Checklist: Neck computed tomography in non-traumatic emergencies.

Patients attending the emergency department (ED) with cervical inflammatory/infectious symptoms or presenting masses that may involve the aerodigestive tract or vascular structures require a contrast-enhanced computed tomography (CT) scan of the neck. Its radiological interpretation is hampered by the anatomical complexity and pathophysiological interrelationship between the different component systems in a relatively small area. Recent studies propose a systematic evaluation of the cervical structures, using a 7-item checklist, to correctly identify the pathology and detect incidental findings that may interfere with patient management. As a conclusion, the aim of this paper is to review CT findings in non-traumatic pathology of the neck in the ED, highlighting the importance of a systematic approach in its interpretation and synthesis of a structured, complete, and concise radiological report.

Lista de verificación: tomografía computarizada de cuello en urgencias no traumáticas / Checklist: Neck computed tomography in non-traumatic emergencies

A los pacientes que acuden a urgencias con síntomas inflamatorio/infecciosos a nivel cervical o con masas que pueden comprometer el tracto aerodigestivo o las estructuras vasculares, es necesario hacerles una tomografía computarizada (TC) de cuello con contraste. Su interpretación radiológica se ve dificultada por la complejidad anatómica y la interrelación fisiopatológica entre los diferentes sistemas que lo componen, en un área de estudio relativamente pequeña. Estudios recientes proponen realizar una evaluación sistemática de las estructuras cervicales, utilizando para ello un listado de verificación de 7 elementos, para identificar correctamente la patología, y detectar los hallazgos incidentales que pueden interferir en el manejo del paciente. El objetivo de este trabajo es revisar los hallazgos de la TC en la patología no traumática del cuello en urgencias siguiendo una lectura sistemática, tras la cual se pueda realizar un informe radiológico estructurado, completo y conciso.(AU)

Patients attending the emergency department (ED) with cervical inflammatory/infectious symptoms or presenting masses that may involve the aerodigestive tract or vascular structures require a contrast-enhanced computed tomography (CT) scan of the neck. Its radiological interpretation is hampered by the anatomical complexity and pathophysiological interrelationship between the different component systems in a relatively small area. Recent studies propose a systematic evaluation of the cervical structures, using a 7-item checklist, to correctly identify the pathology and detect incidental findings that may interfere with patient management. As a conclusion, the aim of this paper is to review CT findings in non-traumatic pathology of the neck in the ED, highlighting the importance of a systematic approach in its interpretation and synthesis of a structured, complete, and concise radiological report.(AU)

Cervical spine trauma.

Cervical spine trauma encompasses a wide of injuries, ranging from stable, minor lesions to unstable, complex lesions that can lead to neurologic sequelae or vascular involvement. The Canadian C-Spine Rule and the NEXUS criteria aim to identify individuals with a low risk of cervical spine trauma who can safely forgo imaging tests. In high-risk patients, an imaging test is indicated. In adult patients the imaging test of choice is multidetector computed tomography. Complementary imaging tests such as CT angiography of the supra-aortic vessels and/or magnetic resonance imaging are occasionally necessary. It can be challenging for radiologists to diagnose and classify these lesions, because some of them can be subtle and difficult to detect. This paper aims to describe the most important imaging findings and the most widely used classification systems.

Radiologic diagnosis of patients with COVID-19. / Diagnóstico radiológico del paciente con COVID-19.

The pandemia caused by the SARS-CoV-2 virus has triggered an unprecedented health and economic crisis. Although the diagnosis of infection with SARS-CoV-2 is microbiological, imaging techniques play an important role in supporting the diagnosis, grading the severity of disease, guiding treatment, detecting complications, and evaluating the response to treatment. The lungs are the main organ involved, and chest X-rays, whether obtained in conventional X-ray suites or with portable units, are the first-line imaging test because they are widely available and economical. Chest CT is more sensitive than plain chest X-rays, and CT studies make it possible to identify complications in addition to pulmonary involvement, as well as to suggestive alternative diagnoses. The most common radiologic findings in COVID-19 are airspace opacities (consolidations and/or ground-glass opacities), which are typically bilateral, peripheral, and located primarily in the lower fields.

Diagnóstico radiológico del paciente con COVID-19 / Radiologic diagnosis of patients with COVID-19

La pandemia por el virus SARS-CoV-2ha desencadenado una crisis económica y sanitaria sin precedentes. Aunque el diagnóstico es microbiológico, las técnicas de imagen tienen un papel importante para apoyar el diagnóstico, graduar la gravedad de la enfermedad, guiar el tratamiento, detectar posibles complicaciones y valorar la respuesta terapéutica. La afectación es principalmente pulmonar. La radiografía de tórax en sala convencional o portátil es el primer método de imagen por su amplia disponibilidad y bajo coste. La tomografía computarizada torácica tiene una mayor sensibilidad que la radiografía de tórax y permite valorar tanto la afectación pulmonar como posibles complicaciones, además de proporcionar diagnósticos alternativos. Los hallazgos radiológicos más frecuentes son las opacidades del espacio aéreo en forma de consolidaciones y/u opacidades en vidrio deslustrado, con distribución típicamente bilateral, periférica y de predominio en los campos inferiores

The pandemia caused by the SARS-CoV-2 virus has triggered an unprecedented health and economic crisis. Although the diagnosis of infection with SARS-CoV-2 is microbiological, imaging techniques play an important role in supporting the diagnosis, grading the severity of disease, guiding treatment, detecting complications, and evaluating the response to treatment. The lungs are the main organ involved, and chest X-rays, whether obtained in conventional X-ray suites or with portable units, are the first-line imaging test because they are widely available and economical. Chest CT is more sensitive than plain chest X-rays, and CT studies make it possible to identify complications in addition to pulmonary involvement, as well as to suggestive alternative diagnoses. The most common radiologic findings in COVID-19 are airspace opacities (consolidations and/or ground-glass opacities), which are typically bilateral, peripheral, and located primarily in the lower fields

CT and MRI Correlations in Patients with Suspected Cholesteatoma after Surgery.

The study of postoperative ear cavities in patients who underwent surgery for cholesteatoma is a difficult challenge for radiologists. In our study we make a correlation between CT and MRI findings, useful tools in patients with suspected residual or recurrent cholesteatoma. The use of different MRI sequences especially DWI can help radiologists to discriminate between cholesteatoma and other different processes.

Ausencia de realce tardío por resonancia magnética en la no compactación del ventrículo izquierdo en lactantes y niños pequeños / Lack of MR late-enhancement in left ventricular non-compaction in infants and young children

Objetivo: La miocardiopatía no compactada o la no compactación del ventrículo izquierdo (NCVI) es una enfermedad rara y probablemente infradiagnosticada. El diagnóstico es ecográfico, si bien la resonancia magnética (RM) aporta importante información morfológica y funcional. El realce tardío es un hallazgo importante que refleja fibrosis o infarto en las zonas afectadas, y se refiere en adultos y niños mayores de forma generalizada. El objetivo de este trabajo es revisar el realce tardío en esta enfermedad en lactantes y niños pequeños. Material y métodos: En nuestra base de datos de RM cardíaca encontramos 5 pacientes (rango de edad: un mes a 5 años; media de 29,4 meses). Se revisaron los hallazgos morfológicos y funcionales, incluyendo el realce tardío de contraste. Resultados: Todos los pacientes se diagnosticaron previamente por ecocardiografía. Los hallazgos morfológicos y el cociente miocardio no compactado/miocardio compactado fueron compatibles con NCVI. Ninguno de los casos mostró realce tardío poscontraste. Conclusiones: Al contrario que en adultos y niños mayores, ninguno de nuestros pacientes mostró realce tardío. Este hallazgo podría reflejar la naturaleza evolutiva de la fibrosis subendocárdica en estos pacientes (AU)

Objective: Non compaction cardiomyopathy or left ventricular non compaction is a rare disease that is probably underdiagnosed. The diagnosis is reached by echocardiography, although MRI provides additional morphological and functional information. Late MRI enhancement is a hallmark of the disease that reflects fibrosis or infarction of affected areas in adults and older children. We aimed to review the presence of late enhancement in left ventricular non compaction in infants and young children. Material and methods: We found five very young patients (mean age, 29.4 months; range 1 month to 5 years) with left ventricular non compaction in our cardiac MRI database. We reviewed the morphological and functional findings, including late enhancement after the administration of contrast material. Results: All patients had been previously diagnosed by echocardiography. At MRI, the morphological findings and the ratio of non compacted myocardium to compacted myocardium were compatible with left ventricular non compaction. None of the cases showed late enhancement after the administration of contrast material. Conclusions: Unlike in adults and older children, none of the infants and young children we studied had late enhancement. This finding might reflect the natural history of the disease, with subendocardial fibrosis developing over time (AU)

[Lack of MR late-enhancement in left ventricular non-compaction in infants and young children]. / Ausencia de realce tardío por resonancia magnética en la no compactación del ventrículo izquierdo en lactantes y niños pequeños.

OBJECTIVE: Noncompaction cardiomyopathy or left ventricular noncompaction is a rare disease that is probably underdiagnosed. The diagnosis is reached by echocardiography, although MRI provides additional morphological and functional information. Late MRI enhancement is a hallmark of the disease that reflects fibrosis or infarction of affected areas in adults and older children. We aimed to review the presence of late enhancement in left ventricular noncompaction in infants and young children. MATERIAL AND METHODS: We found five very young patients (mean age, 29.4 months; range 1 month to 5 years) with left ventricular noncompaction in our cardiac MRI database. We reviewed the morphological and functional findings, including late enhancement after the administration of contrast material. RESULTS: All patients had been previously diagnosed by echocardiography. At MRI, the morphological findings and the ratio of noncompacted myocardium to compacted myocardium were compatible with left ventricular noncompaction. None of the cases showed late enhancement after the administration of contrast material. CONCLUSIONS: Unlike in adults and older children, none of the infants and young children we studied had late enhancement. This finding might reflect the natural history of the disease, with subendocardial fibrosis developing over time.