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Sistema de navegación electromagnética para la ablación percutánea de tumores abdominales guiada por TC: seguridad y efectividad CT引导腹部肿瘤经皮切除的电磁导航系统:安全性和有效性
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2024.07.007
A. González-Huete , S. Ventura-Díaz , A. Olavarría Delgado , R. Romera Sánchez , A. Palomera Rico , J. Cobos Alonso , J. Urbano

Objective

To assess the impact of radiologist experience on the technical success, safety and effectiveness of CT-guided thermal ablation (TA) procedures for abdominal tumours, including hepatocellular carcinomas (HCC), colorectal cancer liver metastases (CRLM), and renal cell carcinomas (RCC), when assisted by an electromagnetic navigation system (EMNS).

Material and methods

We retrospectively collected data for patients who had undergone CT-guided TA between 2020 and 2022, recording the characteristics of the lesions. Lesions were considered high-risk if they were located in the subphrenic or subcapsular areas of the liver or less than 1 cm from the bowel, bile duct, portal vein, vena cava or gallbladder and those located in the kidney in the anterior leaflet or close to the urinary tract. The radiologists who performed the procedures were classified according to whether they had more or less experience (more or less than five years of experience in percutaneous TA). Technical success was assessed immediately after treatment. Procedure data, response and complication rates were recorded.

Results

A total of 139 tumours were treated in 105 ablation sessions in 93 patients, consisting of 69 men and 24 women. Sixty-two percent of the tumours were HCC, 27% were CRLM, and 12% were RCC. The median tumour size was 16 mm. A total of 68% of the tumours were located in high-risk areas. The technical success rate was 96.4%, with minor complications occurring in 20% of the procedures and major complications in 3.8%. The median follow-up was 12 months. The complete response rates were 96.6%, 93.1%, and 86.2% at 3, 6, and 12 months, respectively. There were no significant differences in response at one month (p = 0.706) or one year (p = 0.402), complications (p = 0.583), procedure time (p = 0.729), or the number of follow-up CT scans (p = 0.208) between more and less experienced radiologists.

Conclusion

An EMNS enhances accuracy and standardisation in interventional procedures, enabling precise ablations, regardless of the radiologist's experience or location involved.
目的评估在电磁导航系统(EMNS)的辅助下,放射科医生的经验对ct引导热消融(TA)治疗腹部肿瘤的技术成功、安全性和有效性的影响,包括肝细胞癌(HCC)、结直肠癌肝转移(CRLM)和肾细胞癌(RCC)。材料与方法回顾性收集2020年至2022年间接受ct引导下TA的患者资料,记录病变特征。如果病变位于肝脏的膈下或包膜下区域,或距离肠、胆管、门静脉、腔静脉或胆囊小于1cm,以及位于肾脏前叶或靠近泌尿道的病变,则被认为是高危病变。进行手术的放射科医生根据他们的经验(5年以上或5年以下的经皮TA经验)进行分类。治疗后立即评估技术成功。记录手术数据、反应和并发症发生率。结果93例患者共105次消融治疗139个肿瘤,其中男性69例,女性24例。62%的肿瘤为HCC, 27%为CRLM, 12%为RCC。中位肿瘤大小为16mm。总共68%的肿瘤位于高危区域。技术成功率为96.4%,轻微并发症发生率为20%,严重并发症发生率为3.8%。中位随访时间为12个月。3个月、6个月和12个月的完全缓解率分别为96.6%、93.1%和86.2%。经验丰富和经验不足的放射科医生在1个月(p = 0.706)或1年(p = 0.402)、并发症(p = 0.583)、手术时间(p = 0.729)或随访CT扫描次数(p = 0.208)方面均无显著差异。结论EMNS提高了介入手术的准确性和标准化,无论放射科医生的经验或所涉及的位置如何,都能实现精确的消融。
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引用次数: 0
Trabajo colaborativo como método de enseñanza innovador: beneficios y desafíos 作为创新教学方法的协同工作:益处与挑战
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2023.12.002
M.L. Nieto Morales , C.C. Linares Bello , M.I. Fernández Esteban

Introduction

The use of innovative teaching methodologies, such as collaborative work, constitutes a significant change for both teachers and students. This method requires greater autonomy from students, and significantly more effort from both students and teachers due to the importance of careful planning and the monitoring of learning. Thus, this teaching model promotes the development of various skills which include critical thinking and self-management.

Method

We carried out a cross-sectional observational study of a collaborative activity used in several classes in the subject Diagnostic Imaging and Physical Medicine in the third year of an undergraduate medicine degree. The students were divided into 13 groups of 8 people, separated using the order of the class list to avoid grouping friends. Each group was given a different clinical case with a radiological image of a bone tumour, and the students were asked to describe it individually at home applying the theory they had been taught in previous Semiology of bone tumours classes. Subsequently and autonomously, they then had to describe it to a classmate from the same group. Later, they described it in groups of 2 and 4 during class time before the group of 8 students finally had to describe it in front of the whole class and try to provide a diagnosis. During the preparatory classes, the teacher went around the groups answering questions. After the final description, the teacher provided feedback. The activity was evaluated through a questionnaire filled out by the students.

Results

The results of the survey reveal the opinions of the students. Overall, they found the methodology to be appropriate, and 60% of those surveyed said that it facilitated the acquisition of knowledge, is an innovative form of self-learning, increased their level of involvement and improved their relationships with their colleagues. Likewise, more than 50% of the participants believe that collaborative work is an appropriate method for their training, providing them with a greater sense of participation.

Conclusion

Collaborative work is found to be an appropriate methodology to improve the acquisition of knowledge. However, it requires greater effort and involvement from both teachers and students, which means that students are not keen on applying it to other subjects. Students consider as a drawback the potential for imbalances of participation.
使用创新的教学方法,如合作作业,对教师和学生都构成了重大变化。这种方法需要学生更大的自主权,由于仔细计划和学习监控的重要性,学生和教师都需要付出更多的努力。因此,这种教学模式促进了各种技能的发展,包括批判性思维和自我管理。方法采用横断面观察研究方法,对医学本科三年级“诊断影像与物理医学”课程中几个班级的协作活动进行研究。学生们被分成13组,每组8人,按照班级名单的顺序分开,以避免朋友分组。每一组都有一个不同的临床病例和骨肿瘤的放射图像,学生们被要求在家里单独描述它,应用他们在以前的骨肿瘤符号学课上教过的理论。随后,他们必须自主地向同一组的同学描述它。后来,他们在课堂上分成2和4个小组描述,最后8个学生小组不得不在全班面前描述并试图提供诊断。在预科课上,老师在小组间轮流回答问题。在最后的描述之后,老师给出了反馈。该活动通过学生填写的调查问卷进行评估。调查的结果揭示了学生们的看法。总的来说,他们发现这种方法是合适的,60%的受访者表示,这种方法有助于获取知识,是一种创新的自学形式,提高了他们的参与度,改善了他们与同事的关系。同样,超过50%的参与者认为协作工作是他们培训的合适方法,为他们提供了更大的参与感。结论协同工作是提高知识获取的有效方法。然而,它需要教师和学生更大的努力和参与,这意味着学生不热衷于将其应用到其他科目。学生们认为学生参与不平衡的可能性是一个缺点。
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引用次数: 0
Usos y técnica de la infiltración ecoguiada de toxina botulínica 肉毒杆菌毒素回声引导渗透的使用和技术
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2025.501695
J. Llorente Peris , J. Miranda Bautista , P. Menéndez Fernández-Miranda
Botulinum toxin (BT) is a neurotoxin that causes flaccid paralysis by inhibiting the release of acetylcholine at the neuromuscular junction, and it may lead to long-term muscle atrophy. It is used to treat conditions associated with muscle hypertrophy or to enhance muscle flexibility, thereby facilitating surgical procedures. It has been shown that ultrasound-guided administration is superior to the anatomical landmarks technique as it reduces side effects and improves efficacy. Although some applications are not officially approved, evidence supports its efficacy and safety in the treatment of various conditions. Some of these more established conditions include anterior abdominal wall hernias, piriformis syndrome, thoracic outlet syndrome, bruxism, spasticity and cervical dystonia. The objective of this study is to review the uses of botulinum toxin in muscular and neuromuscular disorders, analysing its efficacy, safety and the importance of ultrasound guidance in its administration.
肉毒杆菌毒素(BT)是一种神经毒素,通过抑制神经肌肉连接处乙酰胆碱的释放而引起弛缓性麻痹,可导致长期肌肉萎缩。它用于治疗与肌肉肥大相关的疾病或增强肌肉柔韧性,从而促进外科手术。超声引导给药优于解剖标记技术,因为它减少了副作用并提高了疗效。虽然有些应用尚未正式批准,但证据支持其治疗各种疾病的有效性和安全性。其中一些较为确定的病症包括前腹壁疝、梨状肌综合征、胸廓出口综合征、磨牙症、痉挛和颈肌张力障碍。本研究的目的是回顾肉毒杆菌毒素在肌肉和神经肌肉疾病中的应用,分析其疗效、安全性以及超声引导给药的重要性。
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引用次数: 0
Revisión por imagen de la lipomatosis del nervio: claves radiológicas y desafíos en el diagnóstico diferencial 神经脂肪瘤成像:放射学的关键和鉴别诊断的挑战
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2024.07.008
P. Briceño Torralba, E. Pascual Pérez, A. Aranaz Murillo, M.B. Fernández Lago, D. Martín Lambas, C. Gutierrez Alonso
Lipomatosis of nerve (LN) is a rare condition characterised by fibroadipose lesions affecting the peripheral nerves. It presents a complex clinical challenge, often associated with macrodystrophia lipomatosa. Various imaging techniques, specifically magnetic resonance imaging (MRI) and ultrasound (US), are crucial for its diagnosis and precise monitoring. On MRI, LN appears as a lesion displacing surrounding structures, presenting as hypointense cable-like nerve bundles. On US, it has a ‘lotus root-like’ appearance. The wide range of clinical presentations of LN and the extensive array of differential diagnoses underscore the need for individualised diagnostic and treatment strategies. The aim of this article is to provide a thorough review of LN through illustrative images.
神经脂肪瘤病是一种罕见的疾病,其特征是纤维脂肪病变影响周围神经。它提出了一个复杂的临床挑战,通常与巨大营养不良性脂肪瘤有关。各种成像技术,特别是磁共振成像(MRI)和超声(US),对其诊断和精确监测至关重要。在MRI上,LN表现为取代周围结构的病变,表现为低信号的索状神经束。在美国,它有一个“莲藕”的外观。LN广泛的临床表现和广泛的鉴别诊断强调了个性化诊断和治疗策略的必要性。本文的目的是通过说明性图像对LN进行全面的回顾。
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引用次数: 0
¿Hacia una radiología de dos velocidades? IA, investigación y formación en entornos desiguales 双速放射学?不平等环境中的人工智能、研究和培训
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2025.501737
A. Navarro-Ballester
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引用次数: 0
Consideraciones sobre el origen histórico de la hiperostosis esquelética difusa idiopática 关于特发性弥漫性骨质增生的历史渊源的思考
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2025.501719
Y. Medrano Plana , C.E. Hernández Borroto
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引用次数: 0
Encefalopatía inmunomediada (lesiones NICE) tras tratamiento endovascular de aneurisma cerebral: a propósito de un caso 脑动脉瘤血管内治疗后的免疫介导性脑病(NICE病变):以一个病例为例
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2024.12.002
S.M. Bretos Azcona, E. Marín-Díez, E. Torres Díez
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引用次数: 0
Estadificación de cáncer de endometrio. Guía ilustrada para comprender y afrontar la clasificación FIGO 2023 子宫内膜癌的发展。理解和处理FIGO 2023分类图解指南
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2024.06.004
A. García Bolado , E. Julián Gómez , D. Val Garijo
The FIGO (International Federation of Gynaecology and Obstetrics) staging system for endometrial cancer was updated in 2023. This new classification, based on clinical and pathological data, introduces changes for radiologists who now need to know histological data before they can assign a prognostic stage to a tumour. This article provides histopathological information, needed to better understand the FIGO 2023 staging system. It also includes explanatory diagrams and a comparison of the current FIGO classification with the previous version, highlighting new features and potential errors of interpretation, all with the aim of facilitating the work of radiologists.
FIGO(国际妇产科联合会)子宫内膜癌分期系统于2023年更新。这种基于临床和病理数据的新分类为放射科医生带来了变化,他们现在需要知道组织学数据才能为肿瘤分配预后阶段。本文提供了组织病理学信息,需要更好地了解FIGO 2023分期系统。它还包括解释性图表和目前的FIGO分类与以前版本的比较,突出了新的特点和解释的潜在错误,所有这些都是为了促进放射科医生的工作。
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引用次数: 0
La resonancia magnética cardíaca de estrés como fuerte predictor de eventos cardiovasculares en población diabética 应力核磁共振作为糖尿病人群心血管事件的有力预测器
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2024.10.004
M. Jiménez Martín , P.M. Azcárate , J. Urmeneta Ulloa , A. Ezponda , G. Bastarrika

Introduction

Various studies have explored the concept of diabetes mellitus (DM) as a coronary risk equivalent. However, current evidence does not wholly support this conclusion. This study aimed to ascertain whether DM can be validated as a coronary risk equivalent through stress perfusion cardiac magnetic resonance (stress CMR) imaging.

Material and methods

Three hundred thirty-three patients with and without DM who were referred for stress CMR between 2009 and 2013 were retrospectively reviewed. Images were visually interpreted and classified based on the presence of myocardial ischemia. Survival data and occurrence of major cardiovascular events were recorded and compared.

Results

Of the 333 patients, 139 had DM (133 DM type I y 6 type II), (101 without ischemia, 38 with ischemia) and 194 had no DM (165 without ischemia and 29 with ischemia). A total of 70 events occurred during a median follow-up of 27 months. Diabetic patients without myocardial ischemia had a lower incidence of major cardiovascular events (death any cause, acute coronary syndrome, or need for revascularization) compared with non-diabetic patients with ischemia (16.8% vs. 41.1% respectively, p < 0.001).

Conclusion

Diabetic patients with high cardiovascular risk without ischemia exhibit a more favourable prognosis compared to non-diabetic subjects with high prevalence of obstructive coronary artery disease and ischemia. According to our results, DM may not be considered as equivalent to coronary risk. Patients should be treated individually, given the heterogeneity found in DM population.
各种研究已经探讨了糖尿病(DM)作为冠状动脉危险等同物的概念。然而,目前的证据并不完全支持这一结论。本研究旨在通过压力灌注心脏磁共振(stress CMR)成像确定糖尿病是否可以作为冠状动脉风险当量。材料和方法回顾性分析2009年至2013年间333例有或无糖尿病的患者进行应激性CMR。根据心肌缺血的存在对图像进行视觉解释和分类。记录生存数据和主要心血管事件的发生并进行比较。结果333例患者中,糖尿病139例(1型糖尿病133例,2型糖尿病6例),无缺血101例,有缺血38例,无糖尿病194例(无缺血165例,有缺血29例)。在27个月的中位随访期间共发生了70例事件。无心肌缺血的糖尿病患者的主要心血管事件(任何原因死亡、急性冠状动脉综合征或需要血运重建术)发生率低于无缺血的糖尿病患者(分别为16.8%和41.1%,p < 0.001)。结论无缺血的糖尿病高危心血管患者的预后优于有阻塞性冠状动脉疾病和缺血的非糖尿病患者。根据我们的研究结果,糖尿病可能不等同于冠状动脉风险。鉴于糖尿病人群的异质性,患者应单独治疗。
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引用次数: 0
Donar datos, construir salud: altruismo de datos en el Espacio Europeo de Datos de Salud 捐赠数据,建立健康:欧洲卫生数据区数据利他主义
IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 DOI: 10.1016/j.rx.2025.501726
A. de Marco García , A. Penadés Blasco , R. Martínez Martínez , L. Martí-Bonmatí
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引用次数: 0
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