RESUMEN
BACKGROUND: Scrotal swellings have a non-specific clinical picture, so their clinical diagnosis is challenging. Scrotal grayscale and color Doppler ultrasound are non-invasive methods used in both adult and childhood groups and act as accurate screening and diagnostic modalities. PURPOSE: To evaluate the diagnostic validity of grayscale and color Doppler ultrasound in the assessment of scrotal swelling to reach accurate diagnosis. MATERIAL AND METHODS: A retrospective study included 181 patients (mean age = 35.5 ± 7.3, age range = 1-71 years) with scrotal swelling. Examinations were performed by an experienced radiologist using grayscale and color Doppler ultrasound. The diagnostic validity of grayscale and color Doppler ultrasound for diagnosing scrotal swelling were estimated using surgical findings, histopathological results, and imaging and clinical follow-up as reference standards. RESULTS: Overall, 202 scrotal swellings were detected. The final diagnoses were 13 (6.4%) malignant and 189 (93.6%) benign alterations. Varicocele was the most common scrotal swelling (26%), followed by hydrocele (23.8%). Matched to the reference standards, grayscale and color Doppler ultrasound represented a sensitivity of 84.6% (95% confidence interval [CI] = 54.6-98.1), a specificity of 76.2% (95% CI = 69.5-82.1), a positive predictive value of 19.6% (95% CI = 10.2-32.4), and a negative predictive value of 98.6% (95% CI = 95.1-99.8) for diagnosing scrotal tumors. CONCLUSION: Scrotal grayscale and color Doppler ultrasound provide high diagnostic validity for assessment of scrotal swellings.
Asunto(s)
Edema/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Escroto/diagnóstico por imagen , Ultrasonografía/métodos , Adolescente , Adulto , Anciano , Niño , Preescolar , Diagnóstico Diferencial , Edema/etiología , Humanos , Lactante , Masculino , Enfermedades Urogenitales Masculinas/complicaciones , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Ultrasonografía Doppler en Color/métodos , Adulto JovenRESUMEN
Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterized by focal or diffuse organ infiltration of IgG4-bearing plasma cells. The diagnosis of IgG4-RD is based on a combination of clinical, serologic, radiologic, and histopathologic findings. IgG4-RD has been reported to affect almost all organ systems. The kidney is the most frequently involved of the genitourinary organs. The most common renal manifestation of IgG4-RD is IgG4-RD tubulointerstitial nephritis, followed by membranous glomerulonephropathy and, less frequently, obstructive nephropathy involving the renal pelvis, ureter, or retroperitoneum. Renal parenchymal lesions may appear as multiple nodular lesions, diffuse patchy infiltrative lesions, or a single nodular lesion. Multiple small nodular cortical lesions are the most common imaging findings of IgG4-RD involving the kidney. Renal pelvic, sinus, or perinephric lesions can also occur. IgG4-RD involvement of other genitourinary organs including the ureter, bladder, urethra, and male and female reproductive organs is rare compared with kidney involvement but may show variable imaging findings such as a localized mass within or surrounding the involved organ or diffuse enlargement of the involved organ. Imaging findings of IgG4-RD involving the genitourinary system are nonspecific but should be differentiated from inflammatory and neoplastic lesions that mimic IgG4-RD. The online slide presentation from the RSNA Annual Meeting is available for this article. ©RSNA, 2020.
Asunto(s)
Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Enfermedades Urogenitales Femeninas/inmunología , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/inmunología , Diagnóstico Diferencial , Femenino , Humanos , MasculinoRESUMEN
Contrast-enhanced ultrasonography (US) has become an important supplementary tool in many clinical applications in children. Contrast-enhanced voiding urosonography and intravenous US contrast agents have proved useful in routine clinical practice. Other applications of intracavitary contrast-enhanced US, particularly in children, have not been widely investigated but could serve as a practical and radiation-free problem-solver in several clinical settings. Intracavitary contrast-enhanced US is a real-time imaging modality similar to fluoroscopy with iodinated contrast agent. The US contrast agent solution is administered into physiological or non-physiological body cavities. There is no definitive list of established indications for intracavitary US contrast agent application. However, intracavitary contrast-enhanced US can be used for many clinical applications. It offers excellent real-time spatial resolution and allows for a more accurate delineation of the cavity anatomy, including the internal architecture of complex collections and possible communications within the cavity or with the surrounding structures through fistulous tracts. It can provide valuable information related to the insertion of catheters and tubes, and identify related complications such as confirming the position and patency of a catheter and identifying causes for drainage dysfunction or leakage. Patency of the ureter and biliary ducts can be evaluated, too. US contrast agent solution can be administered orally or a via nasogastric tube, or as an enema to evaluate the gastrointestinal tract. In this review we present potential clinical applications and procedural and dose recommendations regarding intracavitary contrast-enhanced ultrasonography.
Asunto(s)
Enfermedades de las Vías Biliares/diagnóstico por imagen , Medios de Contraste , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Enfermedades Gastrointestinales/diagnóstico por imagen , Aumento de la Imagen/métodos , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Ultrasonografía/métodos , Cavidad Abdominal/diagnóstico por imagen , Adolescente , Niño , Preescolar , Europa (Continente) , Femenino , Humanos , Lactante , Masculino , Pediatría , Sociedades MédicasAsunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Asma/tratamiento farmacológico , Dermatitis Atópica/tratamiento farmacológico , Enfermedad Relacionada con Inmunoglobulina G4/tratamiento farmacológico , Anciano , Asma/complicaciones , Dermatitis Atópica/complicaciones , Glucocorticoides/uso terapéutico , Humanos , Enfermedad Relacionada con Inmunoglobulina G4/complicaciones , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico por imagen , Masculino , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/tratamiento farmacológico , Enfermedades Urogenitales Masculinas/etiología , Fibrosis Retroperitoneal/diagnóstico por imagen , Fibrosis Retroperitoneal/tratamiento farmacológico , Fibrosis Retroperitoneal/etiologíaRESUMEN
A wide range of genitourinary pathologies can be diagnosed in utero, from a simple vesicoureteral reflux to a more complex disorder of sexual differentiation. The prognosis and neonatal management of these conditions differ significantly. Evaluation of the fetal perineal anatomy is paramount to making the right diagnosis. The aim of this pictorial essay is to show sonographers how to acquire a perineal midsagittal view in a male fetus, and to demonstrate how this specific view allows assessment of the urethra and penis, to differentiate various genitourinary pathologies.
Asunto(s)
Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/embriología , Ultrasonografía Prenatal/métodos , Femenino , Humanos , Masculino , Embarazo , Vejiga Urinaria , Sistema Urinario/diagnóstico por imagen , Sistema Urinario/embriologíaRESUMEN
Urogenital schistosomiasis is a parasitic disease caused by S. haematobium which is endemic in tropical and sub-tropical areas but is increasingly diagnosed in temperate non-endemic countries due to migration and international travels. Early identification and treatment of the disease are fundamental to avoid associated severe sequelae such as bladder carcinoma, hydronephrosis leading to kidney failure and reproductive complications. Radiologic imaging, especially through ultrasound examination, has a fundamental role in the assessment of organ damage and follow-up after treatment. Imaging findings of urinary tract schistosomiasis are observed mainly in the ureters and bladder. The kidneys usually appear normal until a late stage of the disease.
Asunto(s)
Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Esquistosomiasis Urinaria/diagnóstico por imagen , Ultrasonografía/métodos , Femenino , Genitales/diagnóstico por imagen , Humanos , Riñón/diagnóstico por imagen , Masculino , Vejiga Urinaria/diagnóstico por imagenRESUMEN
Endoscopy is an underutilized technique in the practice of interventional radiology. The objectives of this article are to discuss potential uses of interventional radiology-operated endoscopy and to outline basic endoscopy setup and equipment uses. Endoscopy represents a new frontier to the fluoroscopically-guided procedures in biliary, gastrointestinal, and genitourinary disease that interventional radiologists commonly perform. It shows promise to improve interventional radiology procedure success rates and reduce procedure-associated risk for patients. Endoscopy has been traditionally performed by gastroenterologists and urologists and is relatively new in the practice of interventional radiology. The hand-eye coordination and manual dexterity required to perform standard image-guided procedures places interventional radiologists in a unique position to introduce endoscopy into standard practice. A focused and collaborative effort is needed by interventional radiologists to learn the techniques required to successfully integrate endoscopy into practice.
Asunto(s)
Enfermedades de las Vías Biliares/terapia , Endoscopía/tendencias , Enfermedades Urogenitales Femeninas/terapia , Enfermedades Gastrointestinales/terapia , Enfermedades Urogenitales Masculinas/terapia , Radiografía Intervencional/tendencias , Enfermedades de las Vías Biliares/diagnóstico por imagen , Competencia Clínica , Difusión de Innovaciones , Endoscopios/tendencias , Endoscopía/instrumentación , Endoscopía Gastrointestinal/tendencias , Femenino , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Enfermedades Gastrointestinales/diagnóstico por imagen , Humanos , Masculino , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Destreza Motora , Radiografía Intervencional/instrumentación , RadiólogosRESUMEN
Endoscopy is a technique used by interventional radiology (IR) in only a few centers throughout the United States. When used by IR, endoscopy is most well-known for its role in the treatment of hepatobiliary disease. However, its use with relation to pathology involving the gastrointestinal, genitourinary, and musculoskeletal systems is gaining momentum among IR. The purpose of this article is to demonstrate the potential benefits of IR endoscopy in nonbiliary intervention. A literature review, not requiring IRB approval, was performed via PubMed and Ovid Medline databases using the search terms "interventional radiology-operated endoscopy," "interventional endoscopy," "interventional radiology," "genitourinary," and "gastrointestinal." Literature describing IR endoscopy involving the gastrointestinal, genitourinary, and musculoskeletal systems were identified and described. Nine peer-reviewed articles were identified. While few studies were identified, a general theme suggesting a synergistic relationship between IR and endoscopy was noted. More studies are needed to better understand the role of endoscopy as a technique in the IR suite.
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Endoscopía/métodos , Enfermedades Urogenitales Femeninas/terapia , Enfermedades Gastrointestinales/terapia , Enfermedades Urogenitales Masculinas/terapia , Enfermedades Musculoesqueléticas/terapia , Radiografía Intervencional/métodos , Adulto , Endoscopía/efectos adversos , Endoscopía Gastrointestinal , Femenino , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Enfermedades Gastrointestinales/diagnóstico por imagen , Humanos , Masculino , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades Musculoesqueléticas/diagnóstico por imagen , Radiografía Intervencional/efectos adversos , Resultado del TratamientoRESUMEN
PURPOSE: Imaging features of immune-mediated genitourinary diseases often overlap, and the same disease may manifest in different ways, so understanding imaging findings in the context of the patient's entire clinical picture is important in providing the correct diagnosis. METHODS: In this article, diseases mediated by the immune system which affect the genitourinary system are reviewed. Examples of immune-mediated genitourinary disease including IgG4-related disease, post-transplant lymphoproliferative disorder, immunodeficiency-associated lymphoproliferative disorder due to immunosuppressive and immunomodulatory medications, lymphoma, leukemia, myeloma, amyloidosis, and histiocytosis. RESULTS: Clinical and imaging features will be presented which may help narrow the differential diagnosis for each disease. CONCLUSION: Recognition of immune-related genitourinary disease is important for appropriate medical management as they may mimic other diseases both by imaging and clinical presentation.
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Amiloidosis/diagnóstico por imagen , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Histiocitosis/diagnóstico por imagen , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico por imagen , Leucemia/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Trastornos Linfoproliferativos/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Mieloma Múltiple/diagnóstico por imagen , Amiloidosis/inmunología , Diagnóstico Diferencial , Femenino , Enfermedades Urogenitales Femeninas/inmunología , Histiocitosis/inmunología , Humanos , Enfermedad Relacionada con Inmunoglobulina G4/inmunología , Leucemia/inmunología , Linfoma/inmunología , Trastornos Linfoproliferativos/inmunología , Masculino , Enfermedades Urogenitales Masculinas/inmunología , Mieloma Múltiple/inmunologíaRESUMEN
Multiparametric magnetic resonance imaging (MRI) of the prostate is a powerful and increasingly utilized imaging study for the diagnosis, staging, and surveillance of prostate cancer. With greater adoption by clinicians, it is becoming more common for incidental findings to be first detected on prostate MRI. Inadequate description of clinically significant findings may not prompt appropriate patient management, while over-reporting of indolent findings comes at increased patient anxiety, cost of workup, and iatrogenic risk. This review article aims to improve awareness, review pathophysiology, and present key imaging features of incidental findings seen on prostate MRI, ranging from common to rare and from benign to clinically significant.
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Enfermedades Gastrointestinales/diagnóstico por imagen , Hallazgos Incidentales , Imagen por Resonancia Magnética , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades Musculoesqueléticas/diagnóstico por imagen , Neoplasias de la Próstata/diagnóstico por imagen , Humanos , Masculino , Próstata/diagnóstico por imagen , RadiólogosRESUMEN
Since its introduction, contrast-enhanced ultrasound (CEUS) has gained an important role in the diagnosis and management of abdominal and pelvic diseases. Contrast-enhanced ultrasound can improve lesion detection rates as well as success rates of interventional procedures when compared to conventional ultrasound alone. Additionally, CEUS enables the interventionalist to assess the dynamic enhancement of different tissues and lesions, without the adverse effects of contrast-enhanced computed tomography, such as exposure to ionizing radiation and nephrotoxicity from iodinated contrast material. This review article describes the various applications and advantages of the use of CEUS to enhance performance of ultrasound-guided interventions in the abdomen and pelvis.
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Medios de Contraste , Enfermedades del Sistema Digestivo/diagnóstico por imagen , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Aumento de la Imagen/métodos , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades del Bazo/diagnóstico por imagen , Ultrasonografía Intervencional/métodos , Abdomen/diagnóstico por imagen , Femenino , Humanos , Masculino , Pelvis/diagnóstico por imagenRESUMEN
Hemarthroses and muscle bleeds are well-known and well-documented complications in pediatric and young adult hemophilia patients. In contrast, deep bleeds in atypical locations can be a diagnostic challenge, since clinicians and radiologists are often unfamiliar with their clinical and radiological features. Some atypical bleeds, however, can be life-threatening or severely disabling, highlighting the need for prompt, accurate diagnosis. Rare bleeds include central nervous system bleeds (including intracranial and spinal hematomas), urogenital bleeds, intra-abdominal bleeds (mesenteric and gastrointestinal wall hematomas) and pseudo tumors in unusual locations like the sinonasal cavities. Because clinical assessment can be difficult, clinicians and radiologists should be aware of the possibility of these rare complications in their hemophilia patients, so that they can avoid unnecessary invasive diagnostic and surgical procedures and institute prompt, appropriate treatment. The purpose of this review is to illustrate the imaging features of bleeds that occur in rare locations in young (i.e., children and young adults) patients with hemophilia to make the reader more familiar with these conditions.
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Hemofilia A/diagnóstico por imagen , Hemorragia/diagnóstico por imagen , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Adolescente , Niño , Preescolar , Femenino , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Hemorragia Gastrointestinal/diagnóstico por imagen , Hemorragia Gastrointestinal/etiología , Hemartrosis/diagnóstico por imagen , Hemartrosis/etiología , Hematoma/diagnóstico por imagen , Hematoma/etiología , Hematoma Espinal Epidural/diagnóstico por imagen , Hematoma Espinal Epidural/etiología , Hematoma Subdural Espinal/diagnóstico por imagen , Hematoma Subdural Espinal/etiología , Hemoperitoneo/diagnóstico por imagen , Hemoperitoneo/etiología , Hemofilia B/diagnóstico por imagen , Hemorragia/etiología , Humanos , Lactante , Hemorragias Intracraneales/diagnóstico por imagen , Hemorragias Intracraneales/etiología , Masculino , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Enfermedades Musculares/diagnóstico por imagen , Enfermedades Musculares/etiología , Adulto JovenRESUMEN
Imaging can benefit clinicians in evaluating men with infertility or sexual dysfunction by giving an overview of a patient's overall clinical condition before undertaking an invasive procedure. An understanding of the limitations and advantages of image modalities used in clinical practice will ensure that clinicians can optimize patient care with imaging when necessary. PATIENT SUMMARY: The objective of this article was to review the current literature on imaging modalities used for the diagnosis and management of male infertility and sexual dysfunction. An understanding of the advantages and limitations of these imaging modalities will ensure that clinicians can optimize patient care with imaging when necessary.
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Imagen de Difusión por Resonancia Magnética/métodos , Disfunción Eréctil/diagnóstico por imagen , Infertilidad Masculina/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Ultrasonografía/métodos , Ultrasonido Enfocado Transrectal de Alta Intensidad/métodos , Criptorquidismo/complicaciones , Criptorquidismo/diagnóstico por imagen , Conductos Eyaculadores/anomalías , Conductos Eyaculadores/diagnóstico por imagen , Disfunción Eréctil/epidemiología , Humanos , Hiperprolactinemia/complicaciones , Hiperprolactinemia/diagnóstico por imagen , Hiperprolactinemia/patología , Sistema Hipotálamo-Hipofisario/anomalías , Sistema Hipotálamo-Hipofisario/diagnóstico por imagen , Infertilidad Masculina/epidemiología , Infertilidad Masculina/etiología , Síndrome de Kallmann/complicaciones , Síndrome de Kallmann/diagnóstico por imagen , Masculino , Enfermedades Urogenitales Masculinas/complicaciones , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Induración Peniana/complicaciones , Induración Peniana/diagnóstico por imagen , Enfermedades de la Hipófisis/complicaciones , Enfermedades de la Hipófisis/diagnóstico por imagen , Escroto/anomalías , Escroto/diagnóstico por imagen , Varicocele/complicaciones , Varicocele/diagnóstico por imagen , Conducto Deferente/anomalías , Conducto Deferente/diagnóstico por imagenRESUMEN
With new developments in workflow automation, as well as technological advances enabling faster imaging with improved image quality and dose profile, dual-energy computed tomography is being used more often in the imaging of the acutely ill and injured patient. Its ability to identify iodine, differentiate it from hematoma or calcification, and improve contrast resolution has proven invaluable in the assessment of organ perfusion, organ injury, and inflammation.
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Abdomen Agudo/diagnóstico por imagen , Enfermedades de las Glándulas Suprarrenales/diagnóstico por imagen , Enfermedades del Sistema Digestivo/diagnóstico por imagen , Enfermedades Urogenitales Femeninas/diagnóstico por imagen , Enfermedades Urogenitales Masculinas/diagnóstico por imagen , Imagen Radiográfica por Emisión de Doble Fotón/métodos , Tomografía Computarizada por Rayos X/métodos , Abdomen Agudo/etiología , Enfermedades de las Glándulas Suprarrenales/complicaciones , Glándulas Suprarrenales/diagnóstico por imagen , Sistema Digestivo/diagnóstico por imagen , Enfermedades del Sistema Digestivo/complicaciones , Enfermedades Urogenitales Femeninas/complicaciones , Humanos , Masculino , Enfermedades Urogenitales Masculinas/complicaciones , Sistema Urogenital/diagnóstico por imagenRESUMEN
The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting. Radiologists should be aware of this group of entities, as a preoperative histopathologic diagnosis upon radiological suspicion may help to differentiate IPTs from malignancy and to allow the most appropriate clinical work-up for these patients.