RESUMEN
Transrectal ultrasound-guided (TRUS) biopsy of the prostate is associated with increased risk of post-procedural sepsis with associated morbidity, mortality, re-admission to hospital, and increased healthcare costs. In the study institution, active surveillance of post-procedural infection complications is performed by clinical nurse specialists for prostate cancer under the guidance of the infection prevention and control team. To protect hospital services for acute medical admissions related to the coronavirus disease 2019 (COVID-19) pandemic, TRUS biopsy services were reduced nationally, with exceptions only for those patients at high risk of prostate cancer. In the study institution, this change prompted a complete move to transperineal (TP) prostate biopsy performed in outpatients under local anaesthetic. TP biopsies eliminated the risk of post-procedural sepsis and, consequently, sepsis-related admission while maintaining a service for prostate cancer diagnosis during the COVID-19 pandemic.
Asunto(s)
COVID-19 , Neoplasias de la Próstata , Sepsis , Anestésicos Locales , Biopsia/efectos adversos , Humanos , Masculino , Pandemias/prevención & control , Próstata/diagnóstico por imagen , Próstata/patología , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/diagnóstico , Sepsis/diagnóstico , Sepsis/epidemiología , Sepsis/prevención & control , Ultrasonografía Intervencional/efectos adversosRESUMEN
Scleroderma is a complex multisystem connective tissue disorder. Early visceral disease, such as gastrointestinal (GI) involvement, is associated with significant morbidity and a poorer prognosis. Prompt diagnosis is crucial to allow disease modifying therapies be initiated early in the course of the disease. The primary underlying pathophysiology in the GI tract is dysmotility, muscular atrophy, and fibrosis, and this is reflected in the imaging features. In this paper, we demonstrate the imaging appearances of involvement of the GI tract and describe the use of advanced imaging with magnetic resonance enterography (MRE). A multimodal imaging approach is required to identify both characteristic features of scleroderma and potential complications. Traditional fluoroscopic contrast (barium) studies are still commonly performed for assessment of the oesophagus. More recent advances in cross-sectional imaging allow for thorough three-dimensional assessment of the entire GI tract. MRE is particularly useful for small bowel evaluation while also allowing "pseudodynamic" functional imaging and concomitant assessment of the other abdominal viscera and structures.
Asunto(s)
Enfermedades Gastrointestinales/diagnóstico por imagen , Enfermedades Gastrointestinales/etiología , Imagen por Resonancia Magnética/métodos , Imagen Multimodal/métodos , Esclerodermia Sistémica/complicaciones , Tomografía Computarizada por Rayos X/métodos , Tracto Gastrointestinal/diagnóstico por imagen , HumanosRESUMEN
OBJECTIVES: To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease. METHODS: An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols. RESULTS: One hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached. CONCLUSIONS: These expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon. KEY POINTS: ⢠Cross-sectional imaging is increasingly used to evaluate the bowel ⢠Image quality is paramount to achieving high diagnostic accuracy ⢠Guidelines concerning patient preparation and image acquisition protocols are provided.
Asunto(s)
Enfermedades del Colon/patología , Enfermedades Inflamatorias del Intestino/patología , Intestino Delgado/patología , Adulto , Niño , Consenso , Estudios Transversales , Humanos , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/normas , Encuestas y Cuestionarios , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/normas , Ultrasonografía/métodosRESUMEN
We describe the management principles and different roles of positron emission tomography (PET)/CT in the evaluation of patients with small bowel tumours (adenocarcinoma, gastrointestinal stromal tumour, lymphoma, metastases) from initial staging, monitoring response to treatment, to detection of recurrent disease. We also discuss the various non-malignant aetiologies of small bowel fludeoxyglucose (FDG) PET uptake, and other pitfalls in FDG PET/CT interpretation. Awareness of the imaging appearances of small bowel tumours, patterns of disease spread and potential PET/CT interpretation pitfalls are of paramount importance to optimise diagnostic accuracy.
Asunto(s)
Fluorodesoxiglucosa F18 , Neoplasias Intestinales/diagnóstico , Intestino Delgado/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Imagen Multimodal , Tomografía de Emisión de Positrones , Radiofármacos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
Incidental adrenal lesions are very common. Computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) all have a role to play in characterizing adrenal lesions. The purpose of this review is to discuss the rationale behind both established and emerging imaging techniques. We also discuss how to follow up incidentally found lesions.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Hallazgos Incidentales , 3-Yodobencilguanidina , Neoplasias de las Glándulas Suprarrenales/patología , Glándulas Suprarrenales/diagnóstico por imagen , Radioisótopos de Flúor , Humanos , Imagen por Resonancia Magnética/métodos , Tomografía de Emisión de Positrones/métodos , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía Computarizada por Rayos X/métodosRESUMEN
Magnetic reasonance (MR) enterography enables high contrast resolution depiction of the location and cause of bowel obstruction through a combination of predictable luminal distension and multiplanar imaging capabilities. Furthermore, because the patient is not exposed to ionizing radiation, sequential "dynamic" MR imaging can be performed repeatedly over time further facilitating depiction of the site and/or the cause of obstruction. With increasing availability of MR imaging and standardization of the oral contrast medium regimens, it is likely that this technique will assume an ever-increasing role in the evaluation of small bowel dilation in the coming years. We illustrate the utility of MR enterography in the evaluation of small bowel dilation, whether it be mechanical, functional (e.g., ileus), or related to infiltrative mural disease.
Asunto(s)
Enfermedades Intestinales/diagnóstico , Intestino Delgado/patología , Imagen por Resonancia Cinemagnética/métodos , Adulto , Anciano , Medios de Contraste , Dilatación Patológica/diagnóstico , Enteritis/diagnóstico , Femenino , Hernia/diagnóstico , Humanos , Ileus/diagnóstico , Procesamiento de Imagen Asistido por Computador/métodos , Neoplasias Intestinales/diagnóstico , Obstrucción Intestinal/diagnóstico , Vólvulo Intestinal/diagnóstico , Masculino , Persona de Mediana EdadRESUMEN
Gastrointestinal complications of chemotherapy may be serious and potentially life-threatening. Familiarity with and awareness of the potential complications associated with various chemotherapeutic agents/regimens is paramount to enable accurate and timely diagnosis. In this article we review the radiological manifestations of the most notable gastrointestinal complications associated with chemotherapeutic administration.
Asunto(s)
Antineoplásicos/efectos adversos , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Gastrointestinales/diagnóstico por imagen , Adulto , Anciano , Enterocolitis Neutropénica/inducido químicamente , Enterocolitis Neutropénica/diagnóstico por imagen , Enterocolitis Seudomembranosa/inducido químicamente , Enterocolitis Seudomembranosa/diagnóstico por imagen , Femenino , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/diagnóstico por imagen , Humanos , Perforación Intestinal/inducido químicamente , Perforación Intestinal/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Úlcera Gástrica/inducido químicamente , Úlcera Gástrica/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodosRESUMEN
AIM: To evaluate the mean distance from the odontoid process of C2 to the standard skull-base lines (Chamberlain's, McGregor's, and McRae's lines) on computed tomography (CT) imaging. To compare these measurements to previously documented plain radiograph and magnetic resonance imaging (MRI) measurements. MATERIALS AND METHODS: Reformatted midline sagittal CT images of 150 adults were retrospectively evaluated. The shortest perpendicular distance was measured from the Chamberlain's, McGregor's and McRae's baselines for each subject to the odontoid tip. Statistical analysis was performed to compare the CT data with the previously obtained MRI and plain film data. RESULTS: The mean position of the odontoid process was 1.4mm below Chamberlain's line (median 1.2 mm, SD 2.4 mm), 0.8 mm (median 0.9 mm, SD 3 mm) below McGregor's line and 5 mm (median 5 mm, SD 1.8 mm) below McRae's line. There is no significant difference between male and female results (p>0.05) or between these CT and previous MRI measurements (p>0.05). CONCLUSION: These results provide the mean and range of normal distance from the odontoid process to the most frequently used skull-base lines on the current population on CT.
Asunto(s)
Apófisis Odontoides/diagnóstico por imagen , Base del Cráneo/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antropometría/métodos , Femenino , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Masculino , Persona de Mediana Edad , Apófisis Odontoides/anatomía & histología , Valores de Referencia , Estudios Retrospectivos , Base del Cráneo/anatomía & histología , Tomografía Computarizada por Rayos X/métodos , Adulto JovenRESUMEN
AIM: To measure the normal distances (and range) from the tip of the odontoid peg to the different reference skull baselines (Chamberlain's, McGregor's, and McRae's line) using magnetic resonance imaging (MRI). MATERIALS AND METHODS: We retrospectively evaluated midline sagittal MRI brain images of 200 adults chosen randomly. Patients did not have symptoms or signs suggestive of basilar impression, spinal trauma, vertebral collapse or disease. Using SPSS data analysis program histograms, mean and standard deviation (SD), median and range values were calculated. These findings were then compared with previous plain radiograph measurements. RESULTS: The mean position of the odontoid peg was 1.2 mm (median 1.5 mm, SD 3 mm) below Chamberlain's line; 0.9 mm (median 1.1, SD 3 mm) below McGregor's line; and 4.6 mm (median 4.8, SD 2.6) below McRae's line. CONCLUSION: Based on the current population, these results provide the mean and range of normal distances from the odontoid peg to the most frequently used skull baselines using MRI.