Appendiceal diverticulitis diagnosed by ultrasound.

Appendiceal diverticulitis is a rare entity that may present clinically simulating appendicitis. The importance of its diagnosis lies in the higher risk of complications including malignant transformation. The presence of small cystic appendicular peripheral images with thickened wall and hyperechoic surrounding fat are the diagnostic key.

Imagen hepática de pacientes con cirugía de Fontan. Respuesta / Liver imaging in patients with fontan circulation. Response

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Hígado y enfermedad cardiovascular: lo que el cardiólogo debería conocer de los hallazgos ecográficos / Liver and cardiovascular disease: what cardiologists need to know about ultrasound findings

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Unexpected hosts: imaging parasitic diseases.

Radiologists seldom encounter parasitic diseases in their daily practice in most of Europe, although the incidence of these diseases is increasing due to migration and tourism from/to endemic areas. Moreover, some parasitic diseases are still endemic in certain European regions, and immunocompromised individuals also pose a higher risk of developing these conditions. This article reviews and summarises the imaging findings of some of the most important and frequent human parasitic diseases, including information about the parasite's life cycle, pathophysiology, clinical findings, diagnosis, and treatment. We include malaria, amoebiasis, toxoplasmosis, trypanosomiasis, leishmaniasis, echinococcosis, cysticercosis, clonorchiasis, schistosomiasis, fascioliasis, ascariasis, anisakiasis, dracunculiasis, and strongyloidiasis. The aim of this review is to help radiologists when dealing with these diseases or in cases where they are suspected. Teaching Points • Incidence of parasitic diseases is increasing due to migratory movements and travelling. • Some parasitic diseases are still endemic in certain regions in Europe. • Parasitic diseases can have complex life cycles often involving different hosts. • Prompt diagnosis and treatment is essential for patient management in parasitic diseases. • Radiologists should be able to recognise and suspect the most relevant parasitic diseases.

Predictores de pérdida luminal de venas pulmonares tras ablación por radiofrecuencia / Predictors of luminal loss in pulmonary veins after radiofrequency ablation

Introducción y objetivos: La incidencia descrita de estenosis de venas pulmonares tras la ablación por radiofrecuencia es muy variable. Además, la mayoría de los estudios se han centrado en las estenosis graves y han prestado poca atención a las de carácter leve. El objetivo de este trabajo es estudiar los cambios morfológicos de las venas pulmonares después de la ablación y los posibles factores predictivos de estenosis en la resonancia magnética previa a la ablación. Métodos: Se examinó mediante resonancia magnética cardiaca a un total de 80 pacientes consecutivos con fibrilación auricular antes de practicarles una ablación por radiofrecuencia. Se repitió la resonancia magnética una mediana de 95 días después de la ablación. Entre las variable estudiadas, se midió, utilizando un diseño ciego, el área/elipticidad del ostium, así como el volumen auricular. Se evaluó la presencia de estenosis y se clasificó como leve (< 50% de reducción del área), moderada (50-70%) o grave (> 70%). Resultados: Se identificó estenosis tras la ablación en 78 de 322 venas analizadas (24,2%). La estenosis fue leve en 66 (84,6%) venas, moderada en 11 (14,1%) y grave en 1 (1,3%). Todas estaban asintomáticas. La vena pulmonar inferior izquierda es la que presentó la mayor frecuencia de estenosis: se detectó en un 26% de ellas (p < 0,001). Un análisis de regresión múltiple reveló que el tipo de vena (vena pulmonar inferior izquierda, odds ratio = 3,089; p = 0,02) y una mayor área del ostium antes de la ablación (odds ratio = 1,009; p < 0,001) eran factores independientes predictivos de estenosis tras la ablación. La edad (odds ratio = 1,033) mostró una tendencia fuerte hacia la significación estadística (p = 0,06). Conclusiones: Después de la ablación se produce una disminución del tamaño del ostium de las venas pulmonares y se detecta algún grado de estenosis en menos de una tercera parte de los pacientes. La mayoría son leves y las estenosis graves son excepcionales. Los pacientes de más edad, aquellos con venas de mayor tamaño y las venas inferiores izquierdas tienen mayor probabilidad de presentar estenosis (AU)

Introduction and objectives: The reported incidences of stenosis after radiofrequency ablation of pulmonary veins are highly variable. Moreover, most studies have focused on severe stenosis and have overlooked mild stenosis. Our aims were to study postablation morphological changes in the pulmonary veins and to evaluate preablation magnetic resonance imaging predictors for stenosis. Methods: Eighty consecutive patients with atrial fibrillation underwent cardiac magnetic resonance imaging before undergoing radiofrequency ablation. Magnetic resonance imaging was repeated a median of 95 days after ablation. Ostium area/ellipticity and atrial volume were blindly assessed. We evaluated the presence of stenosis and classified it as mild (< 50% area reduction), moderate (50%-70%), and severe (> 70%). Results: Postablation stenosis was identified in 78 of 322 veins (24.2%). The stenosis was mild in 66 (84.6%), moderate in 11 (14.1%), and severe in 1 (1.3%). All of them were asymptomatic. The left inferior pulmonary vein showed the highest frequency of stenosis, which was detected in 26% of them (P < .001). A multiple regression analysis revealed that left inferior pulmonary vein (odds ratio = 3.089; P = .02) and a greater preablation ostium area (odds ratio = 1.009; P < .001) were independent predictors for postablation stenosis. Age (odds ratio = 1.033) showed a strong trend to statistical significance (P = .06). Conclusions: After ablation, vein ostia size is reduced and stenosis is detected in less than one third of patients. Most cases are mild, and severe stenosis is rare. Postablation stenosis is more likely to develop in older patients, those with larger vein ostia, and in the left inferior pulmonary veins (AU)

Predictors of Luminal Loss in Pulmonary Veins After Radiofrequency Ablation.

INTRODUCTION AND OBJECTIVES: The reported incidences of stenosis after radiofrequency ablation of pulmonary veins are highly variable. Moreover, most studies have focused on severe stenosis and have overlooked mild stenosis. Our aims were to study postablation morphological changes in the pulmonary veins and to evaluate preablation magnetic resonance imaging predictors for stenosis. METHODS: Eighty consecutive patients with atrial fibrillation underwent cardiac magnetic resonance imaging before undergoing radiofrequency ablation. Magnetic resonance imaging was repeated a median of 95 days after ablation. Ostium area/ellipticity and atrial volume were blindly assessed. We evaluated the presence of stenosis and classified it as mild (< 50% area reduction), moderate (50%-70%), and severe (> 70%). RESULTS: Postablation stenosis was identified in 78 of 322 veins (24.2%). The stenosis was mild in 66 (84.6%), moderate in 11 (14.1%), and severe in 1 (1.3%). All of them were asymptomatic. The left inferior pulmonary vein showed the highest frequency of stenosis, which was detected in 26% of them (P < .001). A multiple regression analysis revealed that left inferior pulmonary vein (odds ratio = 3.089; P = .02) and a greater preablation ostium area (odds ratio = 1.009; P < .001) were independent predictors for postablation stenosis. Age (odds ratio = 1.033) showed a strong trend to statistical significance (P = .06). CONCLUSIONS: After ablation, vein ostia size is reduced and stenosis is detected in less than one third of patients. Most cases are mild, and severe stenosis is rare. Postablation stenosis is more likely to develop in older patients, those with larger vein ostia, and in the left inferior pulmonary veins.