RESUMO
Disorders of the foot and ankle are some of the most frequent ones affecting the musculoskeletal system and have a great impact on patients' quality of life. Accurate diagnosis is an important clinical challenge because of the complex anatomy and function of the foot, that make it difficult to locate the source of the pain by routine clinical examination. In the study of foot pathology, anatomical imaging (radiography, magnetic resonance imaging [MRI], ultrasound and computed tomography [CT]) and functional imaging (bone scan, positron emission tomography [PET] and MRI) techniques have been used. Hybrid imaging combines the advantages of morphological and functional studies in a synergistic way, helping the clinician manage complex problems. In this article we delve into the anatomy and biomechanics of the foot and ankle and describe the potential indications for the current hybrid techniques available for the study of foot and ankle disease.
Assuntos
Tornozelo/diagnóstico por imagem , Doenças do Pé/diagnóstico por imagem , Pé/diagnóstico por imagem , Imagem Multimodal , Traumatismos do Tornozelo/diagnóstico por imagem , Pé Diabético/diagnóstico por imagem , Diagnóstico Precoce , Ossos do Pé/diagnóstico por imagem , Doenças do Pé/fisiopatologia , Doenças do Pé/cirurgia , Traumatismos do Pé/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Imagem Multimodal/métodos , Dor Musculoesquelética/diagnóstico por imagem , Dor Musculoesquelética/etiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Ossos do Tarso/diagnóstico por imagemRESUMO
OBJECTIVE: To evaluate the reproducibility of the sentinel lymph node (SLN) technique in male breast cancer. MATERIAL AND METHODS: We retrospectively analysed 21 male patients diagnosed with breast cancer in our hospital from 2008 to 2016 with, at least, 18 months follow-up. Fifteen patients underwent selective sentinel lymph node biopsy (SLNB) following the usual protocols with peritumoral injection of 18.5-111MBq of 99mTc-nanocoloides and acquisition of planar images 2hours after the injection. In 2 cases it was necessary to perform a SPECT/CT to locate the SLN. Immunohistochemistry and molecular techniques (OSNA) were used for their analysis. Six patients did not undergo SLNB because they had pathological nodes or distant disease at the time of diagnosis. RESULTS: SLNB was performed in 15 patients. The SLN was negative in 6 patients and positive in the remaining 9. Three patients with positive SLNB did not need axillary lymphadenectomy because of the low number of copies by molecular analysis OSNA. Axillary lymphadenectomy was performed in the remaining 6 patients with the result of 4 positive axillary lymphadenectomies and 2 that did not show further extension of the disease. CONCLUSIONS: According to our experience, SLNB in males is a reproducible, useful, safe and reliable technique which avoids unnecessary axillary lymphadenectomy and prevents the appearance of undesirable effects.