Pub Date : 2025-05-01DOI: 10.1016/j.rx.2024.11.006
M. Fresno Vallespir , I. Vázquez de las Heras , D. Gasior , A. Morales Rosa , X. Bargalló Castelló
Adenoid cystic carcinoma (ACC) of the breast is a rare tumour that represents less than 0.1% of breast carcinomas. It has a triple-negative phenotype; however, it is associated with a benign course, and both lymph node involvement and distant metastasis are rare. We present seven cases of ACC of the breast diagnosed in our centre. We describe their radiological characteristics, and specifically highlight the findings from magnetic resonance imaging.
{"title":"Hallazgos radiológicos del carcinoma adenoide quístico de mama","authors":"M. Fresno Vallespir , I. Vázquez de las Heras , D. Gasior , A. Morales Rosa , X. Bargalló Castelló","doi":"10.1016/j.rx.2024.11.006","DOIUrl":"10.1016/j.rx.2024.11.006","url":null,"abstract":"<div><div>Adenoid cystic carcinoma (ACC) of the breast is a rare tumour that represents less than 0.1% of breast carcinomas. It has a triple-negative phenotype; however, it is associated with a benign course, and both lymph node involvement and distant metastasis are rare. We present seven cases of ACC of the breast diagnosed in our centre. We describe their radiological characteristics, and specifically highlight the findings from magnetic resonance imaging.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 378-383"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903968","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 : 2025-05-01DOI: 10.1016/j.rx.2023.12.003
D. Herrán de la Gala , C. Cantolla Nates , M. Moris , R. Pellón Daben , J. Crespo del Pozo , F.J. González Sánchez , S. Sánchez Bernal
Gastric and duodenal ulcers (GDUs) are decreasing both in frequency and rate of mortality. However, GDUs with complications continue to have higher mortality rates and are seldom suspected in patients presenting with acute abdomen. Although upper endoscopy plays a central role in the diagnosis and treatment of GDUs, CT is crucial when serious complications appear, namely uncontrolled acute haemorrhage, perforation, organ penetration, or gastric obstruction. Radiologists have a special role to play in these situations, providing the diagnosis and extent of complications, thus contributing to decision making which can range from conservative management to endoscopic, surgical or interventional radiology procedures. The aim of our study is to describe the CT indications and protocols for patients with a suspected GDU with complications and present the main imaging findings for the different types of complications, while providing differential diagnoses.
{"title":"Evaluación mediante TC de las complicaciones de la úlcera gastroduodenal","authors":"D. Herrán de la Gala , C. Cantolla Nates , M. Moris , R. Pellón Daben , J. Crespo del Pozo , F.J. González Sánchez , S. Sánchez Bernal","doi":"10.1016/j.rx.2023.12.003","DOIUrl":"10.1016/j.rx.2023.12.003","url":null,"abstract":"<div><div>Gastric and duodenal ulcers (GDUs) are decreasing both in frequency and rate of mortality. However, GDUs with complications continue to have higher mortality rates and are seldom suspected in patients presenting with acute abdomen. Although upper endoscopy plays a central role in the diagnosis and treatment of GDUs, CT is crucial when serious complications appear, namely uncontrolled acute haemorrhage, perforation, organ penetration, or gastric obstruction. Radiologists have a special role to play in these situations, providing the diagnosis and extent of complications, thus contributing to decision making which can range from conservative management to endoscopic, surgical or interventional radiology procedures. The aim of our study is to describe the CT indications and protocols for patients with a suspected GDU with complications and present the main imaging findings for the different types of complications, while providing differential diagnoses.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 343-356"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277618","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 : 2025-05-01DOI: 10.1016/j.rx.2024.04.005
E. Baettig , M.F. Molina-Centelles , A. Amr-Rey , N. Mancheño-Franch , C. Muñoz-Núñez
Pulmonary neuroendocrine cells, which constitute a small percentage (0.4%) of airway epithelial cells, play a key role in hypoxia detection, epithelial growth and regeneration, and in lung organogenesis through the synthesis and secretion of amines and peptides. Lesions resulting from pulmonary neuroendocrine cell proliferation range from benign and indolent to malignant and highly aggressive. The recently updated WHO classification of pulmonary neuroendocrine neoplasms includes typical and atypical carcinoid tumours as well as high-grade neuroendocrine carcinomas: large cell neuroendocrine carcinomas and small cell carcinomas. This classification also recognises a condition known as diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) as a distinct entity. Radiologists need to become familiar with these pathologies as the symptoms often lack specificity, and thus imaging plays a crucial role in diagnosis. An understanding of the correlation between the radiological and pathological examinations of these pathologies can enhance our awareness of the wide spectrum of imaging manifestations.
{"title":"Las células neuroendocrinas en el pulmón: Espectro de patologías y su correlación radiopatológica","authors":"E. Baettig , M.F. Molina-Centelles , A. Amr-Rey , N. Mancheño-Franch , C. Muñoz-Núñez","doi":"10.1016/j.rx.2024.04.005","DOIUrl":"10.1016/j.rx.2024.04.005","url":null,"abstract":"<div><div>Pulmonary neuroendocrine cells, which constitute a small percentage (0.4%) of airway epithelial cells, play a key role in hypoxia detection, epithelial growth and regeneration, and in lung organogenesis through the synthesis and secretion of amines and peptides. Lesions resulting from pulmonary neuroendocrine cell proliferation range from benign and indolent to malignant and highly aggressive. The recently updated WHO classification of pulmonary neuroendocrine neoplasms includes typical and atypical carcinoid tumours as well as high-grade neuroendocrine carcinomas: large cell neuroendocrine carcinomas and small cell carcinomas. This classification also recognises a condition known as diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) as a distinct entity. Radiologists need to become familiar with these pathologies as the symptoms often lack specificity, and thus imaging plays a crucial role in diagnosis. An understanding of the correlation between the radiological and pathological examinations of these pathologies can enhance our awareness of the wide spectrum of imaging manifestations.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 357-364"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903848","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 : 2025-05-01DOI: 10.1016/j.rx.2024.01.007
M. Pérez Laencina , J.M. Plasencia Martínez , M. Sánchez Canales , C. Jiménez Pulido , R. Rodríguez Mondéjar , L. Martínez Encarnación , C. García Hidalgo , D. Galdo Galián , P. Hernández Madrid , L. Chico Caballero , E. Guillén García , M.N. Plasencia Martínez , S. Martínez Romero , J. García Molina , J.M. García Santos
Introduction
Our objective is to evaluate how useful an artificial intelligence (AI) tool is to chest radiograph readers with various levels of expertise for the diagnosis of COVID-19 pneumonia when the tool has been trained on a non-COVID-19 pneumonia pathology.
Methods
Data was collected for patients who had previously undergone a chest radiograph and digital tomosynthesis due to suspected COVID-19 pneumonia. The gold standard consisted of the readings of two expert radiologists who assessed the presence and distribution of COVID-19 pneumonia on the images. Six medical students, two radiology trainees, and two other expert thoracic radiologists participated as additional readers. Two radiograph readings and a third supported by the AI Thoracic Care Suite tool were performed. COVID-19 pneumonia distribution and probability were assessed along with the contribution made by AI. Agreement and diagnostic performance were analysed.
Results
The sample consisted of 113 cases, of which 56 displayed lung opacities, 52.2% were female, and the mean age was 50.70 ± 14.9. Agreement with the gold standard differed between students, trainees, and radiologists. There was a non-significant improvement for four of the six students when AI was used. The use of AI by students did not improve the COVID-19 pneumonia diagnostic performance but it did reduce the difference in diagnostic performance with the more expert radiologists. Furthermore, it had more influence on the interpretation of mild pneumonia than severe pneumonia and normal radiograph findings. AI resolved more doubts than it generated, especially among students (31.30 vs 8.32%), followed by trainees (14.45 vs 5.7%) and radiologists (10.05% vs 6.15%).
Conclusion
For expert and lesser experienced radiologists, this commercial AI tool has shown no impact on chest radiograph readings of patients with suspected COVID-19 pneumonia. However, it aided the assessment of inexperienced readers and in cases of mild pneumonia.
{"title":"Usar una herramienta comercial de inteligencia artificial no entrenada para COVID-19 mejora ligeramente la interpretación de las radiografías con neumonía COVID-19, especialmente entre lectores inexpertos","authors":"M. Pérez Laencina , J.M. Plasencia Martínez , M. Sánchez Canales , C. Jiménez Pulido , R. Rodríguez Mondéjar , L. Martínez Encarnación , C. García Hidalgo , D. Galdo Galián , P. Hernández Madrid , L. Chico Caballero , E. Guillén García , M.N. Plasencia Martínez , S. Martínez Romero , J. García Molina , J.M. García Santos","doi":"10.1016/j.rx.2024.01.007","DOIUrl":"10.1016/j.rx.2024.01.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Our objective is to evaluate how useful an artificial intelligence (AI) tool is to chest radiograph readers with various levels of expertise for the diagnosis of COVID-19 pneumonia when the tool has been trained on a non-COVID-19 pneumonia pathology.</div></div><div><h3>Methods</h3><div>Data was collected for patients who had previously undergone a chest radiograph and digital tomosynthesis due to suspected COVID-19 pneumonia. The gold standard consisted of the readings of two expert radiologists who assessed the presence and distribution of COVID-19 pneumonia on the images. Six medical students, two radiology trainees, and two other expert thoracic radiologists participated as additional readers. Two radiograph readings and a third supported by the AI Thoracic Care Suite tool were performed. COVID-19 pneumonia distribution and probability were assessed along with the contribution made by AI. Agreement and diagnostic performance were analysed.</div></div><div><h3>Results</h3><div>The sample consisted of 113 cases, of which 56 displayed lung opacities, 52.2% were female, and the mean age was 50.70<!--> <!-->±<!--> <!-->14.9. Agreement with the gold standard differed between students, trainees, and radiologists. There was a non-significant improvement for four of the six students when AI was used. The use of AI by students did not improve the COVID-19 pneumonia diagnostic performance but it did reduce the difference in diagnostic performance with the more expert radiologists. Furthermore, it had more influence on the interpretation of mild pneumonia than severe pneumonia and normal radiograph findings. AI resolved more doubts than it generated, especially among students (31.30 vs 8.32%), followed by trainees (14.45 vs 5.7%) and radiologists (10.05% vs 6.15%).</div></div><div><h3>Conclusion</h3><div>For expert and lesser experienced radiologists, this commercial AI tool has shown no impact on chest radiograph readings of patients with suspected COVID-19 pneumonia. However, it aided the assessment of inexperienced readers and in cases of mild pneumonia.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 273-286"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759367","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 : 2025-05-01DOI: 10.1016/j.rx.2023.11.010
J. Azcona Sáenz , C.V. Martinez Stocker , E.N. Arenas Rivera , S. Marsico , E. Arizaga Batiz , R. Alcantara Souza
Male nipple discharge is uncommon and highly associated with malignancy. However, it can also be due to benign processes. In addition to physical examination, all patients should undergo a radiological examination with mammography and/or ultrasound. Furthermore, we propose the use of contrast-enhanced mammography (CEM) in cases of suspicious nipple discharge due to the high negative predictive value of this technique, potentially reducing the number of unnecessary biopsies. The aim of this article is to review the imaging findings of the most common causes of male nipple discharge, both benign and malignant. Additionally, we would like to share our experience with the use of CEM in studying this condition.
{"title":"Revisión radiológica de la secreción mamaria en el varón","authors":"J. Azcona Sáenz , C.V. Martinez Stocker , E.N. Arenas Rivera , S. Marsico , E. Arizaga Batiz , R. Alcantara Souza","doi":"10.1016/j.rx.2023.11.010","DOIUrl":"10.1016/j.rx.2023.11.010","url":null,"abstract":"<div><div>Male nipple discharge is uncommon and highly associated with malignancy. However, it can also be due to benign processes. In addition to physical examination, all patients should undergo a radiological examination with mammography and/or ultrasound. Furthermore, we propose the use of contrast-enhanced mammography (CEM) in cases of suspicious nipple discharge due to the high negative predictive value of this technique, potentially reducing the number of unnecessary biopsies. The aim of this article is to review the imaging findings of the most common causes of male nipple discharge, both benign and malignant. Additionally, we would like to share our experience with the use of CEM in studying this condition.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 319-330"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279070","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 : 2025-05-01DOI: 10.1016/j.rx.2024.05.005
A. Hilario, E. Salvador, Z.H. Chen, A. Cárdenas, Juan Romero, A. Ramos
Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in young patients. The Marshall classification predicts six-month mortality and divides severe TBI patients into six groups based on CT findings in the acute phase of trauma. MRI also has prognostic value because it detects 30% more traumatic lesions, especially brainstem injury and diffuse axonal injury. Diffuse axonal injury occurs in three different anatomical areas, graded according to severity, and the greater the trauma, the deeper the brain involvement extends. Traumatic brainstem injuries with the worst prognosis are those of posterior location, with bilateral or haemorrhagic involvement. This article analyses the prognostic value of CT and MRI in the assessment of severe TBI and describes the main intracranial traumatic injuries.
{"title":"Hallazgos de imagen en el traumatismo craneoencefálico grave","authors":"A. Hilario, E. Salvador, Z.H. Chen, A. Cárdenas, Juan Romero, A. Ramos","doi":"10.1016/j.rx.2024.05.005","DOIUrl":"10.1016/j.rx.2024.05.005","url":null,"abstract":"<div><div>Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in young patients. The Marshall classification predicts six-month mortality and divides severe TBI patients into six groups based on CT findings in the acute phase of trauma. MRI also has prognostic value because it detects 30% more traumatic lesions, especially brainstem injury and diffuse axonal injury. Diffuse axonal injury occurs in three different anatomical areas, graded according to severity, and the greater the trauma, the deeper the brain involvement extends. Traumatic brainstem injuries with the worst prognosis are those of posterior location, with bilateral or haemorrhagic involvement. This article analyses the prognostic value of CT and MRI in the assessment of severe TBI and describes the main intracranial traumatic injuries.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 331-342"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407021","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 : 2025-05-01DOI: 10.1016/j.rx.2024.01.009
S. Panda , A. Malhotra , S. Chandak , A. Agarwal , S. Dash , P. Singh
Introduction and Objectives
Patients undergoing Magnetic Resonance Imaging (MRI) might face feelings of anxiety and fear in different magnitudes, before and during the scanning process with incidence as high as 37% having been reported, which sometimes leads to motion artifacts or premature termination of the scan. This study was conducted to evaluate the efficacy of two novel interventions, namely, Mock Computerised Tomography (CT) run and counselling by consultant, in anxiety reduction of patients undergoing MRI by 1.5 Tesla scanner.
Methods
This was a prospective study. 90 patients referred for non contrast MRI of Brain or Spine fulfilling inclusion criteria were enrolled in the study and randomized into three groups (Control Group, Mock CT Group and counselling by consultant Group) using chit and box method. Outcome measures included STAI questionnaire, heart rate measurements and motion artifact assessment by two Radiologists. Statistical significance was set at p < 0.05.
Results
ANCOVA showed statistically significant improvement in Post-intervention STAI scores in the Mock CT Group (p = 0.002) and counselling Group (p = 0.02) compared to controls. ANOVA demonstrated significantly lower heart rate elevations for the Mock CT Group compared to Control Group (p = 0.001) and counselling Group (p = 0.02). Motion artifacts were significantly lower in Mock CT Group compared to controls (p = 0.01) as evaluated by Chi Square test. No significant difference was achieved when comparing controls with counselling Group (p = 0.07).
Conclusion
This study showed that Mock CT can significantly lower anxiety levels in patients undergoing MRI, an intervention largely unexplored in existing literature. Although counselling by consultant lowered pre-MRI anxiety levels, this group did not perform as good as Mock CT when assessing anxiety during MRI. It is suggested that patients experiencing anxiety before MRI may undergo pre-MRI Mock CT with the option of counselling whenever feasible.
{"title":"Reducción de la ansiedad en pacientes sometidos a Resonancia Magnética: un estudio institucional único de dos intervenciones no farmacológicas novedosas","authors":"S. Panda , A. Malhotra , S. Chandak , A. Agarwal , S. Dash , P. Singh","doi":"10.1016/j.rx.2024.01.009","DOIUrl":"10.1016/j.rx.2024.01.009","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Patients undergoing Magnetic Resonance Imaging (MRI) might face feelings of anxiety and fear in different magnitudes, before and during the scanning process with incidence as high as 37% having been reported, which sometimes leads to motion artifacts or premature termination of the scan. This study was conducted to evaluate the efficacy of two novel interventions, namely, Mock Computerised Tomography (CT) run and counselling by consultant, in anxiety reduction of patients undergoing MRI by 1.5 Tesla scanner.</div></div><div><h3>Methods</h3><div>This was a prospective study. 90 patients referred for non contrast MRI of Brain or Spine fulfilling inclusion criteria were enrolled in the study and randomized into three groups (Control Group, Mock CT Group and counselling by consultant Group) using chit and box method. Outcome measures included STAI questionnaire, heart rate measurements and motion artifact assessment by two Radiologists. Statistical significance was set at p <<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>ANCOVA showed statistically significant improvement in Post-intervention STAI scores in the Mock CT Group (p<!--> <!-->=<!--> <!-->0.002) and counselling Group (p<!--> <!-->=<!--> <!-->0.02) compared to controls. ANOVA demonstrated significantly lower heart rate elevations for the Mock CT Group compared to Control Group (p<!--> <!-->=<!--> <!-->0.001) and counselling Group (p<!--> <!-->=<!--> <!-->0.02). Motion artifacts were significantly lower in Mock CT Group compared to controls (p<!--> <!-->=<!--> <!-->0.01) as evaluated by Chi Square test. No significant difference was achieved when comparing controls with counselling Group (p<!--> <!-->=<!--> <!-->0.07).</div></div><div><h3>Conclusion</h3><div>This study showed that Mock CT can significantly lower anxiety levels in patients undergoing MRI, an intervention largely unexplored in existing literature. Although counselling by consultant lowered pre-MRI anxiety levels, this group did not perform as good as Mock CT when assessing anxiety during MRI. It is suggested that patients experiencing anxiety before MRI may undergo pre-MRI Mock CT with the option of counselling whenever feasible.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 299-308"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903847","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 : 2025-05-01DOI: 10.1016/j.rx.2024.05.007
G. Muller Bravo , J. Broncano Cabrero , N. Cobo Gómez , A. Luna Alcalá
Four-dimensional flow magnetic resonance imaging (MRI) is a time-resolved three-dimensional phase-contrast technique. It provides volumetric information for the cardiovascular system of interest through blood flow velocity mapping in three spatial dimensions throughout the cardiac cycle. The technological advances of MRI over the last two decades have facilitated its transition from the experimental environment into clinical practice, thereby enabling the non-invasive in vivo assessment of haemodynamics across various vascular territories of the human body. This article endeavours to elucidate its inception and fundamental technical principles, to delineate its main clinical indications—particularly in the cardiothoracic domain—, and to review its limitations and future directions. The ongoing evolution of this diagnostic modality continues to develop further understanding of the interplay between abnormal haemodynamics and cardiovascular pathologies, promising enhanced clinical value.
{"title":"Aplicaciones clínicas del flujo 4D por RM","authors":"G. Muller Bravo , J. Broncano Cabrero , N. Cobo Gómez , A. Luna Alcalá","doi":"10.1016/j.rx.2024.05.007","DOIUrl":"10.1016/j.rx.2024.05.007","url":null,"abstract":"<div><div>Four-dimensional flow magnetic resonance imaging (MRI) is a time-resolved three-dimensional phase-contrast technique. It provides volumetric information for the cardiovascular system of interest through blood flow velocity mapping in three spatial dimensions throughout the cardiac cycle. The technological advances of MRI over the last two decades have facilitated its transition from the experimental environment into clinical practice, thereby enabling the non-invasive in vivo assessment of haemodynamics across various vascular territories of the human body. This article endeavours to elucidate its inception and fundamental technical principles, to delineate its main clinical indications—particularly in the cardiothoracic domain—, and to review its limitations and future directions. The ongoing evolution of this diagnostic modality continues to develop further understanding of the interplay between abnormal haemodynamics and cardiovascular pathologies, promising enhanced clinical value.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 413-429"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903965","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 : 2025-05-01DOI: 10.1016/j.rx.2023.09.007
R. Oca Pernas , N. Hormaza Aguirre , T. Salinas Yeregui , T. Palomares Casado , B. Fernández Ruanova , C. Trinidad López
Background
Soft tissue tumours (STT) constitute a heterogeneous group of lesions frequently studied by Magnetic Resonance Imaging (MRI). It has not yet been clearly established whether the inclusion of apparent diffusion coefficient (ADC) diffusion-weighted imaging (DWI) maps would better determine tumour aggressiveness.
Purpose
To assess the diagnostic value of quantitative ADC DWI maps in the initial diagnosis of STT; and to determine whether the inclusion of DWI provides more valuable information than conventional sequences alone.
Material and methods
Retrospective study of patients with histologically proven STT. Conventional morphological MRI sequences and the DWI sequence were analysed. The ADC was quantified using a region of interest (ROI) that covered the largest sectional area (global ADC) and another that selected the area of greatest restriction (selected ADC). Differences in ADC values were analysed between both benign and malignant lesions and high and low-grade sarcomas. A multivariate analysis was performed to determine the ability of ADC to adequately diagnose the nature of STTs when associated with other morphological characteristics.
Results
84 patients with STT, of which 40 were benign and 44 malignant. The malignant group included 10 low-grade sarcomas, 23 high-grade sarcomas, 4 non-sarcomatous neoplasms and 7 sarcomas with no histological grading. The ADC values were significantly higher in benign lesions for the selected ADC. Significantly higher selected ADC values were also obtained in low-grade sarcomas. In the multivariate analysis, the highest diagnostic precision values were obtained when morphological features and ADC were included, with a sensitivity, specificity, and area under the curve (AUC) of 84, 75 and 91%, respectively.
Conclusion
The inclusion of ADC DWI values improves the diagnostic accuracy of MRI for STTs, especially when used in combination with conventional MRI sequences.
{"title":"Papel de la resonancia magnética de difusión en el diagnóstico inicial de los tumores de partes blandas","authors":"R. Oca Pernas , N. Hormaza Aguirre , T. Salinas Yeregui , T. Palomares Casado , B. Fernández Ruanova , C. Trinidad López","doi":"10.1016/j.rx.2023.09.007","DOIUrl":"10.1016/j.rx.2023.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Soft tissue tumours (STT) constitute a heterogeneous group of lesions frequently studied by Magnetic Resonance Imaging (MRI). It has not yet been clearly established whether the inclusion of apparent diffusion coefficient (ADC) diffusion-weighted imaging (DWI) maps would better determine tumour aggressiveness.</div></div><div><h3>Purpose</h3><div>To assess the diagnostic value of quantitative ADC DWI maps in the initial diagnosis of STT; and to determine whether the inclusion of DWI provides more valuable information than conventional sequences alone.</div></div><div><h3>Material and methods</h3><div>Retrospective study of patients with histologically proven STT. Conventional morphological MRI sequences and the DWI sequence were analysed. The ADC was quantified using a region of interest (ROI) that covered the largest sectional area (global ADC) and another that selected the area of greatest restriction (selected ADC). Differences in ADC values were analysed between both benign and malignant lesions and high and low-grade sarcomas. A multivariate analysis was performed to determine the ability of ADC to adequately diagnose the nature of STTs when associated with other morphological characteristics.</div></div><div><h3>Results</h3><div>84 patients with STT, of which 40 were benign and 44 malignant. The malignant group included 10 low-grade sarcomas, 23 high-grade sarcomas, 4 non-sarcomatous neoplasms and 7 sarcomas with no histological grading. The ADC values were significantly higher in benign lesions for the selected ADC. Significantly higher selected ADC values were also obtained in low-grade sarcomas. In the multivariate analysis, the highest diagnostic precision values were obtained when morphological features and ADC were included, with a sensitivity, specificity, and area under the curve (AUC) of 84, 75 and 91%, respectively.</div></div><div><h3>Conclusion</h3><div>The inclusion of ADC DWI values improves the diagnostic accuracy of MRI for STTs, especially when used in combination with conventional MRI sequences.</div></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":"67 3","pages":"Pages 263-272"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626925","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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