RESUMEN
OBJECTIVES: Define the concept of cerebral microbleeds (CMBs) and describe the most useful MRI sequences for detecting this finding. Review the entities that most frequently present with CMBs and that may benefit from the use of susceptibility-weighted imaging (SWI) sequences. CONCLUSIONS: SWI is a useful MRI sequence for the detection and characterization of microhemorrhages, venous structures and other sources of susceptibility in imaging. SWI is particularly sensitive to local magnetic field inhomogeneities generated by certain substances and is superior to T2* GRE sequences for this assessment. CMBs may be seen in different neurologic conditions, in certain infrequent clinical contexts and have a key role as a biomarker status in gliomas (ITTS) and as a marker of inflammatory activity in multiple sclerosis.
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Hemorragia Cerebral , Imagen por Resonancia Magnética , Humanos , Hemorragia Cerebral/diagnóstico por imagen , Imagen por Resonancia Magnética/métodosRESUMEN
OBJECTIVES: Describe the radiographic features of the different forms of extrauterine leiomyomatosis. CONCLUSIONS: Leiomyomas with a rare growth pattern occur most often in women of reproductive age and with a history of hysterectomy. Extrauterine leiomyomas present a greater diagnostic challenge because they may mimic malignancies, and serious diagnostic errors may result.
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Leiomiomatosis , Neoplasias Uterinas , Femenino , Humanos , Leiomiomatosis/diagnóstico por imagen , Leiomiomatosis/patología , Neoplasias Uterinas/diagnóstico por imagen , Neoplasias Uterinas/patología , HisterectomíaAsunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Meningitis , Vasculitis Sistémica , Humanos , Anticuerpos Anticitoplasma de Neutrófilos , Meningitis/diagnóstico , Sistema Nervioso Central , Hipertrofia , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnósticoRESUMEN
OBJECTIVE: To find out if there is a relation among the diameter of the great saphenous vein (GSV) when it is incompetent, the clinical gravity of the varicose syndrome and the type of insufficiency of the saphenofemoral junction (SFJ) in patients with chronic venous insufficiency (CVI) by means of duplex exploration. METHODS: The sample included 145 extremities, 38 normal as a control group and 107 with incompetence of the GSV. According to the results of the Valsalva and Parana manoeuvres in the SFJ, they were distributed into four groups. The diameter of the GSV and the clinical state according to the clinical, aetiological, anatomical and pathological element classification were recorded for each group. RESULTS: Statistically significant differences were obtained for the diameter and the clinical state in patients with positive manoeuvres with regard to other groups. The diameter was greater and the clinical state more severe (C4, C5 and C6) when two manoeuvres were positive. CONCLUSIONS: The presence of both positive manoeuvres in the SFJ is related to severe clinical states and greater diameters of the GSV, allowing the establishment of a prognosis of the CVI and the most suitable surgical approach.
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Vena Femoral/diagnóstico por imagen , Hemodinámica , Vena Safena/diagnóstico por imagen , Várices/diagnóstico por imagen , Insuficiencia Venosa/diagnóstico por imagen , Adulto , Anciano , Enfermedad Crónica , Femenino , Vena Femoral/fisiopatología , Vena Femoral/cirugía , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Pronóstico , Vena Safena/fisiopatología , Vena Safena/cirugía , Índice de Severidad de la Enfermedad , Ultrasonografía Doppler Dúplex , Maniobra de Valsalva , Várices/fisiopatología , Várices/cirugía , Procedimientos Quirúrgicos Vasculares , Insuficiencia Venosa/fisiopatología , Insuficiencia Venosa/cirugíaRESUMEN
OBJECTIVE: To evaluate the efficacy of densitometric analysis of cranial CT imaging in the measurement of areas with low cerebral blood flow and lack of hemodynamic reserve in patients undergoing carotid endarterectomy. PATIENTS AND METHODS: 40 consecutive patients undergoing carotid endarterectomy have been included in the study. All of them had preoperative cranial CT, pre and postoperative basal and acetazolamide SPECT. Cranial CT imaging after digitalization and computer processing were obtained with 4 densitometric patterns: 1). normal cerebral blood perfusion; 2). ischemic or low brain blood perfusion (patron I); 3). parenchyma without cerebral hemodynamic reserve (patron nR), and 4). brain infarction. RESULTS: 32 out of 40 (80 %) patients had abnormal densitometric patterns: 19 nR patterns (47.5 %), 11 I pattern (27.5 %) and 2 established brain infarction. The correlation between densitometric cranial TC imaging and SPECT was 92% when analyzing areas with hypoperfusion (S: 96.5 %; E: 82 %). Cranial CT detected 12/13 of patients who lacked cerebral hemodynamic reserve in the SPECT analysis (S: 74 %; E: 92 %; Vpp: 95 %). CONCLUSIONS: There is a good correlation between analysis of densitometric cranial TC imaging and SPECT in determining low cerebral blood flow areas and lack of cerebral hemodynamic reserve. This method could help to improve carotid surgery indications in patients with carotid stenosis.
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Encéfalo , Endarterectomía Carotidea/métodos , Tomografía Computarizada por Rayos X , Anciano , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Estenosis Carotídea/fisiopatología , Estenosis Carotídea/cirugía , Femenino , Hemodinámica/fisiología , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
A case of spontaneous acute infrarenal aortic dissection, with extension to the right common iliac artery and proximally to just below the origin of the renal arteries is presented. This dissection did not involve the visceral vessels nor the iliac system. The diagnosis was made with ultrasonography and computed tomography, without the need for angiography, and confirmed during surgical intervention, in which, prosthetic replacement of the affected segment was carried out.