Pub Date : 2025-09-01DOI: 10.1016/j.rx.2023.12.001
S. Cayón Somacarrera , M.L. Parra Gordo , A. Mingo Basaíl , I. Galán González
In patients with blunt pelvic trauma, haemodynamic instability resulting from vascular lesions and active bleeding is the main cause of morbidity and mortality. In order to make treatment decisions, an accurate diagnosis of the origin and characteristics of the bleeding is required, whether from arteries, veins or bony surfaces.
This article describes the anatomy of the pelvic vessels and the CT protocol for the diagnosis of vascular lesions. In addition, it presents a map of pelvic vascularisation that can help us quickly determine the artery most likely responsible for the bleeding in order to guide the interventional radiologist should embolisation be necessary. Early transarterial embolisation is the most effective intervention for managing arterial bleeding associated with pelvic fracture, and it has been proved useful in controlling bleeding and increasing survival.
{"title":"Hemorragias pélvicas postraumáticas: ¿qué debo conocer?","authors":"S. Cayón Somacarrera , M.L. Parra Gordo , A. Mingo Basaíl , I. Galán González","doi":"10.1016/j.rx.2023.12.001","DOIUrl":"10.1016/j.rx.2023.12.001","url":null,"abstract":"<div><div>In patients with blunt pelvic trauma, haemodynamic instability resulting from vascular lesions and active bleeding is the main cause of morbidity and mortality. In order to make treatment decisions, an accurate diagnosis of the origin and characteristics of the bleeding is required, whether from arteries, veins or bony surfaces.</div><div>This article describes the anatomy of the pelvic vessels and the CT protocol for the diagnosis of vascular lesions. In addition, it presents a map of pelvic vascularisation that can help us quickly determine the artery most likely responsible for the bleeding in order to guide the interventional radiologist should embolisation be necessary. Early transarterial embolisation is the most effective intervention for managing arterial bleeding associated with pelvic fracture, and it has been proved useful in controlling bleeding and increasing survival.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 5","pages":"Article 101552"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139888246","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 : 2025-09-01DOI: 10.1016/j.rx.2025.01.007
J. Etxano , A. López-Maseda
Bladder cancer is a cause for serious concern due to its high prevalence and the considerable challenges it poses in terms of morbidity, costs, and mortality. In recent years, magnetic resonance imaging of the bladder has proved to be a useful tool with a significant impact on both local staging and the assessment of neoadjuvant treatment responses. This article reviews the main anatomical, histological and radiological characteristics of bladder neoplasms, describes bladder magnetic resonance imaging, explains the VI-RADS® classification –which should only be used to classify malignant lesions and in studies undertaken principally to evaluate the probability of tumour infiltration in the muscular layer– and specifies how this technique can optimise the clinical management of patients with bladder neoplasms.
{"title":"Aplicaciones clínicas de la resonancia magnética de vejiga: más allá de la clasificación VIRADS®","authors":"J. Etxano , A. López-Maseda","doi":"10.1016/j.rx.2025.01.007","DOIUrl":"10.1016/j.rx.2025.01.007","url":null,"abstract":"<div><div>Bladder cancer is a cause for serious concern due to its high prevalence and the considerable challenges it poses in terms of morbidity, costs, and mortality. In recent years, magnetic resonance imaging of the bladder has proved to be a useful tool with a significant impact on both local staging and the assessment of neoadjuvant treatment responses. This article reviews the main anatomical, histological and radiological characteristics of bladder neoplasms, describes bladder magnetic resonance imaging, explains the VI-RADS® classification –which should only be used to classify malignant lesions and in studies undertaken principally to evaluate the probability of tumour infiltration in the muscular layer– and specifies how this technique can optimise the clinical management of patients with bladder neoplasms.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 5","pages":"Article 101668"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996953","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 : 2025-07-01DOI: 10.1016/j.rx.2024.04.004
A. Mesa Álvarez , M. da Silva Torres , A. Fernández del Valle , A. Cernuda García , E. Turienzo Santos , L. Sanz Álvarez
Peritoneal carcinomatosis (PC) is the spread of a tumour in the peritoneum, sometimes originating from a primary tumour (mesothelioma, peritoneal serous carcinoma) and other times arising from a metastasis from another organ (ovary, colon, appendix, stomach). While it was previously considered incurable, significant improvements have been made thanks to new techniques such as cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). Patients who can benefit from these treatments are identified by radiologists who use imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET/CT). It is important to have an awareness of the different forms of presentation, methods of quantifying tumour burden (peritoneal carcinomatosis index, PCI), and criteria for unresectability for an accurate assessment of the disease's status. All this information should be shared and discussed in multidisciplinary boards for optimal and consensus-driven decision-making.
{"title":"Carcinomatosis peritoneal, como medirla","authors":"A. Mesa Álvarez , M. da Silva Torres , A. Fernández del Valle , A. Cernuda García , E. Turienzo Santos , L. Sanz Álvarez","doi":"10.1016/j.rx.2024.04.004","DOIUrl":"10.1016/j.rx.2024.04.004","url":null,"abstract":"<div><div>Peritoneal carcinomatosis (PC) is the spread of a tumour in the peritoneum, sometimes originating from a primary tumour (mesothelioma, peritoneal serous carcinoma) and other times arising from a metastasis from another organ (ovary, colon, appendix, stomach). While it was previously considered incurable, significant improvements have been made thanks to new techniques such as cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). Patients who can benefit from these treatments are identified by radiologists who use imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET/CT). It is important to have an awareness of the different forms of presentation, methods of quantifying tumour burden (peritoneal carcinomatosis index, PCI), and criteria for unresectability for an accurate assessment of the disease's status. All this information should be shared and discussed in multidisciplinary boards for optimal and consensus-driven decision-making.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 4","pages":"Article 101593"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400378","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}
{"title":"Radiología y carrera profesional: una reflexión desde la etapa media","authors":"Erika Natalia Arenas Rivera , Rodrigo Alcántara Souza","doi":"10.1016/j.rx.2025.501682","DOIUrl":"10.1016/j.rx.2025.501682","url":null,"abstract":"","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 4","pages":"Article 501682"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588797","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 : 2025-07-01DOI: 10.1016/j.rx.2025.01.001
A. Páez-Carpio , P. Bermúdez , M. Sanduzzi Zamparelli , M. Barrufet , O. Arrabal , A. Forner , A. Darnell , J. Bruix , F. Torres , M. Reig , M. Burrel
Aim
To evaluate the safety and efficacy of transarterial chemoembolization with radiopaque doxorubicin-loaded microspheres (rDEB-TACE) in patients with hepatocellular carcinoma (HCC).
Materials and Methods
This single-center, retrospective, observational study included all patients 18 years and older diagnosed with HCC and treated with rDEB-TACE from 2017 to 2020 at our institution. rDEB-TACE efficacy was evaluated by type of response after treatment at 1-, 3- and 6-month, time to progression (TTP), and overall survival (OS). Safety of the technique was assessed based on the occurrence of adverse events (AEs). rDEB distribution was classified by overall distribution as type 1: intratumoral, type 2: intratumoral-feeding artery, and type 3: feeding artery and by intratumoral distribution in 0-50% and 50-100%.
Results
Twenty-one patients with 36 lesions treated with rDEB-TACE were included. Median follow-up time was 17 months (IQR: 6.0-45.5). Local and overall objective response at 1, 3 and 6 months was 86%, 85%, 84% and 91%, 78% and 84%, respectively. Median TTP was 27.0 months (95%CI: 8.9-28.1) and median OS was 54.9 months (95%CI: 16.3-NE). No major AEs were reported. The most common particle distribution was type 2 (69.4%). Concordance of particle distribution between intraprocedural cone beam CT and follow-up CT was high (kappa = 0.80). Most lesions treated showed a 50-100% intratumoral particle distribution, with higher rates of local (95.5% vs 71.4%) and overall objective response in this group (100% vs 71.4%) compared with the 0-50% group.
Conclusion
rDEB-TACE is a safe and effective treatment for patients with HCC. Distribution of rDEB can be accurately assessed during and after the procedure and may predict early response.
.
目的评价载多柔比星微球（rDEB-TACE）经动脉化疗栓塞治疗肝癌（HCC）的安全性和有效性。材料与方法本研究为单中心、回顾性、观察性研究，纳入我院2017 - 2020年所有18岁及以上HCC确诊患者，并接受rDEB-TACE治疗。rDEB-TACE的疗效通过治疗后1、3和6个月的反应类型、进展时间（TTP）和总生存期（OS）来评估。该技术的安全性是根据不良事件（ae）的发生来评估的。rDEB分布按总体分布分为1型：瘤内，2型：瘤内供血动脉，3型：供血动脉，按瘤内分布0-50%和50-100%。结果采用rDEB-TACE治疗的36例病变共21例。中位随访时间为17个月（IQR: 6.0 ~ 45.5）。1个月、3个月和6个月的局部和总体客观缓解率分别为86%、85%、84%和91%，78%和84%。中位TTP为27.0个月（95%CI: 8.9-28.1），中位OS为54.9个月（95%CI: 16.3-NE）。没有重大爆炸事件的报告。最常见的颗粒分布为2型（69.4%）。术中锥束CT与随访CT颗粒分布一致性高（kappa = 0.80）。大多数治疗的病变显示50-100%的瘤内颗粒分布，与0-50%组相比，该组局部（95.5% vs 71.4%）和总体客观缓解率（100% vs 71.4%）更高。结论rdeb - tace治疗肝癌安全有效。rDEB的分布可以在手术期间和手术后准确评估，并可以预测早期反应。
{"title":"Quimioembolización transarterial con microesferas radiopacas cargadas de doxorrubicina para el carcinoma hepatocelular: seguridad, eficacia y distribución","authors":"A. Páez-Carpio , P. Bermúdez , M. Sanduzzi Zamparelli , M. Barrufet , O. Arrabal , A. Forner , A. Darnell , J. Bruix , F. Torres , M. Reig , M. Burrel","doi":"10.1016/j.rx.2025.01.001","DOIUrl":"10.1016/j.rx.2025.01.001","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the safety and efficacy of transarterial chemoembolization with radiopaque doxorubicin-loaded microspheres (rDEB-TACE) in patients with hepatocellular carcinoma (HCC).</div></div><div><h3>Materials and Methods</h3><div>This single-center, retrospective, observational study included all patients 18 years and older diagnosed with HCC and treated with rDEB-TACE from 2017 to 2020 at our institution. rDEB-TACE efficacy was evaluated by type of response after treatment at 1-, 3- and 6-month, time to progression (TTP), and overall survival (OS). Safety of the technique was assessed based on the occurrence of adverse events (AEs). rDEB distribution was classified by overall distribution as type 1: intratumoral, type 2: intratumoral-feeding artery, and type 3: feeding artery and by intratumoral distribution in 0-50% and 50-100%.</div></div><div><h3>Results</h3><div>Twenty-one patients with 36 lesions treated with rDEB-TACE were included. Median follow-up time was 17 months (IQR: 6.0-45.5). Local and overall objective response at 1, 3 and 6 months was 86%, 85%, 84% and 91%, 78% and 84%, respectively. Median TTP was 27.0 months (95%CI: 8.9-28.1) and median OS was 54.9 months (95%CI: 16.3-NE). No major AEs were reported. The most common particle distribution was type 2 (69.4%). Concordance of particle distribution between intraprocedural cone beam CT and follow-up CT was high (kappa<!--> <!-->=<!--> <!-->0.80). Most lesions treated showed a 50-100% intratumoral particle distribution, with higher rates of local (95.5% vs 71.4%) and overall objective response in this group (100% vs 71.4%) compared with the 0-50% group.</div></div><div><h3>Conclusion</h3><div>rDEB-TACE is a safe and effective treatment for patients with HCC. Distribution of rDEB can be accurately assessed during and after the procedure and may predict early response.</div><div>.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 4","pages":"Article 101656"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588799","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 : 2025-07-01DOI: 10.1016/j.rx.2024.06.005
C. Pineda Ibarra , L. Oleaga Zufiria , I. Valduvieco Ruiz , E. Pineda Losada , T. Pujol Farré , S. González Ortiz
Follow-up of patients with gliomas remains a challenge in the field of neuro-oncology. The RANO group published its first follow-up criteria for high-grade gliomas in 2010. While it originally focused on clinical trials, it was also useful as a guide in clinical practice. They then went on to publish revised editions which included follow-up criteria for low-grade tumours, immunotherapy, and updates to the original criteria.
In 2023, they published a more comprehensive guide, RANO 2.0, which included all glioma types and different treatments. For the first time, they considered the latest WHO classification and objective data in addition to expert opinion. RANO 2.0 establishes which type of MRI should be used for the baseline MRI, describes the different responses of contrast-enhanced and non-contrast-enhanced tumour components, and determines in what circumstances a confirmatory MRI is required.
In light of these changes, it is worth reviewing these new criteria to enable a better understanding of the revisions and their applicability in routine radiological practice.
{"title":"RANO-2.0: actualización en la valoración de la respuesta tumoral en gliomas","authors":"C. Pineda Ibarra , L. Oleaga Zufiria , I. Valduvieco Ruiz , E. Pineda Losada , T. Pujol Farré , S. González Ortiz","doi":"10.1016/j.rx.2024.06.005","DOIUrl":"10.1016/j.rx.2024.06.005","url":null,"abstract":"<div><div>Follow-up of patients with gliomas remains a challenge in the field of neuro-oncology. The RANO group published its first follow-up criteria for high-grade gliomas in 2010. While it originally focused on clinical trials, it was also useful as a guide in clinical practice. They then went on to publish revised editions which included follow-up criteria for low-grade tumours, immunotherapy, and updates to the original criteria.</div><div>In 2023, they published a more comprehensive guide, RANO 2.0, which included all glioma types and different treatments. For the first time, they considered the latest WHO classification and objective data in addition to expert opinion. RANO 2.0 establishes which type of MRI should be used for the baseline MRI, describes the different responses of contrast-enhanced and non-contrast-enhanced tumour components, and determines in what circumstances a confirmatory MRI is required.</div><div>In light of these changes, it is worth reviewing these new criteria to enable a better understanding of the revisions and their applicability in routine radiological practice.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 4","pages":"Article 101621"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588777","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 : 2025-07-01DOI: 10.1016/j.rx.2024.05.011
S. Pereiro Pérez, S. Lojo-Lendoiro, M. Pérez Costas, A. Robles Gómez, S. García Benito, P. Rodríguez Fernández
Acute aortic syndrome is a potentially fatal clinical entity that encompasses different pathologies affecting the aortic wall: aortic dissection, intramural hematoma, penetrating aortic ulcer and other less common entities. All are characterised by the sudden onset of thoracic-abdominal pain and all share similar features, preventing differentiation. Computed tomography plays a crucial role in the diagnostic process, enabling a rapid and accurate assessment and contributing to early therapeutic management.
This article reviews the main entities that make up acute aortic syndrome, their aetiologies, pathophysiology and characteristic radiological findings. Imaging tests are mainly used to confirm the diagnosis and determine the location and extent as well as possible complications.
{"title":"Síndrome aórtico agudo ¿qué necesitas saber?","authors":"S. Pereiro Pérez, S. Lojo-Lendoiro, M. Pérez Costas, A. Robles Gómez, S. García Benito, P. Rodríguez Fernández","doi":"10.1016/j.rx.2024.05.011","DOIUrl":"10.1016/j.rx.2024.05.011","url":null,"abstract":"<div><div>Acute aortic syndrome is a potentially fatal clinical entity that encompasses different pathologies affecting the aortic wall: aortic dissection, intramural hematoma, penetrating aortic ulcer and other less common entities. All are characterised by the sudden onset of thoracic-abdominal pain and all share similar features, preventing differentiation. Computed tomography plays a crucial role in the diagnostic process, enabling a rapid and accurate assessment and contributing to early therapeutic management.</div><div>This article reviews the main entities that make up acute aortic syndrome, their aetiologies, pathophysiology and characteristic radiological findings. Imaging tests are mainly used to confirm the diagnosis and determine the location and extent as well as possible complications.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 4","pages":"Article 101613"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588800","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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