Radiología intervencionista. Problemas actuales y nuevos caminos / Interventional radiology: current problems and new directions

La Radiología Vascular e Intervencionista (RVI) se ha convertido en una de las especialidades diagnósticas y terapéuticas con mayor expansión en los últimos años. Este crecimiento se ha basado en un concepto fundamental, la realización de procedimientos mínimamente invasivos guiados por imagen. Esta atractiva combinación ha hecho que otras especialidades clínicas, fuera del ámbito de la Radiología, se sintieran atraídas por este tipo de intervenciones. El futuro de la RVI aunque incierto, se debe vincular a la práctica clínica y al trabajo multidisciplinar (AU)

In recent years, vascular and interventional radiology has become one of the fastest growing diagnostic and therapeutic specialties. This growth has been based on a fundamental concept: performing minimally invasive procedures under imaging guidance. This attractive combination has led to the interest of professionals from other clinical specialties outside radiology in performing this type of intervention. The future of vascular and interventional radiology, although uncertain, must be linked to clinical practice and multidisciplinary teamwork (AU)

[Interventional radiology: current problems and new directions]. / Radiología intervencionista. Problemas actuales y nuevos caminos.

In recent years, vascular and interventional radiology has become one of the fastest growing diagnostic and therapeutic specialties. This growth has been based on a fundamental concept: performing minimally invasive procedures under imaging guidance. This attractive combination has led to the interest of professionals from other clinical specialties outside radiology in performing this type of intervention. The future of vascular and interventional radiology, although uncertain, must be linked to clinical practice and multidisciplinary teamwork.

Successful rectal cancer local recurrence radiofrequency ablation.

Local rectal cancer recurrences represent a great challenge, as surgical re-excisions or re-irradiation procedures are not always feasible. Moreover, scar or local recurrence is hard to elucidate with conventional diagnosis techniques. Emerging diagnostic and therapeutic procedures may be useful in this setting. A local rectal cancer recurrence radiofrequency ablation is reported. PET scan confirmed the recurrence, defined the target volume and assessed the success of the local therapy.

Successful rectal cancer local recurrence radiofrequency ablation

Local rectal cancer recurrences represent a great challenge, as surgical re-excisions or re-irradiation procedures are not always feasible. Moreover, scar or local recurrence is hard to elucidate with conventional diagnosis techniques. Emerging diagnostic and therapeutic procedures may be useful in this setting. A local rectal cancer recurrence radiofrequency ablation is reported. PET scan confirmed the recurrence, defined the target volume and assessed the success of the local therapy (AU)

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Malformaciones arteriovenosas en la infancia: a propósito de cuatro casos / Arteriovenous malformations in children: a report of four cases

Introducción y objetivo. Las malformaciones vascularesson la causa más corriente de hemorragia intracraneal (HI) notraumática tras la etapa neonatal. Las malformaciones arteriovenosas(MAV) son las malformaciones vasculares que con mayorfrecuencia causan síntomas en la infancia y la causa más habitualde HI en niños mayores de un año. Casos clínicos. Se revisaron lashistorias clínicas de todos los pacientes menores de 16 años quepresentaron un diagnóstico de MAV desde el año 2000 hasta laactualidad. Encontramos cuatro casos de edades comprendidasentre los 7 y los 15 años, todos ellos estudiados con tomografíacomputarizada y/o resonancia magnética y arteriografía cerebrales.Un paciente comenzó con cefaleas y otro presentaba alteracionesdel aprendizaje. Los otros dos empezaron con HI. Las manifestacionesclínicas más frecuentes de ésta fueron la disminución delnivel de conciencia y los vómitos. La arteriografía estableció eldiagnóstico definitivo en todos los casos. Se realizó tratamientoquirúrgico en tres casos (mediante cirugía, embolización por catétery radiocirugía estereoatáxica con excelente evolución posterior.Conclusiones. La hemorragia espontánea constituye el iniciomás frecuente de las MAV, pero a veces existen manifestacionesprevias que constituyen un reto diagnóstico y que deberían resultarel objetivo de futuras investigaciones, pues evitar la HI significaríareducir drásticamente la morbimortalidad de las MAV

Introduction and aims. Vascular malformations are the most frequent cause of intracranial haemorrhage (IH) afterthe neonatal period that are not due to traumatic injury. Arteriovenous malformations (AVM) are the vascular malformationsthat most often give rise to symptoms in infancy and are the most common cause of IH in children over one year of age. Casereports. We reviewed the medical records of all patients under the age of 16 years diagnosed with AVM from the year 2000 tothe present. Four cases aged between 7 and 15 years were found, all of whom were examined with computerised tomographyand/or magnetic resonance imaging and cerebral arteriography scans. One patient started with headaches and another hadlearning disabilities. The other two began with IH, the most common clinical manifestations of which were a diminished levelof awareness and vomiting. The final diagnosis was established by means of arteriography in all cases. Surgical treatment wascarried out in three cases (using surgery, catheter embolisation and stereotaxic radiosurgery) and the patients’ progressfollowing the intervention was excellent. Conclusions. Spontaneous haemorrhage constitutes the most common presentingsymptom of AVM. However, there are sometimes earlier manifestations that are a challenge to diagnosis and which should bethe target of future research, since preventing IH would lead to a drastic reduction in the morbidity and mortality rate of AVM

[Arteriovenous malformations in children: a report of four cases]. / Malformaciones arteriovenosas en la infancia: a proposito de cuatro casos.

INTRODUCTION AND AIMS: Vascular malformations are the most frequent cause of intracranial haemorrhage (IH) after the neonatal period that are not due to traumatic injury. Arteriovenous malformations (AVM) are the vascular malformations that most often give rise to symptoms in infancy and are the most common cause of IH in children over one year of age. CASE REPORTS: We reviewed the medical records of all patients under the age of 16 years diagnosed with AVM from the year 2000 to the present. Four cases aged between 7 and 15 years were found, all of whom were examined with computerised tomography and/or magnetic resonance imaging and cerebral arteriography scans. One patient started with headaches and another had learning disabilities. The other two began with IH, the most common clinical manifestations of which were a diminished level of awareness and vomiting. The final diagnosis was established by means of arteriography in all cases. Surgical treatment was carried out in three cases (using surgery, catheter embolisation and stereotaxic radiosurgery) and the patients' progress following the intervention was excellent. CONCLUSIONS: Spontaneous haemorrhage constitutes the most common presenting symptom of AVM. However, there are sometimes earlier manifestations that are a challenge to diagnosis and which should be the target of future research, since preventing IH would lead to a drastic reduction in the morbidity and mortality rate of AVM.