Role and usefulness of mr imaging in the assessment of peritoneal carcinomatosis.

BACKGROUND: For many years, peritoneal carcinomatosis (PC) entitled poor prognosis until the development of the cytoreductive surgery technique associated with hyperthermic intraperitoneal chemotherapy. Imaging of peritoneal carcinomatosis plays an essential role in the diagnosis and management of the patients being considered for cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC). MAIN BODY: The key role of imaging in patients with peritoneal malignancy is to aid surgical decision making. A standardized peritoneal magnetic resonance (MR) imaging protocol, including T2-weighted fat suppressed, diffusion-weighted and gadolinium-enhanced sequences, allows to detect small peritoneal tumours that are often missed on other imaging. A systematic approach to MR imaging and a close collaboration between the radiologist and the oncologic surgeon are key elements for an accurate evaluation of candidate patients for CRS and HIPEC. CONCLUSION: MR imaging provides a powerful tool for accurate preoperative imaging in patients considered for curative surgery and assists the surgeon in evaluating patients for CRS and HIPEC.

Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon.

Wandering spleen is a rare condition, characterized by a mobile spleen that is attached only by an elongated vascular pedicle, allowing it to migrate to any part of the abdomen or pelvis. Mesenteroaxial gastric volvulus usually occurs in children and may be associated with wandering spleen. Both entities result from abnormal laxity or absence of the peritoneal attachments due to abnormal fusion of the peritoneal mesenteries. Pancreatic volvulus is a very rare anomaly, with only a few isolated case reports described in association with wandering spleen. Anomalous right sided descending and sigmoid colon is a very rare entity and its association with wandering spleen has not been previously reported. We report a case of wandering spleen associated with mesenteroaxial gastric volvulus, pancreatic volvulus and rightward shift of the splenic flexure of the colon and right sided descending and sigmoid colon in a young female.

Surface primary bone tumors: Systematic approach and differential diagnosis.

Surface primary bone tumors may appear similar to their intramedullary counterpart, but because they are rare, they may pose diagnostic challenges when showing different characteristics compared to their intramedullary counterpart. It is important for radiologists to recognize the imaging findings for various uncommon surface primary bone tumors, which may help to reduce the differential diagnosis or to lead to a specific diagnosis. Radiography is typically used for first-line imaging. If necessary, it is followed by CT or MRI for evaluation and characterization of surface bone tumors. The aim of this article is to review the imaging findings and differential diagnosis for surface primary bone tumors.

Exercise echocardiography and cardiac magnetic resonance imaging to predict outcome in patients with hypertrophic cardiomyopathy.

AIMS: We have observed that wall motion abnormalities (WMAs) during exercise echocardiography (ExE) are associated to events in hypertrophic cardiomyopathy (HCM). Our objective was to evaluate ExE and cardiac magnetic resonance (CMR) to predict outcome in HCM. METHODS AND RESULTS: ExE and CMR were performed in 148 patients with HCM. During follow-up (7.1 ± 2.7 years), there were 7 hard events (Hard-E) and 26 combined events (Comb-E). Exercise WMAs were observed in 13 patients (8.8%), perfusion defects in 10 (6.8%), and late gadolinium enhancement (LGE) in 48 (32.4%). WMAs were seen in 57% of patients with Hard-E vs. 6% without (P = 0.001) and in 23 and 6% with and without Comb-E (P = 0.005). Perfusion defects were also more frequent in patients with Hard-E than without (43 vs. 5%, P = 0.007) and in patients with Comb-E than without (23 vs. 5%, P = 0.002). LGE (g) was greater in patients with Comb-E than without [median (25th-75th percentile) 0 (0-21.1) vs. 0 (0-9.3) g P = 0.04]. Univariable predictors of Comb-E included NYHA class ≥2, peak double product, ΔWMSI, and CMR data. Peak double product [Hazard ratios (HR) = 0.99, confidence intervals (CI) 95% 0.99-0.99, P = 0.02] and ΔWMSI (HR = 404, CI 95% 12-13681, P = 0.001) remained independent predictors. Peak WMSI correlated with myocardial mass with LGE (r = 0.20, P = 0.02) and with perfusion defect area (r = 0.40, P < 0.001). LGE affecting ≥15% of the left ventricle was observed in 38% of patients with exercise WMAs vs. 12% without (P = 0.009). CONCLUSION: CMR data are associated to exercise WMAs in patients with HCM. ExE and CMR may help to predict outcome in them.

Conocimientos básicos necesarios para realizar resonancia magnética en cardiología / Basic knowledge needed for using magnetic resonance imaging in cardiology

La resonancia magnética es ya una técnica diagnóstica utilizada de forma sistemática por los cardiólogos. Su demostrada utilidad y superioridad frente a otras técnicas de imagen en el estudio de la cardiopatía isquémica es, muy probablemente, la causa del gran interés que ha despertado en los últimos años. La cuantificación de la función ventricular global y segmentaria, de la perfusión miocárdica y de la viabilidad ha hecho que con una sola técnica pueda valorarse de forma completa al paciente con cardiopatía isquémica. Sin embargo, muchos aspectos básicos de la resonancia magnética siguen siendo desconocidos para una amplia mayoría. En este trabajo exponemos sus fundamentos, componentes del equipo, distintas secuencias, utilización de contrastes, seguridad y contraindicaciones (AU)

Magnetic resonance imaging is routinely employed for diagnosis in cardiology. Its proven usefulness and superior imaging ability in ischemic heart disease probably explain the increasing attention it has received in the last decade. Its ability to quantify global and regional ventricular function as well as myocardial perfusion and viability means that it is possible to carry out a thorough evaluation of the patient using just one technique. Nevertheless, many basic features of magnetic resonance imaging are unknown to clinicians. In this article, we describe the fundamental principles of the technique, technical details of the equipment, the different imaging sequences used, the use of contrast, safety, and contraindications (AU)

Necesidad de tratamiento parodontal en oficiales de una unidad de tanques

Se realizó un estudio en 237 oficiales de una unidad de tanques, en edades comprendidas entre 20 y 50 años, con el objetivo de determinar la necesidad de tratamiento parodontal de acuerdo a los signos y síntomas detectados al examen bucal. Se observó que 59.1(por ciento) de los pacientes estaban afectados por la enfermedad parodontal, siendo el sangramiento gingival el signo más característico para un 45.7(por ciento) correspondiendo al grupo de menor edad (20-29) el 27.5(por ciento) miestran que los signos más graves de la enfermedad porodontal (representados por bolsas moderadas) corresponden al 12.8(por ciento) siendo el grupo más afectado el de 40-49 años de edad. Se concluyó la importancia de priorizar la atención estomatológica primaria con enfoque preventivo, debido a la alta prevalencia de enfermedad gingival incipiente en el grupo de oficiales estudiados(AU)

Necesidad de tratamiento parodontal en oficiales de una unidad de tanques

Se realizo un estudio en 237 oficiales de una Unidad de Tanques, en edades comprendidas entre 20 y 50 años, con el objetivo de determinar la necesidad de tratamiento parodontal de cauerdo a examen bucal. Se observo que el 59,1 porciento de los pacientes estaban afectados por la enfermedad parodontal, siendo el sangramiento gingival el signo mas caracteristico para un 45,7 porciento, correspondiendo al grupo menor de edad (20-29 años) el 27,5 porciento, mientras que los signos mas graves de la enfermedad parodontal (representados por bolsas moderadas), corresponden al 12,8 porciento, siendo el grupo mas afectado el de 40-49 años de edad. Se concluyo la importancia de priorizar la Atencion Estomatologica Primaria con enfoque preventivo, debido a la alta prevalencia de enfermedad gingival incipiente en el grupo de oficiales estudiados (AU)