Pub Date : 2024-11-01DOI: 10.1016/j.rx.2024.09.001
L. Concepción Aramendía, M. Otero García, J.C. Albillos Merino, M.J. Díaz Candamio, M. Navallas Irujo, D. Domínguez Pinos, E. Alvarez-Hornia Pérez, M. Rovira Cañellas, E. Inarejos Clemente, A. Arjonilla López, M.L. Parra Gordo
{"title":"Radiólogos en comités multidisciplinares en España: realidad asistencial, esfuerzo invertido y acciones necesarias para su mejora","authors":"L. Concepción Aramendía, M. Otero García, J.C. Albillos Merino, M.J. Díaz Candamio, M. Navallas Irujo, D. Domínguez Pinos, E. Alvarez-Hornia Pérez, M. Rovira Cañellas, E. Inarejos Clemente, A. Arjonilla López, M.L. Parra Gordo","doi":"10.1016/j.rx.2024.09.001","DOIUrl":"10.1016/j.rx.2024.09.001","url":null,"abstract":"","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 499-500"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2023.10.001
Spectral computed tomography has represented a major breakthrough in radiology thanks to its multiple applications and potential to provide more information than conventional CT techniques. It is very useful for diagnosing and describing findings as well as the management of patients, thus avoiding further imaging or invasive procedures.
The aim of this article is to explain basic concepts of spectral CT and highlight key practical features in a range of abdominal and pelvic pathologies, along with a brief description of different post-processing maps and their clinical applications including incidental, oncological and urgent findings.
{"title":"Tomografía computarizada espectral en patología abdominopélvica. Una guía práctica","authors":"","doi":"10.1016/j.rx.2023.10.001","DOIUrl":"10.1016/j.rx.2023.10.001","url":null,"abstract":"<div><div>Spectral computed tomography has represented a major breakthrough in radiology thanks to its multiple applications and potential to provide more information than conventional CT techniques. It is very useful for diagnosing and describing findings as well as the management of patients, thus avoiding further imaging or invasive procedures.</div><div>The aim of this article is to explain basic concepts of spectral CT and highlight key practical features in a range of abdominal and pelvic pathologies, along with a brief description of different post-processing maps and their clinical applications including incidental, oncological and urgent findings.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 564-576"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139813910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2023.03.005
Background and aims
To analyze the radiologic and histologic characteristics of screening and interval cancers diagnosed in the period comprising 2007 through 2018 in a total of six rounds of a population-based breast cancer screening program.
Material and methods
We analyzed 1395 carcinomas detected at screening and 300 interval carcinomas diagnosed in women aged 50 to 69 years old who underwent digital mammography every two years during the study period. Screening mammograms were read once.
To classify the interval carcinomas, we retrospectively reviewed (blind reading followed by unblinded reading) at the end of each round, recording the radiologic findings, breast density, histologic characteristics, phenotype, and surgical treatment.
Results
The interval carcinomas were classified as true interval cancers in 156 (52%) cases, false-negatives in 62 (20.5%), minimal signs in 39 (13%), occult lesions in 29 (9.5%), and impossible to classify in 14 (5%).
Retrospectively, the most common radiologic findings in the false-negative cases were mass/asymmetry (64%), calcifications (16%), and distortion (13%); the most common radiologic findings in the cases with minimal signs were mass/asymmetry (58%) and calcifications (31%).
There were significant differences in the histologic characteristics between cancers detected at screening and interval cancers: T1a-b (9% of the interval cancers vs. 34% of those detected at screening; P < .001); T1c (30% of the interval cancers vs. 44% of those detected at screening; P < .001); T2 or greater (61% of the interval cancers vs. 22% of those detected at screening; P < .001), and the degree of axillary involvement (45% of the interval cancers vs. 27% of those detected at screening; P < .001).
There were also significant differences between cancers detected at screening and interval cancers in the proportion of cases with more aggressive subtypes (HER2+ and triple-negative): 38.5% of the interval cancers vs. 23% of those detected at screening; P < .001.
A significantly higher proportion of interval cancers were treated with mastectomies (80% vs. 67% of those detected at screening; P < .001).
Conclusions
About 20% of interval cancers were evident on screening mammograms. The most common radiologic finding in interval cancers was asymmetry/mass. Interval cancers are diagnosed at a more advanced stage than cancers identified at screening, so they are more often treated by mastectomy. Reviewing interval cancers is essential for quality control in screening programs.
{"title":"Carcinoma de intervalo en un programa de cribado de cáncer de mama (2007-2018). Características y pronóstico","authors":"","doi":"10.1016/j.rx.2023.03.005","DOIUrl":"10.1016/j.rx.2023.03.005","url":null,"abstract":"<div><h3>Background and aims</h3><div>To analyze the radiologic and histologic characteristics of screening and interval cancers diagnosed in the period comprising 2007 through 2018 in a total of six rounds of a population-based breast cancer screening program.</div></div><div><h3>Material and methods</h3><div>We analyzed 1395 carcinomas detected at screening and 300 interval carcinomas diagnosed in women aged 50 to 69<!--> <!-->years old who underwent digital mammography every two years during the study period. Screening mammograms were read once.</div><div>To classify the interval carcinomas, we retrospectively reviewed (blind reading followed by unblinded reading) at the end of each round, recording the radiologic findings, breast density, histologic characteristics, phenotype, and surgical treatment.</div></div><div><h3>Results</h3><div>The interval carcinomas were classified as true interval cancers in 156 (52%) cases, false-negatives in 62 (20.5%), minimal signs in 39 (13%), occult lesions in 29 (9.5%), and impossible to classify in 14 (5%).</div><div>Retrospectively, the most common radiologic findings in the false-negative cases were mass/asymmetry (64%), calcifications (16%), and distortion (13%); the most common radiologic findings in the cases with minimal signs were mass/asymmetry (58%) and calcifications (31%).</div><div>There were significant differences in the histologic characteristics between cancers detected at screening and interval cancers: T1a-b (9% of the interval cancers vs. 34% of those detected at screening; <em>P</em> <!--><<!--> <!-->.001); T1c (30% of the interval cancers vs. 44% of those detected at screening; <em>P</em> <!--><<!--> <!-->.001); T2 or greater (61% of the interval cancers vs. 22% of those detected at screening; <em>P</em> <!--><<!--> <!-->.001), and the degree of axillary involvement (45% of the interval cancers vs. 27% of those detected at screening; <em>P</em> <!--><<!--> <!-->.001).</div><div>There were also significant differences between cancers detected at screening and interval cancers in the proportion of cases with more aggressive subtypes (HER2+ and triple-negative): 38.5% of the interval cancers vs. 23% of those detected at screening; <em>P</em> <!--><<!--> <!-->.001.</div><div>A significantly higher proportion of interval cancers were treated with mastectomies (80% vs. 67% of those detected at screening; <em>P</em> <!--><<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>About 20% of interval cancers were evident on screening mammograms. The most common radiologic finding in interval cancers was asymmetry/mass. Interval cancers are diagnosed at a more advanced stage than cancers identified at screening, so they are more often treated by mastectomy. Reviewing interval cancers is essential for quality control in screening programs.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 513-525"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130501049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2023.08.004
Pyle's disease (PD) is a rare autosomal recessive metaphyseal dysplasia with approximately 30 reported cases and has recently gained interest due to its association with specific genes. While most cases are diagnosed in childhood and are asymptomatic, we present the case of a 39-year-old woman who presented to the Emergency Department with left knee pain, patellar fracture, and «Erlenmeyer flask» deformity. Retrospective review of imaging studies and medical history revealed the symmetric and systemic nature of the skeletal disorder, confirming the diagnosis of PD. Familiarity with this disease is crucial for optimal patient management, and the radiologist plays a crucial role in its diagnosis.
{"title":"Fractura ósea tras un traumatismo menor en la enfermedad de Pyle: un caso poco frecuente en un adulto","authors":"","doi":"10.1016/j.rx.2023.08.004","DOIUrl":"10.1016/j.rx.2023.08.004","url":null,"abstract":"<div><div>Pyle's disease (PD) is a rare autosomal recessive metaphyseal dysplasia with approximately 30 reported cases and has recently gained interest due to its association with specific genes. While most cases are diagnosed in childhood and are asymptomatic, we present the case of a 39-year-old woman who presented to the Emergency Department with left knee pain, patellar fracture, and «Erlenmeyer flask» deformity. Retrospective review of imaging studies and medical history revealed the symmetric and systemic nature of the skeletal disorder, confirming the diagnosis of PD. Familiarity with this disease is crucial for optimal patient management, and the radiologist plays a crucial role in its diagnosis.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 588-591"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2024.05.003
Central nervous system (CNS) involvement by lymphoproliferative disorders is rare and associated with a poor prognosis. CNS involvement can be exclusive, primary or appear in a secondary manner as part of a systemic process. The spectrum of involvement that we encounter is varied and neuroimaging plays a key role in diagnosis. This article reviews less commonly presented patterns of primary involvement of CNS lymphoproliferative processes such as lymphomatosis cerebri, intravascular lymphoma or dural lymphoma. We will also review other atypical lymphoproliferative processes associated with Epstein-Barr virus (EBV) infection, such as lymphomatoid granulomatosis (LG) or post-transplant lymphoproliferative disorders (PTLD). An awareness of these patterns of presentation and less frequent entities will allow us to make earlier diagnoses and establish treatments that will lead to better prognoses for patients.
{"title":"Presentaciones atípicas de los procesos linfoproliferativos primarios del sistema nervioso central","authors":"","doi":"10.1016/j.rx.2024.05.003","DOIUrl":"10.1016/j.rx.2024.05.003","url":null,"abstract":"<div><div>Central nervous system (CNS) involvement by lymphoproliferative disorders is rare and associated with a poor prognosis. CNS involvement can be exclusive, primary or appear in a secondary manner as part of a systemic process. The spectrum of involvement that we encounter is varied and neuroimaging plays a key role in diagnosis. This article reviews less commonly presented patterns of primary involvement of CNS lymphoproliferative processes such as lymphomatosis cerebri, intravascular lymphoma or dural lymphoma. We will also review other atypical lymphoproliferative processes associated with Epstein-Barr virus (EBV) infection, such as lymphomatoid granulomatosis (LG) or post-transplant lymphoproliferative disorders (PTLD). An awareness of these patterns of presentation and less frequent entities will allow us to make earlier diagnoses and establish treatments that will lead to better prognoses for patients.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 555-563"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141414996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2023.01.011
Objective
To demonstrate the safety and efficacy of endovascular treatment in postpartum hemorrhage.
Material and methods
We conducted a retrospective observational study with a sample from our Interventional Vascular Radiology unit, from 2004 to 2020. Patients who developed postpartum hemorrhage treated by arterial embolization were selected. Inclusion criteria were established to standardize the study group. Variables for the study of the efficacy and safety of the technique are defined.
Results
The final sample of the study was 56 patients. Technical success turned was 100%, while clinical success after endovascular treatment was 92.85%, with a hysterectomy rate due to failed arterial embolization of 7.14%, with uterine rupture observed in 3 cases as a cause of postpartum hemorrhage. No technique-related mortality was recorded. The rate of periprocedural complications was 3.56%, the same as that of late complications. No major or infectious complications were recorded. The pregnancy rate after embolization was 23.52%.
Conclusions
Selective arterial embolization of the uterine artery in postpartum hemorrhage is a safe and effective procedure, being a therapeutic alternative in the face of failure of pharmacological and obstetric management, with preservation of fertility.
{"title":"Eficacia y seguridad de la embolización de arterias uterinas en el manejo de la hemorragia posparto","authors":"","doi":"10.1016/j.rx.2023.01.011","DOIUrl":"10.1016/j.rx.2023.01.011","url":null,"abstract":"<div><h3>Objective</h3><div>To demonstrate the safety and efficacy of endovascular treatment in postpartum hemorrhage.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective observational study with a sample from our Interventional Vascular Radiology unit, from 2004 to 2020. Patients who developed postpartum hemorrhage treated by arterial embolization were selected. Inclusion criteria were established to standardize the study group. Variables for the study of the efficacy and safety of the technique are defined.</div></div><div><h3>Results</h3><div>The final sample of the study was 56 patients. Technical success turned was 100%, while clinical success after endovascular treatment was 92.85%, with a hysterectomy rate due to failed arterial embolization of 7.14%, with uterine rupture observed in 3 cases as a cause of postpartum hemorrhage. No technique-related mortality was recorded. The rate of periprocedural complications was 3.56%, the same as that of late complications. No major or infectious complications were recorded. The pregnancy rate after embolization was 23.52%.</div></div><div><h3>Conclusions</h3><div>Selective arterial embolization of the uterine artery in postpartum hemorrhage is a safe and effective procedure, being a therapeutic alternative in the face of failure of pharmacological and obstetric management, with preservation of fertility.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 501-512"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129194694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2022.03.008
Acute rhinossinusitis is defined as a symptomatic inflammation of the nasal fossa and paranasal sinuses. The diagnosis of this disease is clinical and usually does not require imaging evaluation. However, when there is a suspicion of a complication or even for surgical planning, imaging is of primordial importance.
The aim of this paper is to provide a concise pictorial review with clinical and imagiological correlation of the most common complications in acute rhinossinusitis to provide relevant clinical data and highlight the most important imaging findings.
{"title":"Complicaciones de la rinosinusitis aguda. Una revisión clínica radiológica","authors":"","doi":"10.1016/j.rx.2022.03.008","DOIUrl":"10.1016/j.rx.2022.03.008","url":null,"abstract":"<div><div>Acute rhinossinusitis is defined as a symptomatic inflammation of the nasal fossa and paranasal sinuses. The diagnosis of this disease is clinical and usually does not require imaging evaluation. However, when there is a suspicion of a complication or even for surgical planning, imaging is of primordial importance.</div><div>The aim of this paper is to provide a concise pictorial review with clinical and imagiological correlation of the most common complications in acute rhinossinusitis to provide relevant clinical data and highlight the most important imaging findings.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 577-587"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123147345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rx.2023.07.007
Radiology, mainly computed tomography, has a fundamental role in diagnosis, staging and follow-up of lung adenocarcinoma, the most common type of pulmonary cancer. Within its broad spectrum of presentation, the pathological, clinical and morphological characteristics of this neoplasm allow, in an appropriate clinical context, to suggest certain histological subtypes among which are mucinous adenocarcinoma, lepidic growth adenocarcinoma or associated with cystic lung lesions. The objective of this review is to describe the pathologic, clinical and radiological features of those characteristic forms of lung carcinoma that can be diagnosed radiologically with fair accuracy.
{"title":"Adenocarcinoma de pulmón: Presentaciones radiológicas características","authors":"","doi":"10.1016/j.rx.2023.07.007","DOIUrl":"10.1016/j.rx.2023.07.007","url":null,"abstract":"<div><div>Radiology, mainly computed tomography, has a fundamental role in diagnosis, staging and follow-up of lung adenocarcinoma, the most common type of pulmonary cancer. Within its broad spectrum of presentation, the pathological, clinical and morphological characteristics of this neoplasm allow, in an appropriate clinical context, to suggest certain histological subtypes among which are mucinous adenocarcinoma, lepidic growth adenocarcinoma or associated with cystic lung lesions. The objective of this review is to describe the pathologic, clinical and radiological features of those characteristic forms of lung carcinoma that can be diagnosed radiologically with fair accuracy.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"66 6","pages":"Pages 542-554"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132289275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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