Estudio de las enfermedades de las trompas de Falopio mediante resonancia magnética / Fallopian tube disease on magnetic resonance imaging

Conocer las enfermedades de las trompas de Falopio es esencial para valorar la pelvis ginecológica. Las alteraciones primarias y secundarias de las trompas, cursen o no con alteraciones ováricas asociadas, son muy variadas. Pese a que la ecografía, por su gran sensibilidad y disponibilidad, es la técnica inicial para estudiar las alteraciones anexiales, la RM es muy útil en el diagnóstico de las enfermedades tubáricas porque su elevada resolución tisular y el detalle anatómico que proporciona le confieren una mayor especificidad. Los hallazgos morfológicos y las características del contenido tubárico con la RM posibilitan un diagnóstico más preciso o limitan el diagnóstico diferencial y permiten orientar el tratamiento más adecuado en cada caso(AU)

Knowledge about fallopian tube disease is essential in the assessment of the pelvis in female patients. Primary and secondary changes in the tubes vary widely, regardless of whether associated changes in the ovaries are present. Ultrasonography is the initial technique in the study of adnexal disease because it is very sensitive and widely available; however, MRI is also very useful in this context because its high tissue resolution and anatomic detail make it more specific. The morphologic findings and the characteristics of the contents of the tubes on MRI enable a more accurate diagnosis or limit the differential diagnosis, helping to ensure that the most appropriate treatment is provided in each case(AU)

[Fallopian tube disease on magnetic resonance imaging]. / Estudio de las enfermedades de las trompas de Falopio mediante resonancia magnética.

Knowledge about fallopian tube disease is essential in the assessment of the pelvis in female patients. Primary and secondary changes in the tubes vary widely, regardless of whether associated changes in the ovaries are present. Ultrasonography is the initial technique in the study of adnexal disease because it is very sensitive and widely available; however, MRI is also very useful in this context because its high tissue resolution and anatomic detail make it more specific. The morphologic findings and the characteristics of the contents of the tubes on MRI enable a more accurate diagnosis or limit the differential diagnosis, helping to ensure that the most appropriate treatment is provided in each case.

Meningioma lipomatoso: una forma de presentación atípica de los meningiomas / No disponible

No disponible

[Radiologic findings in non-Wilms' renal tumors in children]. / Hallazgos radiológicos de los tumores renales no-Wilms en la edad pediátrica.

OBJECTIVES: To analyze the radiologic findings of non-Wilms' renal tumors in children. MATERIAL AND METHODS: This is a retrospective study of 26 patients with histologically confirmed non-Wilms' renal tumors. The following variables were evaluated on radiological studies: location, size, margins, necrosis, hemorrhage, calcifications, subcapsular hematoma, adenopathies, and metastases. Age and clinical presentation were also analyzed. RESULTS: We found 11 mesoblastic nephromas (predominantly solid masses, ill-defined margins, necrosis, hemorrhage, and peritumoral collections; mean patient age, 15 years old); 7 multilocular cystic nephromas (multicystic masses, thickened septa, well-defined margins, capsule, and partial involvement of the kidney; patient age range: 5 to 12 months); 4 renal carcinomas (one with dense calcifications, one mass in the pyelocaliceal system, one with infiltration of the excretory tract, one solid infiltrating mass, retroperitoneal adenopathies, and one metastasis; age range: 2 to 15 years); one clear cell sarcoma (circumscribed solid mass with necrosis and retrocaval adenopathy in a two-year-old boy); one rhabdoid tumor (hypodense mass, ill-defined margins, retroperitoneal adenopathy, vesical clots, and synchronous intracranial tumor, in a six-month-old boy); one intrarenal neuroblastoma (infiltrating solid mass, necrosis, retroperitoneal adenopathy, and bone marrow infiltration in an eight-year-old boy); and one angiomyolipoma (tumor in the upper pole, extrarenal growth, hypoenhancing, and two fatty lesions in the contralateral kidney, in a ten-year-old patient with tuberous sclerosis). CONCLUSIONS: Radiology, together with clinical and epidemiological data, enables the diagnostic work-up of pediatric renal tumors. Histological diagnosis remains indispensable.

Hallazgos radiológicos de los tumores renales no-Wilms en la edad pediátrica / Radiologic findings in non-Wilms' renal tumors in children

Objetivos. Analizar los hallazgos radiológicos de los tumores renales diferentes del tumor de Wilms en edad pediátrica. Material y métodos. Estudio retrospectivo de 26 pacientes con tumor renal no-Wilms con confirmación patológica. Se evaluó mediante estudios radiológicos: localización, tamaño, márgenes, necrosis, hemorragia, calcificaciones, hematoma subcapsular, adenopatías y metástasis. Se analizaron la edad y la presentación clínica. Resultados. Once nefromas mesoblásticos (masas de predominio sólido, márgenes mal definidos, necrosis, hemorragias y colecciones peritumorales en pacientes de 15 días de media de edad). Siete nefromas quísticos multiloculares (masas multiquísticas, septos engrosados, márgenes bien definidos, cápsula y afectación parcial del riñón, edades entre 5 meses y 12 años). Cuatro carcinomas renales (calcificaciones densas uno, masa en sistema pielocalicial uno, infiltración de vía excretora uno, masa sólida infiltrante, adenopatías retroperitoneales y metástasis uno, con edades de 2 a 15 años). Un sarcoma de células claras (masa sólida circunscrita con necrosis y adenopatía retrocava en niño de 2 años). Un tumor rabdoide (masa hipodensa, márgenes mal definidos, adenopatía retroperitoneal, coágulos vesicales y tumoración intracraneal sincrónica en un niño de 6 meses). Un neuroblastoma intrarrenal (masa sólida infiltrante, necrosis, adenopatía retroperitoneal e infiltración de médula ósea en un niño de 8 años). Un angiomiolipoma (tumoración en polo superior, crecimiento extrarrenal, hipocaptante, dos lesiones grasas en riñón contralateral en un paciente de 10 años con esclerosis tuberosa). Conclusiones. La radiología, junto a datos clínicos y epidemiológicos, permite una aproximación diagnóstica de los tumores renales pediátricos. El diagnóstico histológico sigue siendo indispensable (AU)

Objectives. To analyze the radiologic findings of non-Wilms' renal tumors in children. Material and methods. This is a retrospective study of 26 patients with histologically confirmed non-Wilms' renal tumors. The following variables were evaluated on radiological studies: location, size, margins, necrosis, hemorrhage, calcifications, subcapsular hematoma, adenopathies, and metastases. Age and clinical presentation were also analyzed. Results. We found 11 mesoblastic nephromas (predominantly solid masses, ill-defined margins, necrosis, hemorrhage, and peritumoral collections; mean patient age, 15 years old); 7 multilocular cystic nephromas (multicystic masses, thickened septa, well-defined margins, capsule, and partial involvement of the kidney; patient age range: 5 to 12 months); 4 renal carcinomas (one with dense calcifications, one mass in the pyelocaliceal system, one with infiltration of the excretory tract, one solid infiltrating mass, retroperitoneal adenopathies, and one metastasis; age range: 2 to 15 years); one clear cell sarcoma (circumscribed solid mass with necrosis and retrocaval adenopathy in a two-year-old boy); one rhabdoid tumor (hypodense mass, ill-defined margins, retroperitoneal adenopathy, vesical clots, and synchronous intracranial tumor, in a six-month-old boy); one intrarenal neuroblastoma (infiltrating solid mass, necrosis, retroperitoneal adenopathy, and bone marrow infiltration in an eight-year-old boy); and one angiomyolipoma (tumor in the upper pole, extrarenal growth, hypoenhancing, and two fatty lesions in the contralateral kidney, in a ten-year-old patient with tuberous sclerosis). Conclusions. Radiology, together with clinical and epidemiological data, enables the diagnostic work-up of pediatric renal tumors. Histological diagnosis remains indispensable (AU)

Abdominal cerebrospinal fluid pseudocyst: a complication of ventriculoperitoneal shunts in adults.

Abdominal cerebrospinal fluid pseudocyst is an uncommon complication of using ventriculoperitoneal shunt (VPS). Although many cases have been reported in children, abdominal pseudocysts are rare in adult patients. The purpose of this article is to describe and illustrate the findings for this condition on commonly used abdominal diagnostic imaging modalities. This is a retrospective review of the six adult patients diagnosed with abdominal pseudocyst as a consequence of VPS at our centre from 1995 to 2006. We reviewed patients' prior history, cerebral and abdominal clinical manifestations, imaging findings, treatment and evolution. All patients presented with pain and abdominal distension associated with the presence of a palpable mass. Plain-film radiography was carried out in one patient, ultrasound in three and CT in all six. A fluid collection close to or associated to the VPS catheter was observed in all cases. Visualization of the distal tip of the VPS within a homogeneous intraperitoneal collection is the principal diagnostic sign of an abdominal cerebrospinal fluid pseudocyst at ultrasound and CT.

Estudio mediante técnicas de imagen de las fístulas del seno piriforme / Diagnostic imaging of piriform sinus fistulas

Objetivos. Establecer la utilidad de la ecografía, tomografía computarizada (TC), resonancia magnética (RM) y estudios baritados en el diagnóstico de las fístulas del seno piriforme (FSP). Material y métodos. Se han revisado las historias clínicas y los estudios de imagen de cuatro pacientes de edad pediátrica diagnosticados de FSP. La primera técnica de imagen que se realizó en todos los casos fue la ecografía cervical; a tres se les realizó posteriormente TC con contraste intravenoso y a uno RM; a todos ellos, de forma diferida, se les practicó esofagograma con bario. En todos los casos hubo comprobación quirúrgica. Resultados. En los cuatro pacientes la ecografía permitió identificar la localización de las lesiones en el lado izquierdo, así como la existencia de colecciones heterogéneas en tiroides y tejido peritiroideo. Posteriormente, mediante la TC y la RM se delimitaron las lesiones abscesificadas. El esofagograma con bario demostró la existencia de la FSP en los cuatro casos. Conclusiones. La presencia de un proceso inflamatorio de repetición y de tiroiditis supuradas agudas de localización izquierda debe hacernos sospechar la existencia de FSP. Tanto la TC como la RM son útiles en el estudio de la FSP pero, en nuestra experiencia, la ecografía es la técnica de elección en su valoración inicial y seguimiento evolutivo. Tras el proceso agudo, el esofagograma con bario sigue siendo el principal método diagnóstico del trayecto fistuloso

Objectives. To establish the usefulness of ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and barium contrast swallow studies in the diagnosis of piriform sinus fistulas (PSF). Material and methods. We reviewed the clinical histories and imaging studies of four pediatric patients diagnosed with PSF. Cervical ultrasound was the first imaging study performed in all cases. Three patients subsequently underwent intravenous contrast-enhanced CT examination and one underwent MRI. Barium contrast swallow studies were performed in all patients at a later time. All cases were confirmed at surgery. Results. Ultrasound enabled the lesions to be located on the left side and showed the existence of heterogeneous collections in and around the thyroid glands in all four patients. Posterior CT and MRI studies determined the exact size of the abscessed lesions. Barium contrast swallow studies demonstrated the existence of the PSF in all four cases. Conclusions. The presence of a recurrent inflammatory process and acute suppurating thyroiditis located on the left side should raise suspicions of PSF. Both CT and MRI are useful in the study of PSF; however, in our experience, ultrasound examination is the technique of choice for initial evaluation and follow-up. After the acute process, barium swallow studies continue to be the main method for diagnosing the trajectory of the fistulous tract

[Diagnostic imaging of piriform sinus fistulas]. / Estudio mediante técnicas de imagen de las fístulas del seno piriforme.

OBJECTIVES: To establish the usefulness of ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and barium contrast swallow studies in the diagnosis of piriform sinus fistulas (PSF). MATERIAL AND METHODS: We reviewed the clinical histories and imaging studies of four pediatric patients diagnosed with PSF. Cervical ultrasound was the first imaging study performed in all cases. Three patients subsequently underwent intravenous contrast-enhanced CT examination and one underwent MRI. Barium contrast swallow studies were performed in all patients at a later time. All cases were confirmed at surgery. RESULTS: Ultrasound enabled the lesions to be located on the left side and showed the existence of heterogeneous collections in and around the thyroid glands in all four patients. Posterior CT and MRI studies determined the exact size of the abscessed lesions. Barium contrast swallow studies demonstrated the existence of the PSF in all four cases. CONCLUSIONS: The presence of a recurrent inflammatory process and acute suppurating thyroiditis located on the left side should raise suspicions of PSF. Both CT and MRI are useful in the study of PSF; however, in our experience, ultrasound examination is the technique of choice for initial evaluation and follow-up. After the acute process, barium swallow studies continue to be the main method for diagnosing the trajectory of the fistulous tract.