de Diagnóstico por Imagen, Hospital Clínico San Carlos, Madrid, Spain; Servicio de Tomografía Computarizada y Resonancia Magnética, Hospital Nuestra Señora del Rosario, Madrid, Spain
| | - David Calvo
- Unidad de Arritmias, Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain; Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - José Luis Reyes-Juárez
- Área de Imagen Cardiovascular, Servicio de Radiodiagnóstico, Instituto de Diagnóstico por la Imagen (IDI), Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Tomás Datino
- Unidad de Arritmias, Departamento de Cardiología, Hospital Universitario Quirónsalud Madrid, Madrid, Spain; Unidad de Arritmias, Servicio de Cardiología, Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain; Departamento de Medicina, Universidad Europea de Madrid, Madrid, Spain
| | - Eliseo Vañó Galván
- Servicio de Tomografía Computarizada y Resonancia Magnética, Hospital Nuestra Señora del Rosario, Madrid, Spain
| | - Alicia M Maceira González
- Unidad Cardiovascular, Grupo Biomético Ascires, Valencia, Spain; Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Valencia, Spain
| | | | - Susanna Prat-González
- Servicio de Cardiología, Instituto Clínic Cardiovascular (ICCV), Hospital Clínic, Barcelona, Spain
| | - Rosario J Perea
- Servicio de Radiología, Centro de Diagnóstico por la Imagen (CDI), Hospital Clínic, Barcelona, Spain
| | - Gorka Bastarrika
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Marcelo Sánchez
- Servicio de Radiología, Centro de Diagnóstico por la Imagen (CDI), Hospital Clínic, Barcelona, Spain
| | | | - Covadonga Fernández-Golfín Lobán
- Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | | | - José F Rodríguez Palomares
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - José María Tolosana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Esther Pérez-David
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Vicente Bertomeu-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - Hug Cuéllar
- Área de Imagen Cardiovascular, Servicio de Radiodiagnóstico, Instituto de Diagnóstico por la Imagen (IDI), Hospital Universitario Vall d'Hebron, Barcelona, Spain
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García-Lezama M, Carrillo-Ruiz JD, Moreno-Jiménez S, Roldán-Valadez E. WHO CNS5 2021 includes specific mutations in gliomas that can be identified with MRI quantitative biomarkers. GAC MED MEX 2023; 159:161-168. [PMID: 37094238 DOI: 10.24875/gmm.m22000757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
In 2021, the latest version of the World Health Organization classification of central nervous system tumors (WHO CNS5) was published, which is considered an international standard. The first editions of this classification were based on histological characteristics and, subsequently, aspects related to new knowledge were incorporated. In the 2016 revision, molecular characteristics were implemented for the classification and staging of gliomas, such as the presence of mutations in IDH1 or IDH2. Currently, advanced magnetic resonance imaging (MRI) techniques allow assessing for the presence of 2-HG (increased oncometabolite that precedes IDH mutations), whereby IDH mutations can be indirectly identified, without invasive procedures being required. Advanced MRI is a growing field, highly useful for diagnosis and management of different pathologies. This document addresses the implications of WHO CNS5 classification in the evaluation of gliomas, as well as historical aspects, the bases of conventional MRI, and advanced MRI sequences useful in current classification.
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Affiliation(s)
| | | | - Sergio Moreno-Jiménez
- Directorate of Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez". Mexico City, Mexico
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Moreno-Reina C, Martínez-Moya M, Piñero-González de la Peña P, Caro-Domínguez P. Neuroinvasive disease due to West Nile virus: Clinical and imaging findings associated with a re-emerging pathogen. Radiologia (Engl Ed) 2022; 64:473-483. [PMID: 36243447 DOI: 10.1016/j.rxeng.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/21/2021] [Indexed: 06/16/2023]
Abstract
The West Nile virus (WNV) is an arbovirus than can infect human beings and cause severe neuroinvasive disease. Taking the outbreak that occurred in Spain in 2020 as a reference, this article reviews the clinical and imaging findings for neuroinvasive disease due to WNV. We collected demographic, clinical, laboratory, and imaging (CT and MRI) variables for 30 patients with WNV infection diagnosed at our center. The main clinical findings were fever, headache, and altered levels of consciousness. Neuroimaging studies, especially MRI, are very useful in the diagnosis and follow-up of these patients. The most common imaging findings were foci of increased signal intensity in the thalamus and brainstem in T2-weighted sequences; we illustrate these findings in cases from our hospital.
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Affiliation(s)
- C Moreno-Reina
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - M Martínez-Moya
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - P Caro-Domínguez
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Álvarez Sarrado E, Giner Segura F, Batista Domenech A, Garcia-Granero García-Fuster Á, Frasson M, Rudenko P, Flor Lorente B, Garcia-Granero Ximénez E. Rectal cancer at the peritoneal reflection. Preoperative MRI accuracy and histophatologic correlation. Prospective study. Cir Esp 2022; 100:488-495. [PMID: 35597413 DOI: 10.1016/j.cireng.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/15/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION To investigate magnetic resonance imaging (MRI) accuracy for determining the location of rectal tumors with respect to the peritoneal reflection (PR) and its potential involvement. METHODS Prospective study of 161 patients ongoing surgery for rectal cancer. A double-ink method has been aplied to examine surgical specimen, orange ink for the serosal surface and indian ink for the mesorrectal margin, and assess preoperative MRI accuracy. RESULTS Twenty-two tumors were located above, 65 at and 74 below PR. MRI accuracy was 90.6% for determining tumor's location with respect to the PR and 80.5% for defining peritoneal involvement. For classifying tumors according to their intra or extraperitoneal location an accuracy of 92.5% was set for MRI. Histophatologic peritoneal involvement was found in 28.7% of tumors located above or at the PR. CONCLUSIONS Magnetic resonance imaging accurately predicts the location of rectal tumors with respect to the PR and its potential involvement. The double-ink method is useful to assess serosal involvement (pT4a) and to distinguish mesorrectal fascia from the peritonealized surface.
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Affiliation(s)
| | - Francisco Giner Segura
- Servicio de Anatomía Patológica, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Adela Batista Domenech
- Sección de Abdomen, Servicio de Radiodiagnóstico, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Matteo Frasson
- Unidad de Coloproctología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Polina Rudenko
- Sección de Abdomen, Servicio de Radiodiagnóstico, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Blas Flor Lorente
- Unidad de Coloproctología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Gündüz N, Eser MB, Yıldırım A, Kabaalioğlu A. Radiomics improves the utility of ADC for differentiation between renal oncocytoma and chromophobe renal cell carcinoma: Preliminary findings. Actas Urol Esp 2022; 46:167-177. [PMID: 35216964 DOI: 10.1016/j.acuroe.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/17/2021] [Accepted: 04/18/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Differentiation between renal oncocytoma (RON) and chromophobe renal cell carcinoma (chRCC) remains challenging. We aimed to assess the accurate apparent diffusion coefficient (ADC) radiomics features in differentiating these tumors. MATERIALS AND METHODS This single-center retrospective study included 14 patients with histopathologically proven RON (n = 6) and chRCC (n = 8) who underwent magnetic resonance imaging. Features were extracted from ADC maps. Features with an intraclass correlation coefficient >0.90, an intergroup p < 0.01 and interrater differences with normal distribution underwent agreement and receiver operating characteristic curve analyses. RESULTS Overall, 6 features qualified for further analysis and Bland-Altman plots revealed acceptable agreement for all. Only 1 first order feature and 5 high order texture features successfully predicted RON with more than 90% sensitivities and specificities more than 80%. CONCLUSION Squared mean ADC and certain gray level run length matrix features extracted by radiomics of ADC mapping provide quite high diagnostic precision in terms of distinguishing between RON and chRCC.
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Affiliation(s)
- N Gündüz
- Istanbul Medeniyet University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey.
| | - M B Eser
- Istanbul Medeniyet University, Prof. Dr. Süleyman Yalçın City Hospital, Department of Radiology, Istanbul, Turkey
| | - A Yıldırım
- Istanbul Medeniyet University, Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - A Kabaalioğlu
- Istanbul Medeniyet University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey
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Molina-Ruiz RM, Looi JCL, Walterfang M, García-Saiz T, Wilkes FA, Liu LL, Velakoulis D, Perera JLC, Diaz-Marsa M. Striatal volumes as potential biomarkers in Eating Disorders: A pilot study. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:65-73. [PMID: 35840286 DOI: 10.1016/j.rpsmen.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 01/20/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Differences in bulimic and impulsive behaviours in Eating Disorders (ED) have been associated with cortico-striatal circuit dysfunction at a neurobiological level. We sought to investigate neo-striatal volume as a biomarker in ED subgroups as well as the possible relationship with trauma history. MATERIAL AND METHODS We studied 24 female patients: Anorexia Nervosa AN (n=8), Bulimia Nervosa BN (n=9), comorbid ED with borderline personality disorder (EDc; n=7), and a group of Healthy Controls (n=19). Binge eating behaviours and impulsivity scales were used to characterize our sample as well as Trauma Questionnaires and Magnetic resonance imaging (MRI) volumetric manual measurements of caudate and putamen nuclei (striatum). RESULTS Our preliminary results showed a significantly larger left putaminal volume in AN compared to the other three groups [C (p=0.008), BN (p<.001) and EDc (p=.001)] and a smaller right putaminal volume in EDc compared to controls (p=.045) and AN (p=.039). Some negative correlations were found between bilateral putaminal volumes and self-reported general and early traumatization scores. CONCLUSION This pilot study suggested that striatal volumes might differentiate AN from BN and EDc at a neurobiological level with implications for treatment strategies. Larger scale studies should be carried out that allow replication of these data.
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Affiliation(s)
- Rosa M Molina-Ruiz
- Complutense University Medical School, Hospital Clínico San Carlos, Madrid, Spain.
| | - Jeffrey C L Looi
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra. Hospital, Canberra, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital; Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia
| | | | - Fiona A Wilkes
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra. Hospital, Canberra, Australia
| | - Lena L Liu
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra. Hospital, Canberra, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital; Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia
| | | | - Marina Diaz-Marsa
- Complutense University Medical School, Hospital Clínico San Carlos, Madrid, Spain
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Cordero Devesa A, Polo López R, Vaca González M, Del Mar Medina González M, Pérez Martínez C, Ropero Romero F, de Los Santos Granados G. Checklist for the evaluation of magnetic resonance imaging in otological pathology. Acta Otorrinolaringol Esp (Engl Ed) 2022; 73:113-122. [PMID: 35397820 DOI: 10.1016/j.otoeng.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/22/2021] [Indexed: 10/18/2022]
Abstract
Otolaryngology specialists must be familiar with radiological studies that allow the diagnosis of different otological pathologies. Magnetic resonance imaging is a complement to computed tomography, which allows a better evaluation of soft tissues and contributes to the differential diagnosis of space-occupying lesions located in the temporal bone and lateral skull base. It is also the technique of choice for the evaluation of the inner ear and the anatomical structures located in the cerebellopontine angle. In this article we present a checklist for magnetic resonance imaging of the ear with different sections that will allow a systematic review of all structures of interest in otological practice, as well as the preferred sequences for each situation.
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Affiliation(s)
- Adela Cordero Devesa
- Sección de Otología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Príncipe de Asturias, Meco, Madrid, Spain.
| | - Rubén Polo López
- Sección de Otología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Escobar Castellanos M, de la Mata Navazo S, Carrón Bermejo M, García Morín M, Ruiz Martín Y, Saavedra Lozano J, Miranda Herrero MC, Barredo Valderrama E, Castro de Castro P, Vázquez López M. Association between neuroimaging findings and neurological sequelae in patients with congenital cytomegalovirus infection. Neurologia 2022; 37:122-129. [PMID: 30857789 DOI: 10.1016/j.nrl.2018.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/01/2018] [Accepted: 11/15/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is an important cause of disability. There is little evidence on the prognostic value of lesions identified in neuroimaging studies. AIM The study aimed to assess the severity of lesions detected with brain MRI and transfontanellar ultrasound and their relationship with long-term neurological deficits. PATIENTS AND METHODS We performed a retrospective, analytical, observational study of 36 patients with congenital CMV infection. Neuroimaging studies were reviewed and classified according to the modified Noyola' scale. Imaging findings were compared with neurological alterations in the patients' most recent follow-up evaluation at the paediatric neurology department. RESULTS Thirty-six patients were studied (transfontanellar ultrasound: 30; brain MRI: 29). Twenty of 30 patients showed ultrasound abnormalities; of these, 11 showed alterations on brain MR images (P=.04) and 10 had neurological impairment (P=.008). Transfontanellar ultrasound had a sensitivity of 83.3%, 90% CI: 58-100 and a specificity of 44.4%, 90% CI: 18.7-70.2 for predicting neurological sequelae. Brain MRI displayed abnormalities in 20 of 29 patients, of whom 16 had neurological impairment (P<.001). MRI had a sensitivity of 94%, 95% CI: 80-100 and a specificity of 66.6%, 95% CI: 36-97.5 for predicting neurological sequelae. Modified Noyola' scale values >2 were correlated with psychomotor retardation (P<.001). CONCLUSIONS Our findings validate previous studies reporting a statistical significant correlation between the extension of neuroimaging lesions and severity of neurological deficits.
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Affiliation(s)
- M Escobar Castellanos
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España.
| | - S de la Mata Navazo
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - M Carrón Bermejo
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - M García Morín
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - Y Ruiz Martín
- Sección de Radiología, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - J Saavedra Lozano
- Sección de Infectología, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - M C Miranda Herrero
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - E Barredo Valderrama
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - P Castro de Castro
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
| | - M Vázquez López
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España
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Carmona-Ruiz HA, Orihuela-Rodríguez Ó, Morales-Gudiño I. Asymptomatic giant pericardial cyst. CIR CIR 2021; 89:68-71. [PMID: 34932548 DOI: 10.24875/ciru.21000280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pericardial cysts are uncommon masses and are the third most common cystic mass of the mediastinum. The majority are asymptomatic, however, they can be associated with serious complications such as cardiac tamponade, bronchial obstruction, or even sudden death. CASE REPORT An asymptomatic female patient, who was referred due to a chest radiograph showing cardiomegaly. The transthoracic echocardiogram showed an image consistent with a pericardial cyst, the diagnosis was confirmed with a magnetic resonance imaging. CONCLUSIONS Pericardial cysts may appear as an incidental finding in the chest radiograph, either computed tomography scan or magnetic resonance imaging are useful to confirm the diagnosis.
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Affiliation(s)
- Héctor A Carmona-Ruiz
- Servicio de Cardiología, Hospital General de Zona y Medicina Familiar No. 1 Dr. Alfonso Mejía Schroeder, Instituto Mexicano del Seguro Social (IMSS), Pachuca de Soto, Hidalgo. México
| | - Óscar Orihuela-Rodríguez
- Servicio de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades Dr. Bernardo Sepúlveda Gutiérrez, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México. México
| | - Ian Morales-Gudiño
- Servicio de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades Dr. Bernardo Sepúlveda Gutiérrez, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México. México
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Genis-Mendoza AD, Elizalde-Martínez C, Martínez-Magaña JJ, Cabrera-Mendoza B, Morales-Guadarrama A, Sacristán E, Beltrán-Villalobos I, Tovilla-Zarate CA, Nicolini H. Longitudinal magnetic resonance evaluation of the schizophrenia model of neonatal lesion in the ventral hippocampus. CIR CIR 2021; 89:785-791. [PMID: 34851586 DOI: 10.24875/ciru.20001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the progression by means of nuclear magnetic resonance of the lesion in the schizophrenia model of lesion of the ventral hippocampal nucleus (LVNH). METHOD Magnetic resonance imaging (MRI) were performed in male Wistar rats, from 8 days postnatal to 139 days, in animals with LNHV and without lesion (sham). The MRI were carried out on a Variant 7 T equipment. The data were analyzed with the Amira software, for a voxel-based morphometric analysis. RESULTS We observed the presence of hypersignals with a significant enhancement in the structures analyzed in the group with LVNH, and greater volume in the lateral ventricles, presenting a larger size of the lesion on day PD96 and significantly reducing on day PD139. CONCLUSIONS We found a cell rearrangement during the progression of the lesion, which could be the effect of the activation of immune cells.
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Affiliation(s)
- Alma D Genis-Mendoza
- Instituto Nacional de Medicina Genómica, Secretaría de Salud, Ciudad de México.,Servicio de Atención Psiquiátrica, Hospital Psiquiátrico Infantil Juan N. Navarro, Secretaría de Salud, Ciudad de México
| | | | - José J Martínez-Magaña
- Servicio de Atención Psiquiátrica, Hospital Psiquiátrico Infantil Juan N. Navarro, Secretaría de Salud, Ciudad de México
| | | | - Axayacatl Morales-Guadarrama
- Centro Nacional de Imagenología e Instrumentación Médica (CI3M), Universidad Autónoma Metropolitana, Iztapalapa, Ciudad de México
| | - Emilio Sacristán
- Centro Nacional de Imagenología e Instrumentación Médica (CI3M), Universidad Autónoma Metropolitana, Iztapalapa, Ciudad de México
| | | | - Carlos A Tovilla-Zarate
- Universidad Autónoma de la Ciudad de México, Ciudad de México.,Unidad Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco. México
| | - Humberto Nicolini
- Instituto Nacional de Medicina Genómica, Secretaría de Salud, Ciudad de México
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Azcona Sáenz J, Herrán de la Gala D, Arnáiz García AM, Salas Venero CA, Marco de Lucas E. Atypical bacterial infections of the central nervous system transmitted by ticks: An unknown threat. Radiologia (Engl Ed) 2021; 63:425-435. [PMID: 34625198 DOI: 10.1016/j.rxeng.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
Infections of the central nervous system caused by atypical bacteria are becoming more common. Borrelia burgdorferi and Rickettsia conorii are microorganisms transmitted by ticks; infection with these bacteria result in a wide spectrum of manifestations on imaging. In areas where these tick-borne microorganisms are endemic, including Spain, these infections must be included in the differential diagnosis of patients with a variety of systemic and neurologic symptoms. The clinical presentation of these infections is nonspecific, and CT is normally the initial imaging technique, although MRI is more sensitive to early changes. On MRI, these infections can manifest as small lesions in the deep supratentorial white matter that are hyperintense on T2-weighted/FLAIR sequences. It is fundamental to know the imaging characteristics of the different atypical bacterial infections and their differential diagnoses. Good history taking combined with complementary tests (blood tests and CSF analysis) and the neuroimaging findings can help reach the right diagnosis and enable appropriate treatment, thereby preventing possible neurological sequelae.
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Affiliation(s)
- J Azcona Sáenz
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - D Herrán de la Gala
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A M Arnáiz García
- Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - C A Salas Venero
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - E Marco de Lucas
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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42
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Escobar Castellanos M, de la Mata Navazo S, Carrón Bermejo M, García Morín M, Ruiz Martín Y, Saavedra Lozano J, Miranda Herrero MC, Barredo Valderrama E, Castro de Castro P, Vázquez López M. Association between neuroimaging findings and neurological sequelae in patients with congenital cytomegalovirus infection. Neurologia (Engl Ed) 2021; 37:122-129. [PMID: 34531153 DOI: 10.1016/j.nrleng.2018.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/15/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is an important cause of disability. There is little evidence on the prognostic value of lesions identified in neuroimaging studies. AIM The study aimed to assess the severity of lesions detected with brain MRI and transfontanellar ultrasound and their relationship with long-term neurological deficits. PATIENTS AND METHODS We performed a retrospective, analytical, observational study of 36 patients with congenital CMV infection. Neuroimaging studies were reviewed and classified according to the modified Noyola' scale. Imaging findings were compared with neurological alterations in the patients' most recent follow-up evaluation at the paediatric neurology department. RESULTS Thirty-six patients were studied (transfontanellar ultrasound: 30; brain MRI: 29). Twenty of 30 patients showed ultrasound abnormalities; of these, 11 showed alterations on brain MR images (P = .04) and 10 had neurological impairment (P = .008). Transfontanellar ultrasound had a sensitivity of 83.3%, 90% CI: 58-100 and a specificity of 44.4%, 90% CI: 18.7-70.2 for predicting neurological sequelae. Brain MRI displayed abnormalities in 20 of 29 patients, of whom 16 had neurological impairment (P < .001). MRI had a sensitivity of 94%, 95% CI: 80-100 and a specificity of 66.6%, 95% CI: 36-97.5 for predicting neurological sequelae. Modified Noyola' scale values > 2 were correlated with psychomotor retardation (P < .001). CONCLUSIONS Our findings validate previous studies reporting a statistical significant correlation between the extension of neuroimaging lesions and severity of neurological deficits.
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Affiliation(s)
- M Escobar Castellanos
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain.
| | - S de la Mata Navazo
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - M Carrón Bermejo
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - M García Morín
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - Y Ruiz Martín
- Sección de Radiología, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - J Saavedra Lozano
- Sección de Infectología, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - M C Miranda Herrero
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - E Barredo Valderrama
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - P Castro de Castro
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - M Vázquez López
- Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
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Cordero Devesa A, Polo López R, Vaca González M, Medina González MDM, Pérez Martínez C, Ropero Romero F, de Los Santos Granados G. Checklist for the evaluation of magnetic resonance imaging in otological pathology. Acta Otorrinolaringol Esp (Engl Ed) 2021; 73:S0001-6519(21)00083-2. [PMID: 34462115 DOI: 10.1016/j.otorri.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 11/18/2022]
Abstract
Otolaryngology specialists must be familiar with radiological studies that allow the diagnosis of different otological pathologies. Magnetic resonance imaging is a complement to computed tomography, which allows a better evaluation of soft tissues and contributes to the differential diagnosis of space-occupying lesions located in the temporal bone and lateral skull base. It is also the technique of choice for the evaluation of the inner ear and the anatomical structures located in the cerebellopontine angle. In this article we present a checklist for magnetic resonance imaging of the ear with different sections that will allow a systematic review of all structures of interest in otological practice, as well as the preferred sequences for each situation.
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Affiliation(s)
- Adela Cordero Devesa
- Sección de otología, Hospital Universitario Ramón y Cajal, Madrid, España; Hospital Universitario Príncipe de Asturias, Meco, Madrid, España.
| | - Rubén Polo López
- Sección de otología, Hospital Universitario Ramón y Cajal, Madrid, España
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Garrido Márquez I, Fernández Navarro L, Moya Sánchez E. The diagnosis of the middle interhemispheric variant of holoprosencephaly with fetal MRI. Radiologia (Engl Ed) 2021; 64:S0033-8338(21)00121-1. [PMID: 34399977 DOI: 10.1016/j.rx.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Congenital anomalies of the central nervous system comprise a wide spectrum of malformations associated with a wide variety of genetic syndromes and chromosomal anomalies, and they are among the principal causes of morbidity and mortality in infants. Among these anomalies, holoprosencephaly arises from the complete or partial failure of the brain to divide into the cerebral hemispheres. Imaging tests are fundamental for the prenatal diagnosis of holoprosencephaly; the diagnostic process usually starts with sonography and then the findings are refined with fetal MRI. Radiologists need to be familiar with the possible findings because the prognosis varies.
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Affiliation(s)
- I Garrido Márquez
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Cecilio, Granada, España.
| | - L Fernández Navarro
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Cecilio, Granada, España
| | - E Moya Sánchez
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Cecilio, Granada, España
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45
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Pumar Pérez M, Marsico S, Rodríguez Baeza A, Solano López A. Role of imaging techniques in the diagnosis of selective hypertrophy of the tensor fascia lata. Radiologia (Engl Ed) 2021; 64:S0033-8338(21)00117-X. [PMID: 34384599 DOI: 10.1016/j.rx.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022]
Abstract
The tensor fascia lata is a muscular structure that forms part of the lateral portion of the pelvis and proximal thigh. Because conditions affecting this muscle have not been widely reported and are relatively unknown, hypertrophy and pseudo-hypertrophy of the tensor fascia lata, although relatively common imaging findings, often go undiagnosed; instead, radiologists perform the differential diagnosis with more complex and more dangerous conditions. This article aims to review the anatomic and functional characteristics of the tensor fascia lata, going into detail about the radiological description of this muscle and pathological conditions that can affect it, as well as reviewing the relevant literature.
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Affiliation(s)
| | | | - Alfonso Rodríguez Baeza
- Departamento de Ciencias Morfológicas. Universitat Autònoma de Barcelona. Bellaterra, Barcelona, España
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Corominas H, Balius R, Estrada-Alarcón P, Reina D, Moya P, Videla M. Giant pes anserinus bursitis: A rare soft tissue mass of the medial knee. ACTA ACUST UNITED AC 2021; 17:420-421. [PMID: 34301386 DOI: 10.1016/j.reumae.2020.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/22/2020] [Indexed: 10/20/2022]
Abstract
Bursae are small, jelly-like sacs that are located throughout the body, mainly around the shoulder, elbow, hip, knee, and heel in a number over 150. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction. Pes anserinus bursae, despite being clinically frequent, are not visible either by ultrasound (US) or magnetic resonance image (MRI). In some cases, we may observe a small fluid collection. The present case-report demonstrates the full clinical picture of a giant pes anserinus bursae beginning from clinical observation to its final pathology exam.
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Affiliation(s)
- Hèctor Corominas
- Servei de Reumatologia, Hospital Universitari de Sant Pau & Hospital Dos de Maig, Barcelona, Spain.
| | | | | | - Dèlia Reina
- Servei de Reumatologia, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - Patricia Moya
- Servei de Reumatologia, Hospital Universitari de Sant Pau & Hospital Dos de Maig, Barcelona, Spain
| | - Miquel Videla
- Servei de Traumatologia, Hospital Moisès Broggi,Sant Joan Despí, Barcelona, Spain
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Moreno-Reina C, Martínez-Moya M, Piñero-González de la Peña P, Caro-Domínguez P. Neuroinvasive disease due to West Nile virus: clinical and imaging findings associated with a re-emerging pathogen. Radiologia (Engl Ed) 2021; 64:S0033-8338(21)00114-4. [PMID: 34325916 DOI: 10.1016/j.rx.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 05/10/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
The West Nile virus (WNV) is an arbovirus than can infect human beings and cause severe neuroinvasive disease. Taking the outbreak that occurred in Spain in 2020 as a reference, this article reviews the clinical and imaging findings for neuroinvasive disease due to WNV. We collected demographic, clinical, laboratory, and imaging (CT and MRI) variables for 30 patients with WNV infection diagnosed at our center. The main clinical findings were fever, headache, and altered levels of consciousness. Neuroimaging studies, especially MRI, are very useful in the diagnosis and follow-up of these patients. The most common imaging findings were foci of increased signal intensity in the thalamus and brainstem in T2-weighted sequences; we illustrate these findings in cases from our hospital.
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Affiliation(s)
- C Moreno-Reina
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - M Martínez-Moya
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, España
| | | | - P Caro-Domínguez
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, España
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Schwartzmann I, Celma A, Regis L, Planas J, Roche S, de Torres IM, Semidey ME, Morote J. The current value of histological findings in negative prostate biopsies to predict the future risk of clinically significant prostate cancer. Actas Urol Esp 2021; 45:447-454. [PMID: 34140257 DOI: 10.1016/j.acuroe.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Repeat prostate biopsy (PBx) is recommended under persistent suspicion of prostate cancer (PCa) or in the face of the following findings: atypical small acinar proliferation (ASAP); extense (≥3 biopsy sites) high-grade prostatic intraepithelial neoplasia (HGPIN); or HGPIN with atypical glands; suspicious for adenocarcinoma (PIN-ATYP). Nowadays; multiparametric magnetic resonance imaging (mpMRI) and mpMRI targeted PBx (MRI-TBx) are recommended in repeat PBx. Our objective was to analyze the current value of ASAP; mHGPIN; PIN-ATYP and other histological findings to predict clinically significant PCa (csPCa) risk. METHODS Retrospective analysis of 377 repeat PBxs. MRI-TBx was performed when Prostate Imaging-Reporting and Data System (PI-RADS) score >3 and 12-core transrectal ultrasound (TRUS) systematic PBx when ≤2. ASAP; HGPIN; mHGPIN; PIN-ATYP; and 8 other histological findings were prospectively reported in negative PBx. CsPCa was defined as ISUP group grade >2. RESULTS Incidence of ASAP; multifocal HGPIN (mHGPIN) and PINATYP was 4.2%; 39.7% and 3.7% respectively; and csPCa rate was statistically similar among men with these histological findings. However; the rate of csPCa was 22.2% when proliferative inflammatory atrophy (PIA) was present; and 36.1% when it was not. PIA was the only histological finding which predicted lower risk of csPCa; with an OR of 0.54 (95%CI: 0.308-0.945; P = .031). In addition; PIA was an independent predictor of a model combining clinical variables and mpMRI which reached area under de ROC curve of 0.86 (95%CI: 0.83-0.90). CONCLUSION PIA emerged as the only predictive histological finding of csPCa risk and can contribute to a predictive model. mHGPIN failed to predict csPCa risk. The low incidence of ASAP (4.2%) and PIN-ATYP (3.7%) prevented us from drawing conclusions.
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Affiliation(s)
- I Schwartzmann
- Departamento de Urología y Trasplante Renal, Hospital Universitario Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - A Celma
- Departamento de Urología y Trasplante Renal, Hospital Universitario Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - L Regis
- Departamento de Urología y Trasplante Renal, Hospital Universitario Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Planas
- Departamento de Urología y Trasplante Renal, Hospital Universitario Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - S Roche
- Departamento de Radiología, Hospital Universitario Vall d'Hebrón, Univerisad Autónoma de Barcelona, Barcelona, Spain
| | - I M de Torres
- Departamento de Patología, Hospital Universitario Vall d'Hebrón Universidad Autónoma de Barcelona, Barcelona, Spain; Universidad Autónoma de Barcelona, Barcelona, Spain
| | - M E Semidey
- Departamento de Patología, Hospital Universitario Vall d'Hebrón Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Morote
- Departamento de Urología y Trasplante Renal, Hospital Universitario Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain; Universidad Autónoma de Barcelona, Barcelona, Spain
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Ros Castelló V, Sánchez Sánchez A, Natera Villalba E, Gómez López A, Parra P, Rodríguez Jorge F, Buisán Catevilla J, García Barragán N, Masjuan J, Corral I. Spinal cord infarction: aetiology, imaging findings, and prognostic factors in a series of 41 patients. Neurologia (Engl Ed) 2021:S2173-5808(21)00077-8. [PMID: 34130946 DOI: 10.1016/j.nrleng.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/19/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Spinal cord infarction is a rare disease with a high rate of morbidity. Its diagnosis can be challenging and controversy remains regarding the best treatment. Few case series have been published. METHODS We conducted a retrospective review of cases of spinal cord infarction attended in a tertiary hospital from 1999 to 2020. Aetiology and clinical, imaging, and prognostic features were assessed. RESULTS Forty-one patients (58.5% men, mean [standard deviation] age 61 [17] years) were included in the study. Thirty-one patients (75.6%) presented vascular risk factors. Motor deficits were recorded in 39 (95.1%), pain in 20 (48.8%), sensory deficits in 33 (80.4%), and autonomic dysfunction in 24 (58.5%). MRI was performed in 37 (90.2%) patients. Diffusion-weighted images were available for 12 patients, with 10 showing diffusion restriction. The thoracic region was the most frequently affected (68.2%). Vascular imaging studies were performed in 33 patients (80.4%). The most frequent aetiologies were aortic dissection (6 cases), atherosclerosis demonstrated by vascular imaging (6 cases), fibrocartilaginous embolism (6 cases), surgery (5 cases), and hypotension (4 cases). Aetiology was undetermined in 12 patients (29.3%), although 9 of these presented vascular risk factors. At the end of the follow-up period (median, 24 months; interquartile range, 3-70), 12 patients (29.2%) were able to walk without assistance. Vascular risk factors and paraparesis were significantly associated with poorer prognosis (P < .05). DISCUSSION Spinal cord infarction may present diverse aetiologies, with the cause remaining undetermined in many patients. Long-term functional prognosis is poor, and depends on baseline characteristics and clinical presentation. MRI, and especially diffusion-weighted sequences, is useful for early diagnosis.
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50
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Fornell-Pérez R, Alemán-Flores P, Peralta GPD, Rubio-García J, González-Domínguez MC, Aranda-Sánchez J, Vivas-Escalona V, Loro-Ferrer JF. Locoregional staging using magnetic resonance imaging in rectal cancer: influence of diffusion-weighted imaging in the diagnostic accuracy. CIR CIR 2021; 88:420-427. [PMID: 32567593 DOI: 10.24875/ciru.20001719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To assess whether the accuracy in locoregional staging using magnetic resonance imaging (MRI) in rectal cancer (primary or post-chemoradiotherapy) improves by adding diffusion-weighted imaging, according to the radiologist's degree of experience. Method Retrospective study on 100 MRI records (1.5 T, 2011-2016) from patients with rectal cancer (reference standard: histology of surgical specimens). Ten radiologists (three experienced in rectal cancer, three specialized in other areas and four residents) individually reviewed each case twice: first, evaluating just high-resolution T2-weighted sequences; second, evaluation of diffusion-weighted plus high-resolution ones. The analysis focused on the differentiation between early (0-I) and advanced (II-IV) stages. Accuracy, sensitivity/specificity and predictive values were calculated. Results Experienced radiologists showed some worsening by adding diffusion-weighted imaging, mainly at primary staging (accuracy: 0.769 to 0.701). Inexperienced radiologists presented a post-chemoradiotherapy improvement (accuracy: 0.574 to 0.642; specificity of 19.1 to 29.8%), although with no other remarkable changes. Residents demonstrated a worsening at primary staging by adding diffusion (accuracy: 0.670 to 0.633; specificity: 45.8 to 39.6%), but post-chemoradiotherapy improvement (sensitivity: 80.6 to 87%). The differences between both reviews were not statistically significant. Conclusions No significant differences were found in the distinction between early and advanced rectal tumors secondary to adding diffusion-weighted imaging to high-resolution T2-weighted sequences.
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Affiliation(s)
- Roberto Fornell-Pérez
- Departamento de Ciencias Clínicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria. Las Palmas de Gran Canaria, España
| | - Patricia Alemán-Flores
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario Insular Materno-Infantil. Las Palmas de Gran Canaria, España
| | - Gabriela Porcel-de Peralta
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario Insular Materno-Infantil. Las Palmas de Gran Canaria, España
| | - Jano Rubio-García
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario Insular Materno-Infantil. Las Palmas de Gran Canaria, España
| | - María C González-Domínguez
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario Insular Materno-Infantil. Las Palmas de Gran Canaria, España
| | - Joel Aranda-Sánchez
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario Insular Materno-Infantil. Las Palmas de Gran Canaria, España
| | - Valentina Vivas-Escalona
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario Insular Materno-Infantil. Las Palmas de Gran Canaria, España
| | - Juan F Loro-Ferrer
- Departamento de Ciencias Clínicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria. Las Palmas de Gran Canaria, España
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