Resumen:

Abstract

Prostate ultrasound and biopsy in the detection of prostate carcinoma.

Purpose: To present our experience in prostatic transrectal ultrasound and transrectal ultrasound-guided biopsy over a ten-year period by a retrospective analysis in order to determine the detection rate of adenocarcinoma, identify the distribution of positive samples in the gland, and evaluate the usefulness of biopsy of nodules seen on imaging studies.
Materials and Methods: A total of 1163 ultrasound and ultrasound-guided transrectal prostate biopsies were performed between March 2001: and November 2011. The population sample included patients who had more than one biopsy performed. Data obtained from these procedures enables us to identify three age groups according to the incidence of pathology, to determine the most frequent location of adenocarcinoma within the prostate, and to evaluate the usefulness of prostate nodules biopsy in the detection of adenocarcinoma.
Results: The data analysis showed a 16% detection rate of adenocarcinoma in men under 50 years of age, 36% in patients between 50 and 65 years, and 48% in patients older than 65 years. The left base of the prostate had the highest detection rate (15%), followed by left medium (14%), right base (14%), right medium (13%), left apex (12%), left lateral medium (12%), right apex (11%) and right lateral medium (10%). Nodular images were found in 299 patients: 118 were positive for adenocarcinoma (Group A) and 181 were negative (Group B). Group A was divided into 3 subgroups: Subgroup A, with a positive result only in the nodule sample, and a negative result in the rest of the gland sample; Subgroup B, with a positive result in the gland samples but negative in the nodule sample; and Subgroup C, with results that were positive both in the gland and nodule samples.
Conclusion: Ultrasound and ultrasound-guided transrectal prostate biopsy play an important role in the evaluation of the prostate when adenocarcinoma is suspected. Based on our experience, ultrasound-guided prostate biopsy is the most useful method for the detection of adenocarcinoma, especially in patients older than 65 years of age, and the nodule sample (if any) should be included in the eight-biopsy scheme.

Keywords. Ultrasound. Transrectal prostate biopsy. Adenocarcinoma. Nodule. Sample

Resumen:

Objetivos: Describir el comportamiento imagenológico del hepatocarcinoma en pacientes con cirrosis utilizando la tomografía computada multidetector (TCMD) dinámica y correlacionar los hallazgos con el grado histológico de los tumores.
Materiales y métodos: Estudio retrospectivo, observacional y descriptivo, donde se evaluaron 51 nódulos de 32 pacientes trasplantados de hígado con diagnóstico de cirrosis. La anatomía patológica del explante fue utilizada como referencia y los nódulos con histología de hepatocarcinoma fueron analizados retrospectivamente en las tomografías computadas efectuadas antes del trasplante. Las tomografías se llevaron a cabo con técnica dinámica, evaluando las características más frecuentes reportadas en la literatura: realce arterial, lavado del realce, cápsula y vasos arteriales intratumorales.
Resultados: Cuarenta y seis de 51 (90%) tumores mostraron realce arterial. De estos 46 tumores, 39 (85%) mostraron lavado del realce en la fase portal y/o tardía. De los 51, 5 (10%) fueron hipovasculares, 22 (43%) presentaron cápsula y 12 (24%) mostraron vasos arteriales intratumorales. La combinación de hallazgos más frecuente fue la asociación de realce arterial y lavado del realce en la fase portal-tardía (39/51 tumores: 76%), y el grado histológico más usual fue el II en 35 tumores (69%). Se hallaron asociaciones estadísticamente significativas entre el grado histológico de los tumores y los comportamientos imagenológicos realce arterial e hipovascular.
Conclusión: En nuestra población, el hallazgo tomográfico de realce arterial con lavado del realce en tiempo portal y/o tardío fue observado en la mayoría de los tumores. Esto coincide con publicaciones anteriores y contribuye a fortalecer el valor de estos criterios para el diagnóstico del hepatocarcinoma.

Palabras clave:
Cirrosis. Hepatocarcinoma. Tomografía Computada Multidetector. dinámica

Abstract
Findings in multidetector computed tomography in the diagnosis of hepatocellular carcinoma in patients with cirrhosis and correlation with pathology of liver explants

Objectives: To describe the imagenological behavior of hepatocellular carcinoma in cirrhotic patients using a dynamic multidetector computed tomography (MDCT) technique, and correlate these fi ndings with histological tumor grades.
Materials and methods: A retrospective, descriptive observational study was conducted to evaluate 51 nodules in 32 liver transplant patients diagnosed with liver cirrhosis. The pathology of liver explants was used as a reference. Nodules with hepatocellular carcinoma histopathology were retrospectively analyzed by computed tomography scans performed pre-transplant. Using a dynamic multidetector computed tomography technique, we evaluated the most common imagenological behavior reported in the literature: arterial enhancement, washout, capsule, and intratumoral arterial vessels.
Results: Forty-six of 51 (90%) tumors showed arterial enhancement. Of the 46 tumors with arterial enhancement, 39 (85%) had washout in portal-late phase. Five of 51 (10%) were hypovascular. Twenty-two of 51 (43%) had capsule and 12 of 51 (24%) showed intratumoral arterial vessels. The more frequent image combination was the combination of arterial enhancement and washout (39 of 51 tumors or 76%). The most frequent histological grade was II (35 of 51 tumors or 69%). Statistically signifi cant relationships were found between histological grade tumors and imagenological behavior: arterial enhancement and hypovascular.
Conclusion: In our population, arterial enhancement with washout in portal-late phases was observed in most of the tumors. Our results are consistent with previously reported studies, demonstrating the high reliability of this imaging pattern for the diagnosis of hepatocellular carcinoma.

Key Words:
Cirrhosis. Hepatocellular carcinoma. Dynamic multidetector. Computed tomography

Resumen:

En este artículo, el autor realiza una descripción de las diferentes modalidades que constituyen el conjunto de exámenes con imágenes de tipo moleculares que se encuentran disponibles actualmente para el estudio de la glándula mamaria. En efecto, los estudios moleculares de la mama se están convirtiendo en alternativas muy útiles para la evaluación de la enfermedad tumoral primaria y metastásica. La Gammagrafía Específica de Mama (BSGI), las imágenes moleculares de la Mama (MBI), la Tomografía con Emisión de Positrones y la Mamografía con Emisión de Positrones (PEM), constituyen el arsenal de estudios que revelan la actividad metabólica del tumor por la captación de un radiofármaco. El isótopo se absorbe por todas las células en el cuerpo y es atrapado por las células tumorales que emiten rayos gamma que son a su vez captados por la gamma cámara y convertidos en imágenes digitales. Estos estudios son más confiables al diferenciar células malignas de células normales.

Palabras clave: mama. molecular. PET.

In this article, the author makes a description of the different forms that constitute the set of tests with molecular type images that are currently available for the study of the mammary gland. Indeed, molecular studies of the breast is becoming very useful alternative for the evaluation of the primary tumor and metastatic disease. Breast Specific Scintigraphy Image (BSGI), Molecular Breast Imaging (MBI), Positron Emission Tomography (PET) and Positron Emission Mammography (PEM), constitute the arsenal of studies showing tumor metabolic activity by uptake of a radiopharmaco. The isotope is absorbed by all cells in the body and is trapped by the tumor cells which emit gamma rays that are themselves picked up by the gamma camera and converted into digital images. These studies are more reliable in differentiating malignant cells from normal cells.

Key Words: breast. molecular. PET.

Resumen:

La necrosis grasa abdominal puede causar dolor, simular un abdomen agudo o ser asintomática y acompañarse de otros procesos fisiopatológicos. Alteraciones que comúnmente se relacionan a necrosis grasa abdominal incluyen la torsión de un apéndice epiploico (un proceso inflamatorio autolimitado de los apéndices epiploicos), infarto del omento mayor (un infarto hemorrágico resultante del compromiso vascular del omento), necrosis grasa encapsulada (afección traumática o isquémica que causa degeneración grasa), saponificación grasa y pancreatitis y osificación heterotópica vinculada a incisiones quirúrgicas del abdomen (un subtipo de miositis osificante traumática en la que elementos óseos, cartilaginosos y ocasionalmente mielógenos se forman en una incisión quirúrgica).

Palabras clave: necrosis. grasa. abdomen.

Abstract
Abdominal fat necrosis may cause pain, mimic findings of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Common processes that are present in fat necrosis include torsion of an epiploic appendage (a self-limited inflammation of the appendices epiploicae), infarction of the greater omentum (a hemorrhagic infarction resulting from vascular compromise), encapsulated fat necrosis (traumatic or ischemic insult that causes fat degeneration), fat saponification and pancreatitis and heterotopic ossification in surgical incisions of the abdomen (represent a subtype of traumatic myositis ossificans in which osseous, cartilaginous, and, occasionally, myelogenous elements forms within a surgical incision).

Key Words: necrosis. fat. abdominal.

Resumo:

Abstract

Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

Keywords: Inferior vena cava. Congenital abnormalities. Venous thrombosis.

Resumo:

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis



Abstract:Spondylodiscitis represents 2%–4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis.

Keywords: Magnetic resonance imaging. Discitis. Intervertebral disc. Spinal tuberculosis.

Resumen:

Abstract:

This article reviews the radiographic evaluation of articular cartilage lesions with emphasis on its magnetic resonance imaging study, we will discuss the usefulness of conventional sequences and advanced MRI studies which allow detection of incipient intrasubstance chondral lesions, prior to the ulceration of its surface

Keywords: Articular cartilage. Magnetic resonance.

Resumen:

Torticollis in children: A pictographic review

Abstract:

Torticollis describes the clinical finding of an abnormal positioning of the head related with the body axis, with cervical rotation and contralateral tilt of the head, which is usually secondary to an involuntary contraction of the cervical musculature been sternocleidomastoideus muscle (ECM) the most important component. As a clinical sign, differential diagnosis is very broad, and may be secondary to multiple causes. Pediatric population has a particular spectrum of diseases which differs from adults. The aim of this pictorial review is to evaluate some torticollis causes in the pediatric setting recording main imaging findings and their contribution to the clinical diagnosis.

Keywords: Children. Imaging. Torticollis

Resumen:

Abstract

Diagnosis by Ultrasound of Rupture of Mammary Implants and Other Associated Complications: Revision Article
The imaging diagnosis of the rupture of the mammary implant is a frequent consultation and a diagnostic challenge. The factors for occurrence can be related to the patient – reason for the implant, type of incision, location of the implant, age-or the implant itself-type, age of insertion, mark-. In the group of imaging techniques, the one with the best diagnostic performance is magnetic resonance; however, in most cases, the initial diagnosis tool is the ultrasound. The appearance of a normal silicone implant, through ultrasound, includes the visualization of well-defined margins of the cover, and the homogenous and anechoic silicone lumen. There are several imaging signs in the intracapsular rupture. The signs with the best performance are an increase in size of the space between the fibrous capsule and the external cover of the implant due to occupation of the extravasation liquid, as well as the complicated appearance of the implant lumen given by the staircase sign and the internal low-level echoes. The most reliable sign in the extra capsular rupture is the snowstorm sign. Other signs, such as peri-implant effusion and the irregular shape of the implant, are not reliable. Both types must be differentiated from silicone bleeding, which is a silicone exit or transudate through a capsule without evident rupture or another associated finding, due to a change in the permeability of the prosthesis cover, which increases its use over the years, most frequently in a span between 15 and 20 years.

Key words: Breast implant Prostheses and implants. Breast Ultrasonography mammary

Resumen:

Abstract

Magnetic Resonance Imaging: Clinical Utility in the Evaluation of Fetal Central Nervous System

Magnetic Resonance Imaging (MRI) is a valuable complementary technique to prenatal ultrasound. It is useful in the detection and characterization of the fetal central nervous system (CNS) anomalies, partly due to the use of ultrafast sequences to reduce acquisition times. This is a revision article that shows representative cases by the authors. We include a woman in the second and third trimester of pregnancy, referred for an MRI due a suspicion of fetal CNS anomaly during the ultrasound, and images of normal fetal brains, in pregnant women referred for a suspicion of placenta accreta.

Key words:Fetal development. Magnetic resonance imaging. Nervous system. Prenatal diagnosis

Resumen:

Abstract:

The pulsed Doppler ultrasound allows quantitative evaluation of orbital vascular structures by measuring the VPS, VFD, IR, IP, TA, IA. Be valued B-mode, color Doppler and pulsed Doppler patients diagnosed by eye fundus of diabetic retinopathy. We evaluated 12 patients. The ACR showed IR <0.70 1 case, IR from 0.71 - 0.79 12 cases and IR> 0.80 11 cases, in AO the patients showed IR <0.75 3 cases, IR from 0.76 to 0.80 5 cases and IR> 0.81 16 cases. The IR and TA of the ACR are increased and the values are related to the stage of DR, IP and VPS are also increased, the IA and VDF showed no change compared to the control group. The IR, IP, TA, VPS of the AO were increased, VDF decreased, IA shows no change compared to the control group, The assessment of the ACR and AO to determine changes in the pulsed Doppler related to diabetes.

Resumen:

Abstract:

Among the anomalies of the upper urinary tract are the anomalies of ascent, which includes simple renal ectopia, and the anomalies of form and fusion, which includes crossed renal ectopia with and without fusion and horseshoe kidney. Since these pathologies are frequently asymptomatic, the diagnosis is most commonly made after a routine imaging studies due to other causes or when recurrent UTI or urinary obstruction are associated. The radiologic findings of the cases registered in two of the largest and of major national reference are described.

Key Words: renal ectopia, horseshoe kidney, anomalies of the upper urinary tract, renal anomalies, imaging studies.

Resumen:

Diagnostic intervention in breast disease

Abstract:
Imaging-guided percutaneous biopsy techniques have been developed to diagnose the lesions detected in breast cancer screening programs based on mammography. Although traditional fine-needle aspiration cytology continues to be indicated in some cases, in many others it has been supplanted by more modern techniques like core biopsy or vacuumassisted biopsy guided by ultrasonography, stereotaxy, or magnetic resonance imaging. These highly reliable techniques have minimized the need for surgical biopsy. Radiologists play a key role in the histological diagnosis of breast cancer in the early stages of disease and in the evaluation of its local and regional extension through magnetic resonance imaging and sentinel node biopsy.

Keywords: Core biopsy. Vacuum-assisted. breast biopsy. Galactography

Resumen:

Update thoracic sarcoidosis

Abstract:

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. It mainly affects the thoracic lymph nodes and the lungs. The staging of sarcoidosis, which classifies patients according to their probability of spontaneous remission, is based on the plain chest film findings. Plain chest films are not as sensitive as high resolution computed tomography (HRCT) at detecting involvement of the lymph nodes, lungs, or bronchi. The high resolution CT findings can be typical, practically pathognomic, or atypical. High resolution CT provides information about the activity of the disease and detects incipient signs of fibrosis and other complications. To reach the diagnosis, it is necessary to correlate the clinical and radiological findings (and often the histological findings). Cardiac involvement can cause sudden death. The diagnosis of cardiac involvement is difficult; it is based on various imaging tests, like magnetic resonance imaging, which is more specific, and positron emission tomography. Diagnostic confirmation by endomyocardial biopsy is obtained in few patients.

Key Words: Sarcoidosis. Diffuse pulmonary disease. High resolution chest computerized tomography. Cardiac sarcoidosis

Resumen:

Abstract:

We describe a case of a solitary and metachronous breast metastases three years after nefrectomy in a patient with a renal cell carcinoma. Reviewed literature shows that the breast is an unusual site of metastatic extramammary tumors, and metastatic renal cell carcinoma to the breast is extremely rare.

Key Words: Breast metastatic. renal cell. carcinoma. breast neoplasm

Resumen:

Abstract:
The concept of false negative in mammograms is defined and the factors which can define its occurrence are exposed. Mechanisms which can be used to reduce its incidence are indicated. There are six factors implied in false negatives: radiological anatomy of the breast, radiological characteristics of the lesion itself, performance of the radiology doctor, state of the equipment, performance of the radiology technician, and environment in which the process is developed. To reduce the frequency of false negatives, the following procedures must be considered: imaging quality controll, working team training, (including the doctor, technician and the rest of the people involved in the process of diagnosis), double reading of the images and computer aided detection. Analyzing false negative causes should be a frequent practice in every center since this knowledge allows us to take steps to reduce the probability of their occurrence.

Key Words: false negatives. mammogram

Resumen:

Abstract:

Ultrasonography (US) is an indispensable tool in breast imaging and is complementary to both mammography and magnetic resonance (MR) imaging of the breast. Advances in US technology allow confident characterization of not only benign cysts but also benign and malignant solid masses. Knowledge and understanding of current and emerging US technology, along with the application of meticulous scanning technique, is imperative for image optimization and diagnosis. The ability to synthesize breast US findings with multiple imaging modalities and clinical information is also necessary to ensure the best patient care. US is routinely used to guide breast biopsies and is also emerging as a supplemental screening tool in women with dense breasts and a negative mammogram. This review provides a summary of current state-of-the-art US technology, including elastography, and applications of US in clinical practice as an adjuvant technique to mammography, MR imaging, and the clinical breast examination. The use of breast US for screening, preoperative staging for breast cancer, and breast intervention will also be discussed.

Abstract:

Abstract:

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases characterized by synovial inflammation and is the most common rheumatic complaint in children. To facilitate research and treatment, JIA has been further classified on the basis of the number of joints involved, additional symptoms, family history, and serologic findings. Imaging in patients with JIA has historically relied on radiography, which allows the accurate assessment of chronic changes of JIA, including growth disturbances, periostitis, and joint malalignment. However, radiographic findings of active inflammation are nonspecific, and, in the past, clinical evaluation has taken precedence over imaging of acute disease. Recent advances in disease-modifying therapeutic agents that can help prevent long-term disability in patients with JIA have led to greater emphasis on the detection of early joint-centered inflammation that cannot be accurately assessed radiographically and may not be evident clinically. Both contrast material–enhanced magnetic resonance (MR) imaging and Doppler ultrasonography (US) are well suited for this application and are playing an increasingly important role in diagnosis, risk stratification, treatment monitoring, and problem solving. Contrast-enhanced MR imaging is the most sensitive technique for the detection of synovitis and is the only modality that can help detect bone marrow edema, both of which indicate active inflammation. US is more sensitive than radiography for the detection of synovial proliferation and effusions and is particularly useful in the evaluation of small peripheral joints. The complexity of the temporomandibular and sacroiliac joints limits the usefulness of radiographic or US evaluation, and contrast-enhanced MR imaging is the preferred modality for evaluation of these structures.