Resumen:

Abstract:

Study of brain perfusion anomalies assessed with cerebral SPECT in drug abuse patients Psychoactive drug abuse is a major public health problem in many districts. This study seeks to determine the harmful effects of such drugs on the brain parenchyma of patients known to abuse illegal drugs.
Brain scans were obtained using 99 M Tc- ECD SPECT from drug addicts that had been previously surveyed to ascertain the type of drug, the timing and duration of their addiction SPECT findings showed a larger number of cortical perfusion defects, that is to say functional defects located in the orbital-frontal cortex and in the temporal lobes that may explain the significant behavior and personality disorders these patients display.
Cerebral SPECT showed to be an excellent method to detect areas affected by psychoactive drugs, their extent, likely evolution and response to treatment.

Key Words: Key words: Brain SPECT, Drug abuse, Cocaine, Marihuana.

Resumen:

Introducción:
Los miomas uterinos son los tumores sólidos más frecuentes del aparato genital femenino. En un alto porcentaje son asintomáticos, pero cuando se acompañan de sangrado uterino anormal, dolor o síntomas de compresión, se debe aplicar un tratamiento. La Embolización Arterial Uterina (EAU) se presenta como una alternativa al tratamiento quirúrgico.

Objetivo:
El objetivo de este trabajo es medir la eficacia de la EAU como tratamiento de la miomatosis sintomática a corto y mediano plazo, evaluar la seguridad y comparar los resultados con otros tratamientos.

Material y Método: Se realizó un estudio prospectivo de 28 pacientes seleccionadas entre diciembre de 2000 y abril de 2005, cuya edad promedio era 41 años y que presentaban miomatosis sintomática, con alteraciones en el sangrado menstrual y deseos de conservación del útero. Las EAU fueron realizadas con partículas de polivinil alcohol de 500 a 1000 µm. A todas se les hizo un seguimiento posterior mayor de 2 años.

Resultados:
En 27 pacientes, el alta médica se otorgó a las 24 horas post EAU. Una paciente permaneció internada por la persistencia de dolor pelviano y una se reinternó por la misma causa a las 48 horas post procedimiento. Todas las pacientes reanudaron sus actividades rutinarias a los 7 ± 4 días post embolización. No se presentaron complicaciones. Luego de un seguimiento de 6 meses, el 100 % de las pacientes se manifestaron satisfechas con el procedimiento.

Conclusión: La EAU es una excelente alternativa a los tratamientos clásicos y una opción terapéutica para las pacientes portadoras de miomas uterinos sintomáticos.

Palabras clave: Embolización. Arterias uterinas. Miomatosis.

Abstract:
Uterine fibroid embolization: morphologic and functional results at short-to-medium term

Introduction:
Uterine myomas are the most frequent solid tumours of the female reproductive system. In a high percentage of cases patients are asymptomatic; however, when clinical manifestations occur such as abnormal uterine bleeding, pain or compressive symptoms, some kind of therapy must be initiated. Uterine artery embolization (UAE) is an alternative to conventional surgical therapy.

Purpose:
The objective of this study was to evaluate the usefulness of UAE as treatment for symptomatic myomatosis at short and intermediate term, to evaluate the safety of this technique and to compare its results with other alternative treatments.

Material and methods: Prospective study of 28 selected patients who underwent UAE from December 2000 to April 2005 and followed up until April 2008 whose average age was 41 years. All the patients presented with symptomatic myomatosis with menstrual bleeding disorders. All the patients desired to keep their uterus. The embolizing material was polyvinyl alcohol particles of 500-1000 µm.

Results:
Twenty seven patients were discharged 24 hours after the UAE. One patient remained hospitalized 12 more hours and 1 was readmitted 48 hours after the procedure, both due to pelvic pain. All the patients returned to their usual activities 7 + days after the UAE. None of the patients presented complications. All the patients remained satisfied with the results of the procedure at the 6-month control.

Conclusion:
UAE is an outstanding alternative to conventional treatment, with high technical success and safety. It should be considered for patients with symptomatic uterine myomas.

Key Words: Embolizatión. Uterine arteries. Myomatosis.

Resumo:

Objetivo: Descrever as alterações na tomografia computadorizada de tórax de casos comprovados de infecção pelo novo vírus influenza A (H1N1).

Materiais e Métodos: Três observadores avaliaram, em consenso, nove tomografias computadorizadas de pacientes com infecção pelo vírus influenza A (H1N1) comprovada laboratorialmente. A idade dos pacientes variou de 14 a 64 anos (média de 40 anos), sendo cinco do sexo masculino e quatro do sexo feminino. Quatro pacientes eram previamente hígidos, quatro eram transplantados renais e uma era gestante à época do diagnóstico. Foram avaliadas a presença, a extensão e a distribuição de:

a) Opacidades em vidro fosco
b) Nódulos centrolobulares
c) Consolidações
d) Espessamento de septos interlobulares
e) derrame pleural
f) linfonodomegalias.

Resultados: As alterações mais frequentemente encontradas foram opacidades em vidro fosco, nódulos centrolobulares e consolidações, presentes em nove (100%), cinco (55%) e quatro (44%) dos casos, respectivamente. Derrames pleurais e linfonodomegalias foram menos comuns, ocorrendo em apenas dois (22%) dos casos estudados.

Conclusão: Os achados mais comuns nos casos de infecção pelo novo vírus influenza A (H1N1) foram opacidades em vidro fosco, nódulos centrolobulares e consolidações. Estas alterações não são típicas ou únicas a este agente, podendo ocorrer também em outras infecções virais ou bacterianas.

Abstract:
Objective:

The objective of this study was to describe chest computed tomography findings in confirmed cases of infection by the novel influenza A (H1N1) virus.

Materials and Methods:
Computed tomography studies of nine patients with laboratory-confirmed infection by the novel influenza A (H1N1) virus were consensually evaluated by three observers. The sample of the present study included five male and four female patients with ages ranging from 14 to 64 years (mean, 40 years). Four of the patients were previously healthy, four were kidney transplant recipients and one was pregnant at the time of diagnosis. Presence, extent and distribution of the following findings were evaluated:

a) ground-glass opacities
b) centrilobular nodules
c) consolidation
d) interlobular septa thickening
e) pleural effusion
f) lymphadenopathy

Results: The most frequent findings were ground-glass opacities, centrilobular nodules and consolidations, present in nine (100%), five (55%) and four (44%) of cases, respectively. Pleural effusions and lymphadenopathy were less common findings, occurring in only two (22%) of the cases.

Conclusion: Ground-glass opacities, centrilobular nodules and consolidation were the most frequent findings in cases of infection by the novel influenza A (H1N1) virus. These changes are not typical or unique to this agent and may also occur in other viral or bacterial infections.

Key Words: Influenza A virus; Influenza A (H1N1) virus subtype; Viral pneumonia; X-ray computed tomography.

Objetivo:
Estudar a utilidade da sequência pesada em difusão na diferenciação das lesões mamárias benignas e malignas.

Materiais e Métodos:
Quarenta e cinco mulheres (idade média de 46,1 anos) com 52 nódulos de mama foram submetidas a ressonância magnética acrescida da sequência difusão. O coeficiente de difusão aparente (ADC) foi calculado através do mapa de ADC obtido pelo uso de cinco valores de b (0, 250, 500, 750 e 1.000 s/mm ). O valor de ADC médio de cada lesão foi correlacionado com achados de imagem e resultados histopatológicos. Valores de ADC de corte, sensibilidade e especificidade da sequência difusão na diferenciação das lesões benignas e malignas foram calculados. P < 0,05 foi considerado estatisticamente significativo.

Resultados:
O valor de ADC médio foi significativamente menor para as lesões malignas (0,92 ± 0,26 × 10 2 – 3mm/s) comparado com as lesões benignas (1,50 ± 0,34 × 102–3mm/s) (p < 0,0001). A sequência difusão mostrou altas sensibilidade e especificidade (ambas 92,3%) na diferenciação entre lesões benignas e malignas.

Conclusão:
A sequência pesada em difusão representa um recurso potencial como coadjuvante da ressonância magnética das mamas na diferenciação das lesões benignas e malignas. Tal sequência pode ser facilmente inserida no protocolo padrão da ressonância magnética das mamas, sem aumento significativo no tempo de exame.

Unitermos: Câncer de mama; Difusão; Imagem por ressonância magnética.

Objective:
To study the utility of diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant breast lesions.

Materials and Methods:
Forty-five women (mean age, 46.1 years) with 52 focal breast lesions underwent diffusion-weighted magnetic resonance imaging. The calculation of apparent diffusion coefficient (ADC) was based on the ADC map reflecting five b values (0, 250, 500, 750, and 1000 s/mm). The mean ADC value of each lesion was correlated with imaging findings and histopathologic results. Cutoff ADC, sensitivity and specificity of diffusion-weighted imaging in the differentiation between benign and malignant lesions were calculated. P < 0.05 was considered as statistically significant.

Results:
The mean ADC was significantly lower for malignant lesions (0.92 ± 0.26 × 10 mm 22/s) as compared with benign lesions (1.50 ± 0.34 × 10 –3 mm 2 –3 /s) (p < 0.0001). Diffusion-weighted imaging showed high sensitivity and specificity (both, 92.3%) in the differentiation between benign and malignant lesions.

Conclusion:
Diffusion-weighted imaging is a potential resource as an adjuvant to breast magnetic resonance imaging to differentiate benign from malignant lesions. Such sequence can be easily added to the standard breast magnetic resonance imaging protocol, without implying any significant increase in examination time.

Key Words: Breast cancer; Diffusion-weighted imaging; Magnetic resonance imaging.

Resumen:
Las enfermedades que cursan con desarrollo asimétrico de una de las extremidades son entidades raras y se consideran un reto para los radiólogos. dentro de estas entidades encontramos la macrodistrofia lipomatosa, el síndrome de proteus, el síndrome de maffucci y el síndrome de Klippel-trenaunay-Weber. Es importante conocer los hallazgos radiológicos de las enfermedades que se caracterizan por gigantismo, para lograr un diagnóstico acertado

Palabras Clave: Gigantismo; Extremidad Proteus; Klippel - Trenaunay - Weber

Summary:
The diseases that present with asymmetric development of a limb are rare entities and are considered a challenge for radiologists. Within these entities are macrodystrophia lipomatosa, proteus syndrome, maffucci syndrome, and the Klippel-trenaunay-Weber. it is important to know the radiological findings of diseases characterized by gigantism, in order to achieve a right diagnosis.

Key Words: Gigantism; Proteus; Klippel - Trenaunay - Weber syndrome

Resumen:
En este artículo se presentan 13 casos de pacientes con trauma óseo que, en el momento de la consulta, se presentó oculto a los rayos x y se hizo evidente en imágenes por resonancia magnética (Irm), practicadas después. se revisaron las historias clínicas de estos pacientes, en casos en los cuales las radiografías o escanografías habían sido reportadas como normales. la persistencia del dolor osteomuscular con limitación funcional sin mejoría con el manejo médico es el determinante más común que lleva a la solicitud de estudios de mayor complejidad y hacen de ésta una indicación para la realización de IRM.

Palabras Clave: Fracturas ocultas Rayos X Imagen por resonancia magnética Heridas y traumatismos

Summary:
This article presents 13 cases of patients with x-ray occult bony trauma at admission, in which magnetic resonance imaging diagnostic was of bone lesions. clinical charts of these patients, with normal x-rays o Tc and mrI reported bony traumatic lesions were reviewed. Persistent pain with functional impairment unresponsive to medical treatment was the most common feature leading to clinical indication of MRI.

Key Words: Occult fractures X-rays Magnetic resonance imaging Wounds and injuries

Resumen:
La caracterización de las lesiones hepáticas en resonancia magnética se basa en: morfología,comportamiento en las diversas secuencias y con el contraste paramagnético.

Objetivo: Evaluar el comportamiento en difusión de diversas lesiones sólidas, midiendo ADC para determinar su utilidad. En los años 2007-2008, se estudiaron 51 lesiones focales sólidas (26 pacientes) con resonancia magnética, utilizando secuencias convencionales y difusión, que fue adquirida con modalidad EPI con diferentes valores de “b”. Las lesiones correspondieron a: 20 hemangiomas, 12 hiperplasias nodulares focales (HNF), 5 hepatocarcinomas (HCC) y 14 metástasis. El análisis estadístico permitió determinar nivel de corte óptimo (ADC 1.28×10 mm - 3 2/s) para diferenciar lesiones benignas de malignas. Los valores ADC de lesiones benignas fueron significativamente mayores que los de las malignas; el hemangioma fue la lesión sólida con mayor ADC, seguido por HNF, HCC y metástasis, con valores menores. Los valores medios encontra- dos fueron de 1.68, 1.30, 1.08 y 1.03 (x10 mm -3 2/s) respectivamente. En nuestra opinión, la técnica de difusión debe utilizarse como complemento de resonancia magnética convencional, para una adecuada caracterización de lesiones sólidas hepáticas.

Palabras Clave: Difusión, Lesiones Hepáticas Sólidas, Resonancia magnética.

Abstract:
The characterization of liver lesions in MRI is based on morphology, behavior in the various sequences, and with paramagnetic contrast.

Objective: To evaluate the diffusion behavior of various solid lesions, measuring ADC to determine its usefulness. Between 2007 and 2008 we studied 51 solid focal esions (26 patients) with MRI, using conventional sequences and diffusion-weighted imaging obtained with EPI mode with different values of “b”. Lesions corresponded to 20 hemangiomas, 12 focal nodular hyperplasia (FNH), 5 hepatocellular carcinoma (HCC), and 14 metastases. The statistical analysis allowed us o determine optimal cutoff level (ADC 1.28 × 10 mm -3 2/s) o differentiate benign from malignant lesions. ADC values of benign lesions were significantly higher than hose of the malignant ones; the hemangioma wasthe solid lesion with higher ADC values, followed by FNH, HCC and metastases, with lower values. Registered mean values were 1.68, 1.30, 1.08 and 1.03 (x10 mm/s), respectively. In our view, the diffusion-weighted technique should be used to supplement conventional MRI for proper characterization of solid liver lesions.

Key Words: Diffusion, MRI, Solid liver lesions.

Resumen:
Las lesiones del cartílago articular son frecuentes y su diagnóstico por imagen cada día más importante. La resonancia magnética es el método de diagnóstico por imagen de elección para la evaluación de lesiones condrales. Este artículo revisa la utilidad de este método, en relación a estudios convencionales así como también estudios avanzados, cuantitativos, que permiten evaluar alteraciones condrales iniciales antes de ser evidentes en secuencias habituales de resonancia magnética.

Palabras Clave: Cartílago articular, Lesiones condrales, Resonancia magnética.

Abstract:
Articular cartilage injuries is a common event and imaging technique has become increasingly important in diagnosing them. Magnetic Resonance Imaging (MRI) is the imaging method of choice for the evaluation of chondral lesions. This article reviews the usefulness of this method compared to conventional as well as to advanced quantitative studies, thus enabling evaluation of initial cartilage alterations before being evident in normal MRI sequences.

Key Words: Articular cartilage, Chondral lesions, Magnetic Resonance Imaging.

Resumen:
El radiólogo desempeña un papel crucial en el manejo multidisciplinar del paciente politraumatizado, que en las últimas décadas ha sufrido un cambio evolutivo desde la radiología simple hasta la tomografía computarizada multidetector de cuerpo completo, propiciado por los avances tecnológicos y los cambios culturales sanitarios. En este artículo se muestra la evolución de los diferentes protocolos y la situación actual del manejo del paciente politraumatizado. El radiólogo integrado en un equipo multidisciplinar debe decidir la técnica de imagen y el protocolo más idóneo en cada situación, adaptándose a los recursos tecnológicos disponibles.

Palabras Clave: Politrauma; Protocolo; Radiología simple; Tomografía computarizada multidetector de cuerpo completo

Summary:
The radiologist plays a crucial role in the multidisciplinary management of patients with multiple trauma. In the last few decades, technological advances and changes in the healthcare culture have led to changes in the imaging work-up of multiple trauma patients, with emphasis shifting from plain-film radiography to whole-body multidetector CT. This article describes the evolution of the different protocols and the current practice in the management of patients with multiple trauma.

Key Words: Multiple trauma; Protocol; Plain-film radiography; Whole-body multidetector computed tomography