RADIOLOGIA最新文献

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Nefroprotección y contrastes yodados 肾脏保护与碘对比

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-10-01 DOI: 10.1016/j.rx.2024.02.010

The incidence of post-contrast acute kidney injury (PC-AKI) is low with the new low- or iso-osmolar non-ionic iodinated contrast agents. The only proven form of prophylaxis for PC-AKI is hydration, preferably intravenous, although oral hydration is equally effective. In this article we define PC-AKI and its risk factors, propose a prophylaxis protocol and respond to the most common doubts that arise around prophylaxis. We also update the fasting guidelines to be followed prior to contrast testing. In general, fasting of solids is not necessary before injecting iodinated contrast or gadolinium except in tests in which it is necessary to specifically study the upper digestive tract and bile duct. Even in these cases, fasting clear liquids is not required, which is of great help for oral hydration and for reducing the incidence of PC-AKI.

使用新型低或等摩尔非离子碘造影剂时，造影后急性肾损伤（PC-AKI）的发生率很低。预防 PC-AKI 的唯一行之有效的方法是补水，最好是静脉补水，尽管口服补水也同样有效。在本文中，我们定义了 PC-AKI 及其风险因素，提出了预防方案，并回答了围绕预防方案产生的最常见疑问。我们还更新了造影剂检测前应遵循的禁食指南。一般来说，在注射碘化造影剂或钆之前不需要禁食固体食物，除非是需要专门研究上消化道和胆管的检查。即使在这些情况下，也不需要禁食透明液体，这对口腔水合和降低 PC-AKI 的发生率大有帮助。

引用次数: 0

Introducción a los contrastes yodados: propiedades, administración intravascular y distribución en el organismo 碘基造影剂简介：特性、血管内给药和体内分布

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-10-01 DOI: 10.1016/j.rx.2024.03.007

Iodinated contrast media enable greater attenuation of vascular and visceral structures in radiological studies and are widely used due to their high degree of safety, easy administration, acceptable level of tolerance, wide distribution and rapid excretion, qualities determined by their composition.

Automated power injectors are used to administer contrast media. Once injected, contrast is distributed throughout the body, remaining in the intravascular space during its first passage before reaching the organs and spreading into the extracellular interstitial space, followed by a recirculation phenomenon.

In CT studies, the level of contrast enhancement obtained is determined by multiple factors including patient-related factors, contrast medium characteristics, method of administration, equipment and technique. Different methods are available for determining the scan timing depending on the aim of the exploration.

碘化造影剂在放射学研究中能对血管和内脏结构产生更大的衰减，由于其安全性高、给药方便、耐受性可接受、分布广和排泄快等特点而被广泛使用。在 CT 研究中，造影剂的增强程度由多种因素决定，包括患者相关因素、造影剂特性、给药方法、设备和技术。在 CT 研究中，造影剂的增强程度由多种因素决定，包括患者相关因素、造影剂特性、给药方法、设备和技术。

引用次数: 0

La consulta de enfermería y las enfermeras de práctica avanzada en la gestión de la seguridad de los medios de contraste 对比媒体安全管理中的护士咨询和高级执业护士

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-10-01 DOI: 10.1016/j.rx.2024.04.010

In diagnostic imaging departments, there has been a technological evolution in recent years. Progress made in interventional processes and the development of new treatments, as well as an increase in the number of diagnostic and therapeutic tests, has generated a growing and exponential need for specific care. Furthermore, the people who come to these departments are often in a vulnerable state and out of their comfort zone.

The implementation of advanced practice nursing (APN) in the context of metabolic therapies and diagnostic imaging provides expert care with a holistic approach to patient care. It uses the nursing care process as a working method which, through research, logical analysis and critical reasoning, enables nursing care to be developed and applied. This approach contributes to safety management in the different processes in which it is engaged.

The aim of this article is to highlight the interventions in which nursing practice can contribute to contrast media safety management in a diagnostic imaging department.

近年来，影像诊断部门的技术不断发展。介入治疗的进步、新疗法的开发以及诊断和治疗检查项目的增加，使得对特殊护理的需求呈指数级增长。此外，到这些科室就诊的患者往往处于脆弱状态，超出了他们的舒适范围。在代谢疗法和影像诊断方面实施高级实践护理（APN），可为患者提供专家级的整体护理。它将护理流程作为一种工作方法，通过研究、逻辑分析和批判性推理，使护理工作得以发展和应用。本文旨在强调在影像诊断科室中，护理实践可以促进造影剂安全管理的干预措施。

引用次数: 0

Optimización del uso del contraste yodado en las exploraciones de TC: estudios vasculares, viscerales, multifásicos e inyección bifásica 优化 CT 扫描中碘对比剂的使用：血管、内脏、多相和双相注射研究。

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-10-01 DOI: 10.1016/j.rx.2024.05.008

Iodinated contrast is administered when carrying out computed tomography (CT) scans to define anatomical structures and detect pathologies. The contrast is administered according to different protocols which vary significantly and include vascular, visceral, multiphasic and split-bolus injection studies. Each protocol has its own indications and particularities to optimise the use of the contrast medium in each situation. There are numerous factors that influence the degree of contrast enhancement obtained, including the patient's weight, cardiac output, study delay, the technical characteristics used for acquisition—mainly kilovoltage—, and variables related to the administration and dosage of the contrast medium, such as iodine delivery rate and load. This article will discuss how each of these variables affects the level of enhancement achieved and the parameters that can be modified in order to optimise the results of the different types of scans performed with iodinated contrast.

在进行计算机断层扫描（CT）时，需要使用碘对比剂来确定解剖结构和检测病变。造影剂按照不同的方案使用，这些方案差异很大，包括血管、内脏、多相和分流注射研究。每种方案都有自己的适应症和特殊性，以便在各种情况下优化造影剂的使用。影响造影剂增强程度的因素有很多，包括患者的体重、心输出量、研究延迟、采集时使用的技术特性（主要是千伏电压），以及与造影剂给药和剂量有关的变量，如碘给药速率和负荷。本文将讨论这些变量是如何影响所达到的增强水平的，以及为了优化使用碘造影剂进行的不同类型扫描的结果而可以修改的参数。

引用次数: 0

Presentación del suplemento: «actualización y buenas prácticas de uso de medios de contraste» 介绍补编："使用造影剂的最新情况和良好做法"。

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-10-01 DOI: 10.1016/j.rx.2024.06.007

A. Mesa Álvarez , J. Encinas de la Iglesia

引用次数: 0

Hiperostosis esquelética difusa idiopática: hallazgos radiológicos con especial atención a la afectación extraespinal 特发性弥漫性骨骼增生症：放射学发现，特别关注脊柱外受累情况

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-09-01 DOI: 10.1016/j.rx.2023.06.002

Diffuse idiopathic skeletal hyperostosis (DISH) is a multifactorial disease with a high prevalence and that is frequently detected incidentally in imaging tests. Most of its diagnostic criteria are focused on axial involvement and more specifically on the spine. However, peripheral involvement in DISH is less well known despite its non insignificant frequency. DISH can be associated with serious complications, the most severe being vertebral fractures in low energy trauma and dysphagia or airway obstruction in cervical involvement. Knowing how to identify the patterns of peripheral involvement of DISH and its complications helps in the radiological and clinical management of patients with this disease.

弥漫性特发性骨骼增生症（DISH）是一种多因素疾病，发病率很高，经常在影像学检查中偶然发现。其诊断标准大多集中于轴向受累，尤其是脊柱。然而，DISH 的外周受累尽管并不常见，但却鲜为人知。DISH 可伴有严重的并发症，最严重的并发症是低能量创伤中的椎体骨折和颈椎受累时的吞咽困难或气道阻塞。了解如何识别 DISH 周围受累的模式及其并发症有助于对该病患者进行放射学和临床治疗。

引用次数: 0

Rompiendo mitos en radiología: eliminación de las ayunas precontraste 打破放射学中的神话：取消造影前禁食

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-09-01 DOI: 10.1016/j.rx.2023.11.006

Radiology departments have traditionally observed fasting protocols for patients undergoing radiological studies with intravenous contrast. However, there is no scientific evidence to support these protocols.

This practice has potentially harmful consequences, such as interruptions to long-term medication, dehydration, hypoglycaemia, test delays or anxiety, and has no benefits in terms of study interpretation or patient safety.

Numerous studies now suggest the need to review these protocols, as reflected in the updated policies of our specialty's main societies, such as the European Society of Urogenital Radiology (ESUR) and the American College of Radiology (ACR).

In this article, we review the available scientific evidence on this topic, and present our centre's experience of eliminating fasting prior to contrast-enhanced imaging studies.

传统上，放射科在对患者进行静脉注射造影剂的放射检查时都会遵守禁食规定。这种做法可能会造成有害后果，如中断长期用药、脱水、低血糖、检查延迟或焦虑，而且对研究解释或患者安全没有任何益处。目前，大量研究表明有必要对这些方案进行审查，我们专业的主要学会（如欧洲泌尿生殖放射学会（ESUR）和美国放射学会（ACR））更新的政策也反映了这一点。在这篇文章中，我们回顾了有关这一主题的现有科学证据，并介绍了我们中心在造影剂增强成像研究前取消禁食的经验。

引用次数: 0

Actualizando las normas de las Cartas Científicas y Comunicaciones Breves 更新科学信函和短文规则

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-09-01 DOI: 10.1016/j.rx.2024.07.001

Elena Serrano

引用次数: 0

Mamografía con contraste y marcaje con semilla magnética para la detección de enfermedad residual en el cáncer de mama tras tratamiento neoadyuvante 用于检测乳腺癌新辅助治疗后残留病灶的对比增强乳腺 X 线照相术和磁性种子标记技术

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-09-01 DOI: 10.1016/j.rx.2024.04.003

A. Mariscal Martínez , E. Iglesias Bravo , H. Peris Alvà , P. Rodríguez Martínez , M. Luna Tomás , I. Pascual Miguel , P. Puyalto de Pablo

Purpose

Assess whether contrast-enhanced mammography (CEM) enables an evaluation of the residual size of breast tumours following neoadjuvant systemic therapy (NAST) in patients initially marked with magnetic seed.

Materials and methods

This single-centre prospective study was performed between March 2022 and April 2023 with patients with invasive breast carcinoma and lesional marking with magnetic seed. CEM was performed before and after NAST. The lesion size in CEM after NAST was compared to the pathological examination after surgery. Differences between sizes were evaluated and we determined the diagnostic capability indices.

Results

The breast lesions marked with magnetic seed were successfully localised in the preoperative stage for the 42 patients included in the study and selective surgical excision was also achieved in all cases. Tumour diameter after NAST was determined by comparing enhancement on combined CEM images from before and after NAST. The mean diameter was 13.6 mm while post-surgical pathological examination determined the mean diameter to be 12.9 mm. There were therefore no statistically significant differences between the measurements.

Conclusions

There is a positive correlation and similarity between CEM and pathological examination with regards to the detection of residual disease after NAST, with high specificity and positive predictive value.

目的评估对比增强乳腺 X 光造影术（CEM）能否评估最初使用磁性种子标记的患者在接受新辅助系统治疗（NAST）后乳腺肿瘤的残留大小。材料与方法这项单中心前瞻性研究于 2022 年 3 月至 2023 年 4 月间进行，研究对象为浸润性乳腺癌患者和使用磁性种子标记病灶的患者。在NAST前后均进行了CEM检查。将NAST后CEM中的病灶大小与手术后的病理检查结果进行比较。我们评估了不同大小病灶之间的差异，并确定了诊断能力指数。结果42名参与研究的患者在术前阶段均成功定位了磁性种子标记的乳腺病灶，所有病例均实现了选择性手术切除。通过比较磁种标记前后的联合 CEM 图像的增强情况，确定了磁种标记后的肿瘤直径。平均直径为 13.6 毫米，而手术后病理检查确定的平均直径为 12.9 毫米。结论CEM和病理检查在检测NAST术后残留疾病方面存在正相关性和相似性，具有较高的特异性和阳性预测值。

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引用次数: 0

Afectación de los troncos supraaórticos en la arteritis de Takayasu 主动脉上干受累于高安动脉炎

IF 1.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

RADIOLOGIA

Pub Date : 2024-09-01 DOI: 10.1016/j.rx.2023.11.007

引用次数: 0

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