RADIOLOGIA最新文献

英文中文

Fluctuación espontánea del realce de contraste en el astrocitoma pilocítico adulto 成人毛细胞星形胶质细胞瘤对比增强的自发波动

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2025.01.003

S.R.K. Ong , T.J. Rohringer , A.F. Gao , A.E. Para , S. Hiremath , P. Alcaide-Leon

Background

Follow-up imaging is crucial in managing primary brain tumors, with changes in contrast enhancement often used as a marker of tumor activity. However, fluctuations of enhancement independent of tumor progression have been described in low grade tumors in the pediatric population. This study aims to characterize the phenomenon of spontaneous contrast enhancement fluctuations in pilocytic astrocytoma and other low-grade primary brain tumors in the adult population.

Methods

A retrospective review of our MRI database (2011-2021) identified cases of pilocytic astrocytomas, pilomyxoid astrocytoma and rosette-forming glioneuronal tumors with stable tumor size with enhancement changes in clinically stable adult patients off medical treatment. After excluding those without serial MRIs, we reviewed the MRIs and clinical records of 238 patients. Number of cases with enhancement fluctuations, mean duration of increasing enhancement prior to stability or decline and number of fluctuation cycles were recorded.

Results

The cohort included 9 adult patients, 6 pilocytic astrocytomas, 1 pilomyxoid astrocytoma and 2 rosette-forming glioneuronal tumors. Four of these were unresected (44%), while five were residual or recurrent tumors (56%). Despite stable tumor size and clinical status, a variety of enhancement patterns over time were observed: 44% of cases (4/9) demonstrated new or increasing enhancement on follow-up, with subsequent regression of enhancement over a 1-4 year follow-up period. An additional 44% of cases (4/9) displayed cyclical increasing and decreasing enhancement over a longer 7-15 year follow-up period. Mean duration of increasing enhancement prior to stability or decline was 12.3 months (SD 7.1). One case exhibited complete spontaneous resolution of enhancement. Fluctuation in morphology of enhancement was also observed in 44% of cases (4/9).

Conclusions

This is the first study to describe spontaneous fluctuation of enhancement in pilocytic astrocytoma and other circumscribed low-grade brain tumors in an adult population. Awareness of this phenomenon is crucial to prevent misinterpretation of enhancement changes as evidence of tumor progression or regression in clinically stable patients, circumventing unnecessary treatment changes and interventions.

随访影像在原发性脑肿瘤的治疗中至关重要，对比度增强的变化通常被用作肿瘤活动的标志。然而，在儿童低级别肿瘤中，增强的波动与肿瘤进展无关。本研究旨在描述成人毛细胞星形细胞瘤和其他低级别原发性脑肿瘤的自发造影剂增强波动现象。方法回顾性分析我院MRI数据库（2011-2021年），在临床稳定的成人患者中发现肿瘤大小稳定且增强变化的毛细胞星形细胞瘤、毛粘液样星形细胞瘤和玫瑰花形胶质细胞肿瘤。在排除那些没有连续mri的患者后，我们回顾了238例患者的mri和临床记录。记录有增强波动的病例数、增强在稳定或下降之前的平均持续时间以及波动周期数。结果9例成人患者中6例为毛细胞星形细胞瘤，1例为毛细胞样星形细胞瘤，2例为玫瑰花状胶质细胞瘤。其中4例未切除（44%），5例为残留或复发肿瘤（56%）。尽管肿瘤大小和临床状态稳定，但随着时间的推移，观察到各种强化模式：44%的病例（4/9）在随访中表现出新的或增强的强化，随后在1-4年的随访期间增强消退。另外44%的病例（4/9）在较长的7-15年随访期间表现出周期性的增加和减少。在稳定或下降之前，增强的平均持续时间为12.3个月（SD 7.1）。1例表现出完全自发的增强消退。44%的病例（4/9）也观察到增强形态的波动。结论：这是第一个描述成人毛细胞星形细胞瘤和其他局限性低级别脑肿瘤增强的自发波动的研究。意识到这一现象对于防止将增强变化误解为临床稳定患者肿瘤进展或消退的证据，避免不必要的治疗改变和干预至关重要。

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引用次数: 0

Valor de la imagen potenciada en difusión en la estadificación del carcinoma endometrial y en la caracterización de tumores mesenquimales miometriales 放大图像在子宫内膜癌分期和子宫内膜间质肿瘤表征中的价值

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2024.11.005

S. Baleato-González , C. Suárez-Silva , E. Arias Baltar , M. Sanmartín López , J.C. Vilanova , R. García-Figueiras

Diffusion-weighted imaging is an advanced technique that plays a key role in the evaluation of uterine tumours. This pictorial review explores key aspects of diffusion-weighted imaging acquisition and application, emphasising its role in diagnosing endometrial cancer and in identifying prognostic factors that influence staging as well as clinical and surgical patient management. It specifically highlights the new 2023 FIGO classification. Additionally, it examines the use of diffusion in the characterisation of myometrial mesenchymal lesions, applying the acronym BET¹T²ER as a memory aid to distinguish between benign and malignant lesions. It draws particular attention to findings that could lead to misinterpretations.

弥散加权成像是一种先进的技术，在子宫肿瘤的评估中起着关键作用。这篇图片综述探讨了弥散加权成像获取和应用的关键方面，强调了其在诊断子宫内膜癌和确定影响分期以及临床和手术患者管理的预后因素中的作用。它特别强调了新的2023年菲戈分级。此外，它还研究了在肌内膜间质病变表征中弥散的使用，应用首字母缩略词BET1T2ER作为区分良性和恶性病变的记忆辅助。它特别提请注意可能导致误解的调查结果。

引用次数: 0

Integración de la consulta y hospitalización en las unidades de radiología vascular intervencionista: posicionamiento de la SERVEI 将会诊和住院纳入介入性血管放射科：SERVEI的定位

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2025.501739

J.M. Abadal Villayandre , S. Lojo-Lendoiro , C.J. González Nieto , I. Insausti Gorbea , S. Méndez Alonso , M. Gamo Gallego , J.J. Ciampi Dopazo , R. Pintado Garrido , J.A. Guirola Ortiz

What was once a technical discipline, interventional vascular radiology (IVR) has now developed into a patient-centred clinical-surgical speciality. The integration of outpatient consultation and inpatient care within IVR units enhances safety, improves clinical outcomes and consolidates the speciality's role within the healthcare system. However, barriers such as lack of time, resources and recognition hinder its implementation. This SERVEI position statement defines the core principles of clinical care in IVR, examines the legal frameworks underpinning it and identifies viable models for hospitalisation, ranging from day units to dedicated inpatient wards. Progressive levels of healthcare provision are proposed, and an organisational model based on homogeneous functional groups (HFGs) is advocated to achieve greater efficiency and visibility. Outpatient consultation plays a central role in accreditation, the training of future specialists and the sustainability of the speciality in an evolving healthcare landscape.

介入血管放射学（IVR）曾经是一门技术学科，现在已经发展成为一门以患者为中心的临床外科专业。IVR单元内门诊咨询和住院护理的整合提高了安全性，改善了临床结果，并巩固了该专业在医疗保健系统中的作用。然而，诸如缺乏时间、资源和认识等障碍阻碍了它的实施。这份SERVEI立场声明定义了IVR临床护理的核心原则，审查了支撑它的法律框架，并确定了可行的住院模式，从日间病房到专门的住院病房。提出了渐进式医疗保健提供水平，并提倡基于同质功能组（HFGs）的组织模型，以实现更高的效率和可见性。门诊咨询在认证、未来专家的培训和不断发展的医疗保健领域的专业可持续性方面发挥着核心作用。

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引用次数: 0

Estudio ecográfico de la axila normal: características anatómicas de los ganglios linfáticos y variaciones de las mismas con la edad 正常腋窝超声检查：淋巴结的解剖特征及其随年龄变化

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2024.12.001

A.C. Igual Rouilleault , I. Soriano Aguadero , C. Sitges Puigivila , P.L. Quan López , A. Elizalde Pérez , L. Pina

Objectives

To describe the ultrasound characteristics of axillary lymph nodes in healthy individuals and analyse how these characteristics vary with age.

Methods

Between February and April 2021, we enrolled a total of 91 healthcare professionals from our centre with no relevant medical history. All participants underwent an axillary ultrasound before participating in the COVID-19 vaccination campaign. The following parameters were recorded: total number of visible lymph nodes, maximum longitudinal diameter and cortical thickness, Bedi classification, and signal intensity on colour Doppler evaluation. We compared the data collected between two age groups [young (< 45 years) vs middle-aged (≥ 45 years)] using the Student's t-test for continuous quantitative variables and the Mann-Whitney U test for ordinal variables. Variables with a p-value < 0.05 were considered statistically significant.

Results

An average of 2.96 lymph nodes was observed, with mean maximum longitudinal diameter and cortical thickness of 15.8 mm and 1.6 mm, respectively. Regarding the Bedi classification and colour Doppler scale, types 2 and 1 were the most common. A comparative analysis between the two age groups showed significantly higher values for cortical thickness, Bedi classification, and colour Doppler classification in the younger volunteers (p < 0.05).

Conclusions

Our study highlights the radiological differences between lymph nodes in young and middle-aged volunteers under baseline conditions, emphasizing the importance of careful assessments of borderline-appearing nodes in older patients, especially in oncological contexts.

目的探讨健康人群腋窝淋巴结的超声特征，并分析其随年龄的变化规律。方法在2021年2月至4月期间，我们从本中心招募了91名无相关病史的医疗保健专业人员。所有参与者在参加COVID-19疫苗接种活动之前都接受了腋窝超声检查。记录以下参数：可见淋巴结总数、最大纵径和皮质厚度、Bedi分级、彩色多普勒评价信号强度。我们比较了两个年龄组[年轻（45岁）和中年（≥45岁）]收集的数据，使用连续定量变量的学生t检验和有序变量的Mann-Whitney U检验。p值为<； 0.05的变量被认为具有统计学意义。结果平均观察到2.96个淋巴结，平均最大纵径15.8 mm，最大皮质厚度1.6 mm。在Bedi分级和彩色多普勒量表中，2型和1型最为常见。两个年龄组的对比分析显示，年轻志愿者的皮质厚度、Bedi分类和彩色多普勒分类值显著高于年轻志愿者（p < 0.05）。结论我们的研究强调了基线条件下年轻和中年志愿者淋巴结的放射学差异，强调了仔细评估老年患者出现交界性淋巴结的重要性，特别是在肿瘤学背景下。

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引用次数: 0

Resonancia magnética de la ventriculomegalia cerebral fetal 胎儿脑室肥大的磁共振成像

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2024.02.005

P. Caro-Domínguez , L. García Díaz , G. Antiñolo , E. Miller , M. Carvajo , J.A. Sainz-Bueno

Fetal ventriculomegaly is one of the most common findings on prenatal ultrasound, and one of the most common indications for fetal magnetic resonance imaging (MRI). The aim of this article is to explain the different terminology used to describe the dilatation of the fetal cerebral ventricles, explain the impact of imaging (ultrasound and MRI) in this clinical scenario, illustrate common causes of ventriculomegaly and summarise the evidence regarding prognosis for these children, in order to be able to provide appropriate prenatal advice.

胎儿心室肿大是产前超声检查中最常见的发现之一，也是胎儿磁共振成像（MRI）最常见的适应症之一。本文的目的是解释用于描述胎儿脑室扩张的不同术语，解释成像（超声和MRI）在这种临床情况下的影响，说明脑室肿大的常见原因，并总结有关这些儿童预后的证据，以便能够提供适当的产前建议。

引用次数: 0

Actualización de tumores embrionarios, no meduloblastomas: lo que el neurorradiólogo debe saber 胚胎肿瘤的更新，而不是母细胞母细胞瘤：神经放射科医生应该知道的

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2024.07.003

F. Maldonado , A. Guarnizo , A.F. Geraldo , L. Baroni , N. Fernández Ponce , C. Rugilo

In recent years, the classification of embryonal tumours (ETs) of the Central Nervous System (CNS) has significantly evolved to reflect their molecular biology. In the fifth edition of the World Health Organization CNS Tumours classification, published in 2021 (WHO CNS5), diagnostic criteria was clarified for some recognised tumour types. It also added several other newly-identified tumour types, whether definitive or provisional, that particularly affect children. Diagnosis of these neoplasms remains challenging due to these classification changes, the high levels of heterogeneity within the group of «other CNS embryonal tumours», and the scarcity of data on their findings in imaging studies. This review aims to be a useful tool for neuroradiologists, describing the imaging characteristics of this group of neoplasms and providing brief clinical and diagnostic descriptions.

近年来，中枢神经系统（CNS）胚胎肿瘤（ETs）的分类有了显著的发展，以反映其分子生物学。在2021年出版的世界卫生组织中枢神经系统肿瘤分类第五版（世卫组织CNS5）中，澄清了一些已知肿瘤类型的诊断标准。它还增加了其他几种新发现的肿瘤类型，无论是决定性的还是临时的，都特别影响儿童。这些肿瘤的诊断仍然具有挑战性，因为这些分类的变化，“其他中枢神经系统胚胎性肿瘤”组内的高度异质性，以及成像研究中有关其发现的数据的缺乏。本综述旨在为神经放射学家提供一个有用的工具，描述这组肿瘤的影像学特征，并提供简短的临床和诊断描述。

引用次数: 0

El aula invertida como método de mejora del aprendizaje en radiología 将课堂改造为提高放射学学习的一种方法

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2025.501728

M.L. Nieto Morales , C.C. Linares Bello , L. Pérez-Méndez

This article is a narrative review of the flipped classroom methodology, with a special emphasis on its application in radiology teaching within medical degree programmes. Both traditional teaching methods and the flipped classroom model are described, highlighting their benefits and drawbacks based on previous studies and the authors’ personal experience in the Diagnostic Imaging and Physical Medicine course.

The flipped classroom approach requires students to review educational material before attending class, allowing in-person sessions to focus on practical activities and problem-solving, thereby promoting active and meaningful learning. This method demands greater dedication and autonomy from students, as well as preparation and commitment from instructors.

The findings from the teaching experience suggest that students perceive the flipped classroom as a useful method for understanding concepts, but are unkeen on it being implemented in other subjects due to the additional effort required.

It is concluded that the flipped classroom can be an effective pedagogical method for teaching radiology if properly integrated into the curriculum and combined with traditional methods.

本文是对翻转课堂教学方法的叙述性回顾，特别强调其在医学学位课程放射学教学中的应用。根据以往的研究和作者在《影像诊断与物理医学》课程中的个人经验，对传统教学方法和翻转课堂模式进行了描述，并强调了它们的优点和缺点。翻转课堂的教学方法要求学生在上课前复习教育材料，让面对面的课程专注于实践活动和解决问题，从而促进积极和有意义的学习。这种方法需要学生更大的奉献精神和自主权，以及教师的准备和承诺。教学经验的结果表明，学生认为翻转课堂是一种理解概念的有用方法，但由于需要额外的努力，他们不热衷于将其应用于其他学科。结果表明，如果将翻转课堂与传统教学方法相结合，翻转课堂教学将是一种有效的放射学教学方法。

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引用次数: 0

Discordancia clínico-radiológica en el tumor de células granulares mamario 乳腺颗粒细胞肿瘤的临床放射学不匹配

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2025.01.006

H. Font , E. Sanfeliu , S. Ganau

引用次数: 0

Implicaciones de la clasificación TNM-9 de cáncer de pulmón en el radiólogo torácico intervencionista: una revisión pictórica TNM-9分类对介入性胸部放射科医生肺癌的影响：图片综述

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2025.501709

L. Gorospe , M.A. Gómez-Bermejo , R.M. Mirambeaux-Villalona , O. Ajuria-Illarramendi , G.M. Muñoz-Molina , M. García-Pardo de Santayana

Lung cancer (LC) remains the leading cause of cancer mortality worldwide. An accurate staging is pivotal for the development of successful treatment approaches and improvement of patient outcomes. Traditionally, LC staging has depended on the TNM staging system, and the International Association for the Study of Lung Cancer (IASLC) has recently recommended modifications. The updated classification for the ninth edition of the TNM staging system (TNM-9), slated to take effect in January 2025, is derived from an exhaustive analysis of a newly established large international database of LC cases compiled by the IASLC. The main changes in TNM-9 include the following: (1) The N2 category is split into single-station (N2a) and multiple-station (N2b) subcategories, and (2) the multiple extrathoracic metastatic category (M1c) is split into single-organ system (M1c1) and multiple-organ systems (M1c2) subcategories. With these changes in mind, adjustments have been made to the established stage groups. Understanding the changes introduced in TNM-9 enables interventional thoracic radiologists to refine the percutaneous procedures necessary for a more accurate initial staging of LC patients and, subsequently, for an optimized customized treatment.

肺癌（LC）仍然是全球癌症死亡的主要原因。准确的分期对于开发成功的治疗方法和改善患者预后至关重要。传统上，LC分期依赖于TNM分期系统，国际肺癌研究协会（IASLC）最近建议进行修改。第九版TNM分期系统（TNM-9）的最新分类将于2025年1月生效，它是对IASLC编制的新建立的大型国际LC案例数据库进行详尽分析后得出的。TNM-9的主要变化包括：(1)N2类分为单站（N2a）和多站（N2b）亚类；(2)多发胸外转移类（M1c）分为单器官系统（M1c1）和多器官系统（M1c2）亚类。考虑到这些变化，已对既定的舞台组进行了调整。了解TNM-9中引入的变化，使介入胸科放射科医生能够改进经皮手术，以更准确地对LC患者进行初始分期，并随后进行优化的定制治疗。

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引用次数: 0

Papel de la resonancia magnética en la evaluación del cáncer de recto tras terapia neoadyuvante 核磁共振成像在新辅助治疗后直肠癌评估中的作用

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2026-01-01 DOI: 10.1016/j.rx.2024.06.009

D. Luengo Gómez , Á. Salmerón Ruiz , A. Medina Benítez , A.J. Láinez Ramos-Bossini

The management of locally advanced rectal cancer is rapidly evolving and is adapted according to the response to neoadjuvant therapy (NAT). This allows clinicians to tailor strategies for patients with favourable responses, including the possibility of preserving the rectum or of reducing complications associated with a surgery that carries a high-risk for morbidity. Radiologists can have a key influence on decision making through MRI, which characterises patterns of response and post-treatment changes to the tumour as well as other prognostic elements such as lymph nodes, extramural vascular invasion, tumour deposits and mesorectal fascia involvement. However, imaging findings can be difficult to interpret, requiring a thorough understanding of both the findings and the current limitations of MRI. In this review, we address the rationale supporting the paradigm shift towards organ preservation strategies, and the role and current challenges of MRI in the restaging of rectal cancer after NAT.

局部晚期直肠癌的治疗正在迅速发展，并根据对新辅助治疗（NAT）的反应进行调整。这使得临床医生可以为有良好反应的患者量身定制策略，包括保留直肠的可能性或减少与具有高风险发病率的手术相关的并发症。放射科医生可以通过核磁共振成像对决策产生关键影响，核磁共振成像可以表征肿瘤的反应模式和治疗后的变化，以及其他预后因素，如淋巴结、外血管侵入、肿瘤沉积和直肠系膜筋膜受累。然而，影像学结果很难解释，需要对影像学结果和MRI目前的局限性都有透彻的了解。在这篇综述中，我们讨论了支持器官保存策略范式转变的基本原理，以及MRI在直肠癌术后重建中的作用和当前的挑战。

引用次数: 0

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