ABSTRACT
La absorciometría con rayos X de doble energía (DXA o DEXA) es la técnica de elección para diagnosticar la osteoporosis y monitorizar la respuesta al tratamiento. Además, es útil para estudiar la composición corporal. En los últimos años han surgido nuevas aplicaciones como la morfometría vertebral, estudiando la columna en visión lateral, la integración de prótesis en ortopedia, o la lipodistrofia en los pacientes con infección por VIH, aunque su utilización en estos casos no está bien consolidada. En el estudio de la osteoporosis, densitometría es precisa y exacta. Para ello, es imprescindible optimizar cada etapa del proceso diagnóstico, cuidando la adquisición, el análisis de imágenes y la interpretación de los resultados. Por ello, para obtener la máxima utilidad para el clínico y el paciente, el radiólogo debe conocer la técnica, sus indicaciones y las dificultades. El objetivo de este artículo es revisar la DXA, haciendo hincapié en sus fundamentos, modalidades, metodología y aplicaciones clínicas (AU)
Dual-energy X-ray absorptiometry (DXA; DEXA) is the technique of choice to diagnose osteoporosis and to monitor the response to treatment. It is also useful for measuring body composition. In recent years, new applications have been developed, including vertebral morphometry through the study of the lateral spine, prosthesis integration in orthopedics, and lipodystrophy in HIV+ patients, although its use in these cases is not well established. DXA densitometry is accurate and precise. It is essential to optimize each step of the diagnostic process, taking care to ensure the best acquisition, image analysis, and interpretation of the results. Thus, to obtain the greatest utility from DXA, radiologists need to know the technique, its indications, and its pitfalls. This article reviews the fundamentals, modalities, methods, and clinical applications of DXA (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Absorptiometry, Photon/instrumentation , Absorptiometry, Photon/methods , Densitometry/methods , Osteoporosis/complications , Osteoporosis/diagnosis , Body Composition/radiation effects , Bone Density/radiation effects , Absorptiometry, Photon/trends , Absorptiometry, Photon , Technology, Radiologic/methods , Technology, Radiologic/trendsABSTRACT
Dual-energy X-ray absorptiometry (DXA; DEXA) is the technique of choice to diagnose osteoporosis and to monitor the response to treatment. It is also useful for measuring body composition. In recent years, new applications have been developed, including vertebral morphometry through the study of the lateral spine, prosthesis integration in orthopedics, and lipodystrophy in HIV+ patients, although its use in these cases is not well established. DXA densitometry is accurate and precise. It is essential to optimize each step of the diagnostic process, taking care to ensure the best acquisition, image analysis, and interpretation of the results. Thus, to obtain the greatest utility from DXA, radiologists need to know the technique, its indications, and its pitfalls. This article reviews the fundamentals, modalities, methods, and clinical applications of DXA.
Subject(s)
Absorptiometry, Photon , Osteoporosis/diagnostic imaging , Absorptiometry, Photon/methods , HumansABSTRACT
Renal cell carcinoma represents a 2.5-3% of all neoplastic processes, usually seen un patients older than 50 years. 60-75% are resectable at diagnosis, representing local or metastatic advanced disease the rest of them. This tumor tends to spread intravascularly, leading to tumoral thrombosis within the inferior caval vein (ICV) and renal vein 4-10% and 21-35% of cases, respectively. As the only effective treatment is surgical resection, preoperative determining of the thrombus extension is crucial. Thus, an accurate radiological study including ultrasound, doppler sonography, computed tomography and/or Magnetic Resonance, is key for these patients. We present a 49 year-old patient with renal cell carcinoma and associated tumoral thrombosis in inferior caval vein and left renal vein; we provide the most significant figures, explaining its most characteristic radiological findings.
Subject(s)
Carcinoma, Renal Cell/diagnosis , Kidney Neoplasms/diagnosis , Neoplastic Cells, Circulating , Renal Veins , Tomography, X-Ray Computed , Ultrasonography, Doppler , Vena Cava, Inferior , Humans , Male , Middle AgedABSTRACT
El carcinoma de células renales representa un 2,5-3 por ciento de todos los cánceres, siendo más frecuente en pacientes mayores de 50 años. De ellos, el 60-75 por ciento son resecables al momento del diagnóstico, presentando el resto de los casos enfermedad avanzada local o metastásica. Este tumor tiende a extenderse intravascularmente, produciendo trombosis tumoral en la vena cava inferior y vena renal en un 4-10 por ciento y 2135 por ciento de los casos, respectivamente. Dado que el único tratamiento efectivo es la resección quirúrgica, resulta prioritario determinar la extensión de la trombosis tumoral previamente a la cirugía. Por tanto, en estos pacientes es fundamental un cuidadoso estudio radiológico que incluya, al menos, ecografía, eco-doppler, TC y/o RM abdominal. Presentamos el caso de un paciente de 49 años con carcinoma renal y trombosis tumoral secundaria de la vena renal izquierda y de la VCI, aportando las imágenes más significativas y comentando sus principales hallazgos radiológicos (AU)
