Resonancia magnética en pacientes con catéteres peritoneales autoposicionantes: ¿se puede? / Magnetic resonance imaging in patients with self-locating peritoneal catheters: Is it safe?

La presencia de una pieza de metal en el extremo de los catéteres autoposicionantes provoca dudas e incertidumbres a la hora de realizar una resonancia magnética (RM) a pacientes que portan este tipo de catéter. Simulamos un peritoneo con un catéter lastrado para comprobar el comportamiento del catéter durante la realización de una resonancia en equipos 1,5 T y 3 T. Y revisamos los casos en los que se realizaron RM en pacientes con este tipo de catéter. En la simulación, la punta del catéter peritoneal autoposicionante provoca un artefacto de susceptibilidad magnética que dificulta la visión de zonas cercanas, pero se comporta como dispositivo seguro para la RM. Se realizaron 14 RM en pacientes con catéteres autoposicionantes, ninguna en la zona abdominal. No hubo complicaciones en los pacientes ni en la técnica tras la realización de RM

The fact that self-locating catheters have a piece of metal at the tip leads to doubt and uncertainty around performing magnetic resonance imaging (MRI) in patients with this type of catheter. We simulated a peritoneum with a weighted catheter to ascertain how the catheter behaved during MRI scans in 1.5 T and 3 T machines. We also reviewed cases in which MRI had been performed in patients with this type of catheter. In the simulation, the tip of the self-locating peritoneal catheter caused a magnetic susceptibility artefact that made it difficult to see nearby areas, but it proved to be a safe device for MRI. 14 MRI scans were performed in patients with self-locating catheters, none in the abdominal area. There were no complications in the patients or the technique after performing MRI

Magnetic resonance imaging in patients with self-locating peritoneal catheters: Is it safe?

The fact that self-locating catheters have a piece of metal at the tip leads to doubt and uncertainty around performing magnetic resonance imaging (MRI) in patients with this type of catheter. We simulated a peritoneum with a weighted catheter to ascertain how the catheter behaved during MRI scans in 1.5 T and 3 T machines. We also reviewed cases in which MRI had been performed in patients with this type of catheter. In the simulation, the tip of the self-locating peritoneal catheter caused a magnetic susceptibility artefact that made it difficult to see nearby areas, but it proved to be a safe device for MRI. 14 MRI scans were performed in patients with self-locating catheters, none in the abdominal area. There were no complications in the patients or the technique after performing MRI.

Magnetic resonance imaging in patients with self-locating peritoneal catheters: Is it safe? / Resonancia magnética en pacientes con catéteres peritoneales autoposicionantes: ¿se puede?

The fact that self-locating catheters have a piece of metal at the tip leads to doubt and uncertainty around performing magnetic resonance imaging (MRI) in patients with this type of catheter. We simulated a peritoneum with a weighted catheter to ascertain how the catheter behaved during MRI scans in 1.5T and 3T machines. We also reviewed cases in which MRI had been performed in patients with this type of catheter. In the simulation, the tip of the self-locating peritoneal catheter caused a magnetic susceptibility artefact that made it difficult to see nearby areas, but it proved to be a safe device for MRI. 14 MRI scans were performed in patients with self-locating catheters, none in the abdominal area. There were no complications in the patients or the technique after performing MRI.

Diálisis peritoneal: ¿un factor de riesgo o de protección para la encefalopatía posterior reversible (PRES)? Revisión de la literatura / Peritoneal dialysis: A factor of risk or protection for posterior reversible encephalopathy syndrome? review of the literature

El síndrome de encefalopatía posterior reversible es una entidad clínico-radiológica con presentación neurológica aguda o subaguda, asociada a la presencia de lesiones que afectan sobre todo a la sustancia blanca de las regiones cerebrales posteriores. Se asocia principalmente con hipertensión severa de rápido desarrollo, o con insuficiencia renal (aguda o crónica), aunque se ha descrito también como una complicación neurológica de varias entidades médicas. En los últimos años se está produciendo un aumento en el número de casos y publicaciones relacionadas, debido al avance de las técnicas diagnósticas de imagen. El hallazgo radiológico característico es la presencia en la resonancia magnética de lesiones hiperintensas en las secuencias T2 y FLAIR, frecuentemente bilaterales y localizadas en las regiones cerebrales posteriores, que se corresponden con zonas de edema vasogénico. Poco se conoce de la fisiopatología del síndrome de encefalopatía posterior reversible. La teoría más aceptada, sobre todo en los casos con hipertensión asociada, es la de la pérdida de la autorregulación cerebral, que conduce a la aparición de edema vasogénico. Su característica principal es la reversibilidad, tanto de la clínica como de las lesiones cerebrales, con un diagnóstico precoz y adecuado. Pese a la frecuente asociación con insuficiencia renal y con hipertensión severa, son pocos los casos publicados en pacientes de diálisis peritoneal. Presentamos aquí una revisión del síndrome de encefalopatía posterior reversible en pacientes en diálisis peritoneal y de la casuística publicada (AU)

Posterior reversible encephalopathy syndrome is a clinical and radiological entity with acute or subacute neurological presentation associated with brain lesions that primarily affect the white matter of the posterior regions. It is often associated with the rapid onset of severe hypertension and/or with kidney failure (acute and chronic), but it has also been reported as a neurological complication in several medical conditions. In recent years, there has been an increase in the number of cases and related publications due to the advance of diagnostic imaging techniques. The characteristic radiological finding includes hyperintense lesions in T2- and FLAIR-weighted magnetic resonance imaging, which are often bilateral and located in the posterior cerebral regions and correspond to areas of vasogenic oedema. Little is known about the pathophysiology of posterior reversible encephalopathy syndrome. The most accepted theory, especially in cases with associated hypertension, is the loss of cerebral self-regulation which leads to the onset of vasogenic oedema. The main feature of this syndrome is the reversibility of both symptoms and cerebral lesions with an early and appropriate diagnosis. Despite the frequent association with kidney failure and severe hypertension, there are few cases reported in patients on peritoneal dialysis. This article presents a review of PRES in peritoneal dialysis patients in the published literature (AU)

Peritoneal dialysis: A factor of risk or protection for posterior reversible encephalopathy syndrome? review of the literature. / Diálisis peritoneal: ¿un factor de riesgo o de protección para la encefalopatía posterior reversible (PRES)? Revisión de la literatura.

Posterior reversible encephalopathy syndrome is a clinical and radiological entity with acute or subacute neurological presentation associated with brain lesions that primarily affect the white matter of the posterior regions. It is often associated with the rapid onset of severe hypertension and/or with kidney failure (acute and chronic), but it has also been reported as a neurological complication in several medical conditions. In recent years, there has been an increase in the number of cases and related publications due to the advance of diagnostic imaging techniques. The characteristic radiological finding includes hyperintense lesions in T2- and FLAIR-weighted magnetic resonance imaging, which are often bilateral and located in the posterior cerebral regions and correspond to areas of vasogenic oedema. Little is known about the pathophysiology of posterior reversible encephalopathy syndrome. The most accepted theory, especially in cases with associated hypertension, is the loss of cerebral self-regulation which leads to the onset of vasogenic oedema. The main feature of this syndrome is the reversibility of both symptoms and cerebral lesions with an early and appropriate diagnosis. Despite the frequent association with kidney failure and severe hypertension, there are few cases reported in patients on peritoneal dialysis. This article presents a review of PRES in peritoneal dialysis patients in the published literature.