Utilidad del dímero D en el diagnóstico de tromboembolismo pulmonar en los pacientes con COVID-19 en urgencias: estimación de su capacidad discriminativa, sensibilidad y especificidad / Usefulness of D-dimer concentration in the diagnosis of pulmonary thromboembolism in patients with COVID-19 in the emergency department: estimating its discriminative capacity, sensitivity, and specificity

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Case 224: Cardiac Involvement in Erdheim-Chester Disease.

History A 61-year-old man with no relevant medical history was admitted to the emergency department with symptoms of congestive heart failure and a 1-week history of chest pain, progressive dyspnea, abdominal swelling, bipedal edema, and anorexia. Laboratory test results, including complete blood count and electrolyte, creatinine, creatine phosphokinase, and troponin T levels were normal. Electrocardiographic findings were unremarkable. Initial chest radiography showed an enlarged heart with bilateral pleural effusion. Transthoracic echocardiography revealed an irregular right atrial mass and moderate to severe pericardial effusion. The patient subsequently underwent computed tomography (CT) of the chest, abdomen, and pelvis followed by cardiac magnetic resonance (MR) imaging for further evaluation of the atrial mass. Because of the suspected diagnosis, conventional radiography of the skeleton was performed.

MR imaging-based assessment of the female pelvic floor.

Pelvic floor weakness is a functional condition that affects the anatomic structures supporting the pelvic organs: fasciae, ligaments, and muscles. It is a prevalent disorder among people older than 50 years, especially women, and may substantially diminish their quality of life. Many complex causes of pelvic floor weakness have been described, but the greatest risk factors are aging and female sex. Pelvic floor weakness can provoke a wide range of symptoms, including pain, urinary and fecal incontinence, constipation, difficulty in voiding, a sense of pressure, and sexual dysfunction. When the condition is diagnosed solely on the basis of physical and clinical examination, the compartments involved and the site of prolapse are frequently misidentified. Such errors contribute to a high number of failed interventions. Magnetic resonance (MR) imaging, which allows visualization of all three compartments, has proved a reliable technique for accurate diagnosis, especially when involvement of multiple compartments is suspected. MR imaging allows precise evaluation of ligaments, muscles, and pelvic organs and provides accurate information for appropriate surgical treatment. Moreover, dynamic MR imaging with steady-state sequences enables the evaluation of functional disorders of the pelvic floor. The authors review the pelvic floor anatomy, describe the MR imaging protocol used in their institutions, survey common MR imaging findings in the presence of pelvic floor weakness, and highlight key details that radiologists should provide surgeons to ensure effective treatment and improved outcomes.

Función renal, fibrosis sistémica nefrogénica y otras reacciones adversas asociadas a los medios de contraste basados en el gadolinio / Renal function, nephrogenic systemic fibrosis and other adverse reactions associated with gadolinium-based contrast media

La fibrosis sistémica nefrogénica es un trastorno fibrosante que afecta a pacientes con deterioro de la función renal y se asocia a la administración de medios de contraste basados en el gadolinio, empleados en la resonancia magnética. A pesar de tratarse de un grupo de fármacos que se consideraban seguros, la notificación de esta reacción adversa, potencialmente grave, supuso un punto de inflexión en las pautas de administración de estos medios de contraste. Se han intentado establecer parámetros de seguridad a fin de identificar a los pacientes con factores de riesgo por presentar insuficiencia renal. La estrecha farmacovigilancia y el rigor en la observación de las normativas actuales, con especial atención al valor del filtrado glomerular, han reducido los casos publicados relacionados con el uso de medios de contraste basados en el gadolinio. En un encuentro entre radiólogos y nefrólogos revisamos los aspectos más relevantes en la actualidad y las recomendaciones para su prevención (AU)

Nephrogenic systemic fibrosis is a fibrosing disorder that affects patients with impaired renal function and is associated with the administration of gadolinium-based contrast media used in MRI. Despite being in a group of drugs that were considered safe, report about this potentially serious adverse reaction was a turning point in the administration guidelines of these contrast media. There has been an attempt to establish safety parameters to identify patients with risk factors of renal failure. The close pharmacovigilance and strict observation of current regulations, with special attention being paid to the value of glomerular filtration, have reduced the published cases involving the use of gadolinium-based contrast media. In a meeting between radiologists and nephrologists we reviewed the most relevant aspects currently and recommendations for its prevention (AU)

Renal function, nephrogenic systemic fibrosis and other adverse reactions associated with gadolinium-based contrast media.

Nephrogenic systemic fibrosis is a fibrosing disorder that affects patients with impaired renal function and is associated with the administration of gadolinium-based contrast media used in MRI. Despite being in a group of drugs that were considered safe, report about this potentially serious adverse reaction was a turning point in the administration guidelines of these contrast media. There has been an attempt to establish safety parameters to identify patients with risk factors of renal failure. The close pharmacovigilance and strict observation of current regulations, with special attention being paid to the value of glomerular filtration, have reduced the published cases involving the use of gadolinium-based contrast media. In a meeting between radiologists and nephrologists we reviewed the most relevant aspects currently and recommendations for its prevention.