Essential Subcortical Tracts in Language and Reading. 3D-Tractography for Clinical Practice and Anatomic Correlation with Intraoperative Subcortical Electrostimulation.

Diffusion tensor imaging (DTI) and tractography provide the neurosurgeon with a valid 3D view of the white matter tracts of the brain for the presurgical planning of the treatment of lesions close to eloquent areas, this being one of the principal clinical applications of this technique. In this article, we describe through practical cases the anatomic relationships of white matter tracts that are essential for language and reading, based on DTI studies and the excellent anatomic correlation with the intraoperative subcortical map.

La patología benigna de ano y recto con RM 3.0T. 2.a Parte: patología inflamatoria ano-rectal. Anatomía postquirúrgica y complicaciones postratamiento / 3.0T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part 2: anorectal inflammatory disease. Postsurgical anatomy and complications after treatment

La patología benigna anorrectal comprende una vasta cantidad de entidades de muy diversos orígenes, congénitas o adquiridas, inflamatorias o tumorales. Sin embargo, ha recibido menos atención en la bibliografía científica que el estudio de la patología tumoral maligna. En esta segunda entrega de la revisión basada en imágenes de la patología benigna anorrectal describimos la patología inflamatoria y fistulosa más frecuente, la anatomía posquirúrgica y las complicaciones secundarias al tratamiento quirúrgico o radioterápico de la patología anorrectal (AU)

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease (AU)

La patología benigna de ano y recto con Resonancia Magnética 3.0T. 1 a Parte: Protocolo de alta resolución, revisión anatómica, tumores benignos y alteraciones congénitas o adquiridas del complejo esfinteriano / 3.0 T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part one: High resolution protocol for 3.0 T MRI, anatomic review, benign tumors, and congenital or acquired alterations of the sphincter complex

La patología benigna anorrectal comprende una amplio grupo de procesos de muy diversos orígenes, congénitos o adquiridos, inflamatorios o tumorales. Sin embargo, ha recibido en la bibliografía científica menor atención que el estudio de la patología tumoral maligna. Presentamos una revisión basada en imágenes de la patología benigna anorrectal más frecuente. En esta primera parte realizamos un recuerdo anatómico y una breve descripción de las peculiaridades del protocolo de alta resolución que empleamos con la RM de 3.0 T. Después describimos los principales tumores benignos anorrectales y lesiones quísticas del desarrollo junto con sus principales diagnósticos diferenciales y las anomalías congénitas y adquiridas del complejo esfinteriano anorrectal (AU)

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex (AU)

[Posterior tibial tendon dysfunction: what other structures are involved in the development of acquired adult flat foot?]. / Disfunción del tendón tibial posterior: ¿qué otras estructuras están implicadas en el desarrollo del pie plano adquirido del adulto?

OBJECTIVE: To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot. MATERIAL AND METHODS: We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems. In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles' tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher's exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani. RESULTS: Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001). CONCLUSION: We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis.

[3.0 T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part one: High resolution protocol for 3.0 T MRI, anatomic review, benign tumors, and congenital or acquired alterations of the sphincter complex]. / La patología benigna de ano y recto con Resonancia Magnética 3.0T. 1a Parte: Protocolo de alta resolución, revisión anatómica, tumores benignos y alteraciones congénitas o adquiridas del complejo esfinteriano.

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex.

[3.0T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part 2: Anorectal inflammatory disease. Postsurgical anatomy and complications after treatment]. / La patología benigna de ano y recto con RM 3.0T. 2.(a) Parte: patología inflamatoria ano-rectal. Anatomía postquirúrgica y complicaciones postratamiento.

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease.

Entero-resonancia magnética: revisión de la técnica para el estudio de la enfermedad de Crohn / Magnetic resonance enterography: review of the technique for the study of Crohn's disease

La enfermedad de Crohn es una enfermedad crónica de curso imprevisible que requiere numerosos estudios radiológicos durante la vida. Afecta frecuentemente a pacientes jóvenes, más vulnerables a los efectos nocivos de las exploraciones repetidas con radiaciones ionizantes. La precisión diagnóstica de la enterografía por RM es similar a la de la tomografía computarizada por su alta resolución tisular, sin el inconveniente de la radiación. Los índices clínicos de valoración de la enfermedad son poco precisos y subjetivos por lo que las técnicas enterográficas de imagen se están incorporando cada vez más a la práctica clínica como medios objetivos de control de la gravedad de la enfermedad. En este artículo, describimos nuestra técnica enterográfica en RM para la valoración de la enfermedad de Crohn. Revisaremos los hallazgos más relevantes por imagen y los subtipos de la enfermedad, la literatura científica relacionada y los índices por RM en la valoración de la gravedad de la enfermedad (AU)

Crohn's disease is a chronic disease with an unpredictable course. Patients with Crohn's disease will have to undergo numerous imaging tests. Crohn's disease often affects young people, who are more vulnerable to the harmful effects of repeated exposure to ionizing radiation. The high resolution of tissues on MR enterography give it a diagnostic accuracy similar to that of CT; however, MR enterography does not have the drawback of ionizing radiation. The clinical indices used to assess Crohn's disease are subjective and not very accurate; thus, enterographic techniques are becoming more common in clinical practice as a means to follow up patients objectively. In this article, we describe the MR enterography technique we use to evaluate Crohn's disease. We illustrate the most relevant imaging findings, and we review the subtypes of the disease, the related scientific literature, and the MR indices used to assess the severity of Crohn's disease (AU)

[Magnetic resonance enterography: review of the technique for the study of Crohn's disease]. / Entero-resonancia magnética: revisión de la técnica para el estudio de la enfermedad de Crohn.

Crohn's disease is a chronic disease with an unpredictable course. Patients with Crohn's disease will have to undergo numerous imaging tests. Crohn's disease often affects young people, who are more vulnerable to the harmful effects of repeated exposure to ionizing radiation. The high resolution of tissues on MR enterography give it a diagnostic accuracy similar to that of CT; however, MR enterography does not have the drawback of ionizing radiation. The clinical indices used to assess Crohn's disease are subjective and not very accurate; thus, enterographic techniques are becoming more common in clinical practice as a means to follow up patients objectively. In this article, we describe the MR enterography technique we use to evaluate Crohn's disease. We illustrate the most relevant imaging findings, and we review the subtypes of the disease, the related scientific literature, and the MR indices used to assess the severity of Crohn's disease.

Resonancia magnética en flexoextensión en el diagnóstico de la mielopatía cervical en la enfermedad de Hirayama / MRI in flexed and extended positions for the diagnosis of cervical myelopathy in Hirayama's disease

Se expone el caso de un varón joven que debutó con atrofia de la musculatura del antebrazo y mano derechos, en el que el clínico, sospechando esta entidad, y basándose en los hallazgos electromiográficos, recomendó la realización de una resonancia magnética cervical en posición neutra y en flexión, objetivándose los principales signos radiológicos típicos de esta etiología, lo que concretó el diagnóstico. Los hallazgos claves de la enfermedad de Hirayama constituyen la atrofia medular asimétrica con afección de astas anteriores, despegamiento dorsal de la duramadre y dilatación del plexo venoso epidural (AU)

We report the case of a young man who presented with atrophy of the musculature of theright forearm and hand. The clinician suspected cervical myelopathy in Hirayama’s diseaseon the basis of the findings at electromyography and recommended an MRI examinationinboth flexed and neutral position. The typical imaging findings for cervical myelopathy inHirayama’s disease were observed and the diagnosis was confirmed. The key findingsfor Hirayama’s disease consist of a symmetrical medullary atrophy with involvement of theanterior horns, dorsal detachment of the duramater, and dilatation of the epidural venous plexus (AU)

[Median arcuate ligament syndrome: a controversial entity.]. / Síndrome del ligamento mediano arcuato: una entidad controvertida.

Median arcuate ligament syndrome is a disorder resulting from compression of the origin of the celiac trunk by the arcuate ligament, a fibrous arch that connects the right and left diaphragmatic crura. This is a controversial entity because the clinical manifestations are often nonspecific and isolated compression of the celiac trunk is relatively common in asymptomatic individuals. We report two cases of median arcuate ligament syndrome and review the radiographic features necessary for the imaging workup of this entity.

Síndrome del ligamento mediano arcuato: una entidad controvertida / Median arcuate ligament syndrome: a controversial entity

El síndrome del ligamento mediano arcuato resulta de la compresión del origen del tronco celíaco por el ligamento arcuato, una banda fibrosa que une las 2 cruras diafragmáticas. Se trata de una entidad controvertida, dado lo inespecífico de su sintomatología y la relativa frecuencia con la que se presenta la compresión aislada del tronco celíaco en sujetos asintomáticos. A propósito de 2 casos se revisan los hallazgos por imagen que permitirán al radiólogo llevar a cabo una adecuada valoración de esta entidad (AU)

Median arcuate ligament syndrome is a disorder resulting from compression of the origin of the celiac trunk by the arcuate ligament, a fibrous arch that connects the right and left diaphragmatic crura. This is a controversial entity because the clinical manifestations are often nonspecific and isolated compression of the celiac trunk is relatively common in asymptomatic individuals. We report two cases of median arcuate ligament syndrome and review the radiographic features necessary for the imaging workup of this entity (AU)