Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma.

AIM: To compare the accuracy of whole-body magnetic resonance imaging (Wb-MRI) with diffusion-weighted imaging (DWI) to that of contrast-enhanced computed tomography (CE-CT) and 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography co-registered with low dose-CT (PET-CT) in defining lymphoma disease stage. MATERIALS AND METHODS: From February 2010 to May 2014, 41 lymphoma patients underwent Wb-MRI-DWI, CE-CT, and (18)F-FDG PET-CT. Histological subtypes included aggressive B-cell (n=11), follicular (n=13), mantle cell (n=3), and Hodgkin's (n=14) lymphoma. To compare the procedures, the reference standard (RS) assessment was defined by combining the results from (18)F-FDG PET-CT, CE-CT, and bone marrow (BM) histology, modifications after therapy, and histological re-assessments of uncertain lesions. RESULTS: Among 1025 nodal sites, 217 had disease involvement according to the RS. CE-CT yielded 23 false-negative and 11 false-positive errors. Wb-MRI-DWI failed to recognise 17 localisations and had six false-positive errors; (18)F-FDG PET-CT had no errors. Among 458 extranodal sites, 37 were positive according to the RS. (18)F-FDG PET-CT yielded four false-negative and two false-positive results. CE-CT yielded 17 false-negative errors. Wb-MRI-DWI yielded a single false-negative error. Wb-MRI-DWI was the most reliable imaging technique for BM evaluation. Considering each procedure alone, the final stage would have been missed in four cases using (18)F-FDG PET-CT, 12 cases using CE-CT, and none using Wb-MRI-DWI. CONCLUSION: The present data support Wb-MRI-DWI as a sensitive and specific imaging technique for lymphoma evaluation, supporting its use in place of CE-CT for staging.

Diagnostic accuracy of second-generation dual-source computed tomography coronary angiography with iterative reconstructions: a real-world experience.

PURPOSE: The authors evaluated the diagnostic accuracy of second-generation dual-source (DSCT) computed tomography coronary angiography (CTCA) with iterative reconstructions for detecting obstructive coronary artery disease (CAD). MATERIALS AND METHODS: Between June 2010 and February 2011, we enrolled 160 patients (85 men; mean age 61.2±11.6 years) with suspected CAD. All patients underwent CTCA and conventional coronary angiography (CCA). For the CTCA scan (Definition Flash, Siemens), we use prospective tube current modulation and 70-100 ml of iodinated contrast material (Iomeprol 400 mgI/ ml, Bracco). Data sets were reconstructed with iterative reconstruction algorithm (IRIS, Siemens). CTCA and CCA reports were used to evaluate accuracy using the threshold for significant stenosis at ≥50% and ≥70%, respectively. RESULTS: No patient was excluded from the analysis. Heart rate was 64.3±11.9 bpm and radiation dose was 7.2±2.1 mSv. Disease prevalence was 30% (48/160). Sensitivity, specificity and positive and negative predictive values of CTCA in detecting significant stenosis were 90.1%, 93.3%, 53.2% and 99.1% (per segment), 97.5%, 91.2%, 61.4% and 99.6% (per vessel) and 100%, 83%, 71.6% and 100% (per patient), respectively. Positive and negative likelihood ratios at the per-patient level were 5.89 and 0.0, respectively. CONCLUSIONS: CTCA with second-generation DSCT in the real clinical world shows a diagnostic performance comparable with previously reported validation studies. The excellent negative predictive value and likelihood ratio make CTCA a first-line noninvasive method for diagnosing obstructive CAD.

[Giant diverticulum of the colon]. / Divertículo gigante de colon.

The giant diverticulum of the colon is a rare entity first diagnosed by Bouvin and Bonte in 1946. Few cases have been reported in the literature. It is normally located in the antimesenteric border of the sigmoid colon. In most cases it is considered to be an uncommon complication of a common disease: colonic diverticulosis. We present a case of giant diverticulum of the sigma diagnosed in an 80-year-old man and we describe the plain-film and CT findings.

[Diagnosis of Anisakis infestation: experience in our environment]. / Diagnóstico de la infestación por Anisakis. Experiencia en nuestro medio.

OBJECTIVES: To characterize the most frequently found radiological findings in intestinal anisakiasis. MATERIAL AND METHODS: The medical records of 14 patients diagnosed with intestinal anisakiasis between 2000 and 2003 in the Hospital Clinico Universitario Lozano Blesa in Zaragoza (Spain) were retrospectively reviewed. The imaging tests and immunological laboratory tests performed in these patients were evaluated. RESULTS: The most frequent reason for seeking medical assistance was right iliac fossa pain. Radiological findings of an inflammatory intestinal process were observed in 60 % of the patients. Seventy-five percent of the patients had eaten raw or insufficiently cooked fish and had eosinophilia; of these 80 % had elevated specific IgE levels. CONCLUSIONS: The incidence of anisakiasis is increasing and consequently knowledge of its most characteristic clinical, radiological and laboratory manifestations is important. The most frequently affected segment of the digestive tract is the ileum. Many patients have symptoms of acute abdomen, mimicking appendicitis or peritonitis. Anisakiasis is a self-limiting process that usually resolves in 1-2 weeks. Consequently, a conservative attitude is advisable to avoid unnecessary surgery.

Divertículo gigante de colon / Giant diverticulum of the colon

El divertículo gigante de colon es una rara entidad diagnosticada por primera vez por Bouvin y Bonte en 1946. Desde entonces pocos casos han sido descritos en la literatura. Se localiza habitualmente en el borde antimesentérico del sigma. La mayoría se considera una complicación infrecuente de una enfermedad común, la diverticulosis colónica. Presentamos un caso de divertículo gigante de sigma diagnosticado en un varón de 80 años y describimos los hallazgos en la radiología simple y tomografía computarizada

The giant diverticulum of the colon is a rare entity first diagnosed by Bouvin and Bonte in 1946. Few cases have been reported in the literature. It is normally located in the antimesenteric border of the sigmoid colon. In most cases it is considered to be an uncommon complication of a common disease: colonic diverticulosis. We present a case of giant diverticulum of the sigma diagnosed in an 80-year-old man and we describe the plain-film and CT findings

Diagnóstico de la infestación por Anisakis. Experiencia en nuestro medio / Diagnosis of Anisakis infestation: experience in our environment

Objetivo: Mostrar los hallazgos radiológicos más frecuentemente encontrados en la anisakiasis intestinal. Material y métodos: Se revisan retrospectivamente las historias de 14 pacientes diagnosticados de anisakiasis intestinal entre los años 2000-2003 en el Hospital Clínico Universitario Lozano Blesa de Zaragoza. Hemos valorado las pruebas de imagen y las pruebas inmunológicas de laboratorio practicadas a estos pacientes. Resultados: El motivo más frecuente de consulta fue el dolor en fosa iliaca derecha. Se encontraron signos radiológicos de proceso inflamatorio intestinal en el 60 % de los casos. El antecedente de ingesta de pescado crudo o insuficientemente cocinado y la presencia de eosinofilia se encontraba en el 75 % de los pacientes; la IgE específica frente a anisakis estaba elevada en el 80 % de ellos. Conclusiones: La incidencia de la anisakiasis está aumentando en los últimos tiempos, por lo que resulta importante conocer sus manifestaciones más características, tanto clínicas como radiológicas y de laboratorio. El segmento del tubo digestivo afectado con mayor frecuencia, es el íleon. Muchos pacientes presentan clínica de abdomen agudo, simulando una apendicitis o peritonitis. Se trata de un proceso auto-limitado que suele resolverse en 1-2 semanas, por lo que se debe mantener una actitud conservadora, evitando al paciente una cirugía innecesaria

Objectives: To characterize the most frequently found radiological findings in intestinal anisakiasis. Material and methods: The medical records of 14 patients diagnosed with intestinal anisakiasis between 2000 and 2003 in the Hospital Clínico Universitario Lozano Blesa in Zaragoza (Spain) were retrospectively reviewed. The imaging tests and immunological laboratory tests performed in these patients were evaluated. Results: The most frequent reason for seeking medical assistance was right iliac fossa pain. Radiological findings of an inflammatory intestinal process were observed in 60 % of the patients. Seventy-five percent of the patients had eaten raw or insufficiently cooked fish and had eosinophilia; of these 80 % had elevated specific IgE levels. Conclusions: The incidence of anisakiasis is increasing and consequently knowledge of its most characteristic clinical,radiological and laboratory manifestations is important. The most frequently affected segment of the digestive tract is the ileum. Many patients have symptoms of acute abdomen, mimicking appendicitis or peritonitis. Anisakiasis is a self-lim-iting process that usually resolves in 1-2 weeks. Consequently, a conservative attitude is advisable to avoid unnecessary surgery

Una lesión infrecuente en edad pediátrica: el cistoadenoma mucinoso de ovario / A rare lesion in the pediatric population: mucinous cystoadenoma of ovary

No disponible

Disección espontánea de la arteria cerebral media. Presentación de un caso / Spontaneous dissection of the middle cerebral artery. A case report

No disponible

No disponible

Aspectos radiológicos en el diagnóstico de la arteritis de Takayasu / Radiological aspects in the diagnosis of Takayasu´s arteritis

No disponible

No disponible