Discontinuous splenogonadal fusion: new sonographic findings.

Splenogonadal fusion is an uncommon cause of scrotal mass in children that is rarely diagnosed before surgery. Occasionally it leads to unnecessary orchiectomy. We report a case highlighting US findings that could help with correct diagnosis.

[Espondilodiskitis caused by Kingella kingae in children: a case report]. / Espondilodiscitis causada por Kingella kingae en pediatría: reporte de un case.

During the last years, spondilodiskitis due to Kingella kingae has been a new target of interest, since it is the second agent that causes non tuberculous espondilodiskitis in children, after Staphylococcus aureus. Its clinical presentation is very inespecific, sometimes with fever, abdominal or lumbar disconfort, nocturnal pain, altered walking and sedestation. Images, culture methods and PCR (polymerase chain reaction) can be helpful for diagnosis, although in an important percent of the cases, etiology cannot be determined. Although there are no established guidelines for treatment, before the suspicion, empiric antibiotic treatment should be started for good prognosis. We describe a case of a 3 year old boy, who had this disease and then a review about spondilodiskitis in childhood and microbiological aspects of Kingella kingae.

Estudio por imágenes de vía aérea: utilidad de la tomografía computada multidetector con reconstrucción tridimensional / Airway imaging study: usefulness of multidetector computed tomography with three-dimensional reconstruction

Introduction. Information obtained by multidetector computed tomography and using reconstruction software now allows precision of intrinsic and extrinsic airway pathological processes. It also shows the pulmonary involvement beyond an obstructed zone. Visualization of different densities with three-dimensional reconstructions facilitates this task. Objective: To show the usefulness of three-dimensional (3D) reconstruction and volume segmentation in airway pathology particularly extrinsic vascular compression. Material and Methods: Pediatric clinical cases studied with Multidetector Computed Tomography are illustrated (suspected airway compression by vascular abnormalities and other causes), in which 3D reconstruction proved to be an important non-invasive diagnostic tool. Studies were performed with Siemens Somatom Definition Team Flash, with 128 channels, with a dual source phase and angiographic technique using low doses of radiation. The reconstructions were performed on a workstation Carestream Vue Pacs. Conclusion: The study of airway with 3D reconstruction and angiographic volume segments allows a better definition of the relation between the compromised airway vessels and other structures on any level in children.

Introducción: La información obtenida mediante tomografía computada multidetector (TCMD) y el uso de software para reconstrucción permiten en la actualidad demostrar con exacta precisión los procesos patológicos que comprometen la vía aérea y estructuras extrínsecas que pueden producir compresión. Permite además demostrar el compromiso pulmonar mas allá de una zona obstruida. La posibilidad de visualizar diferentes densidades conjuntamente en reconstrucciones 3D facilita esta labor. Objetivo: Mostrar la utilidad de la reconstrucción tridimensional (3D) en patología de la vía aérea particularmente compresión vascular extrínseca. Material y método: Se ilustran casos clínicos pediátricos examinados con TCMD por sospecha de compresión de la vía aérea por anomalías vasculares y otras causas, en los cuales la reconstrucción 3D demostró ser una importante herramienta diagnóstica no invasiva. Los estudios fueron efectuados en equipo Siemens Somatom Definition Flash, de 128 canales, con una fuente dual en fase angiográfica y utilizando técnicas de baja dosis de radiación. Las reconstrucciones fueron realizadas en una estación de trabajo Carestream Vue Pacs. Conclusión: En niños el estudio en la vía aérea con reconstrucción 3D y de segmentos de un volumen de un estudio angiográfico con TCMD permite una mejor demostración en cualquier plano de la relación entre la vía aérea comprometida, los vasos y otras estructuras.

Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis.

BACKGROUND: Although the primary abnormality in testicular torsion is at the spermatic cord, imaging studies up to now have mostly been oriented to evaluation of the testicle itself, with emphasis on color Doppler ultrasonography (US). However, findings can be inaccurate when there is incomplete interruption of testicular flow. Indirect findings, such as morphological changes in the testis alone, are not reliable for the diagnosis since they become evident late in the disease. OBJECTIVE: To call to attention to the fact that sonographic visualization of the spermatic cord can be the key for diagnosis in those patients with acute scrotal pain as a result of testicular torsion, particularly when color Doppler US shows that intratesticular flow is present within the affected testis. PATIENTS AND METHODS: Six patients who presented clinically with acute scrotal pain and had spermatic cord torsion, proven at surgery. All patients were initially studied with color Doppler US, and intratesticular flow was detected in all of them. Patients who showed structural abnormalities on gray-scale US and/or absence of intratesticular vascular flow in the affected testis were not included. In addition to a conventional study, the spermatic cord was examined. RESULTS: The spermatic cord was shown to be rotated on the symptomatic side in all patients. Local morphological and vascular flow changes, distal and at the site of the torsion, were found and registered. CONCLUSIONS: The finding of a rotated spermatic cord could be a highly reliable and direct sign for the diagnosis of a testicular torsion, and this is especially important when vascular flow is present within the affected testis on color Doppler US examination. Examination of the spermatic cord should be added to evaluation of the testis in patients with suspected testicular torsion to enhance sensitivity of the examination.

Reservorios urinarios continentes: evaluación radiológica / Continent urinary reservoirs: radiologic evaluation

En 47 pacientes a quienes se les efectuó un reservorio urinario continente, revisamos los estudios radiológicos realizados como control de su intervención quirúrgica. El radiólogo debe estar familiarizado con estas nuevas técnicas para efectuar una correcta evaluación posterior de ellas