Imagen de la hipoacusia postraumática / Imaging of post-traumatic hearing loss

Objetivo. La hipoacusia es la complicación más frecuente del traumatismo del hueso temporal. El papel del radiólogo es de gran importancia; la adecuación y la selección de las pruebas radiológicas, así como su correcta interpretación, son cruciales para establecer el diagnóstico y el pronóstico, y para seleccionar el tratamiento idóneo. Con el objetivo de sistematizar los conceptos más relevantes en la valoración de los estudios de imagen en este contexto, se esquematizará el desarrollo del tema según el tipo de hipoacusia que condicione el traumatismo. De forma ordenada se valorarán las potenciales lesiones de sus componentes; en cada caso se sugerirá la técnica de imagen para su evaluación y se describirán e ilustrarán los hallazgos. Conclusión. En la hipoacusia postraumática, la tomografía computarizada es la técnica de elección inicial y permitirá la detección de alteraciones que condicionen hipoacusia conductiva; la resonancia magnética es útil en la valoración de la hipoacusia neurosensorial

Objective. Hearing loss is the most frequent complication of temporal bone trauma. The role of the radiologist is of great importance; the adequacy and selection of the imaging technique, as well as its correct interpretation, are crucial to establish the diagnosis, prognosis and enable the selection of appropriate treatment. With the aim of systematizing the most relevant concepts in the evaluation of image studies in this scenario, this review will be outlined according to the hearing loss type. The potential lesions of its components will be assessed; In each case the most appropriate imaging technique will be suggested and the findings will be described and depicted. Conclusion. In postraumatic hearing loss, computed tomography is the initial technique of choice and will allow the detection of alterations that cause conductive hearing loss; magnetic resonance imaging will be useful in the evaluation of sensorineural hearing loss

Imaging of post-traumatic hearing loss. / Imagen de la hipoacusia postraumática.

OBJECTIVE: Hearing loss is the most frequent complication of temporal bone trauma. The role of the radiologist is of great importance; the adequacy and selection of the imaging technique, as well as its correct interpretation, are crucial to establish the diagnosis, prognosis and enable the selection of appropriate treatment. With the aim of systematizing the most relevant concepts in the evaluation of image studies in this scenario, this review will be outlined according to the hearing loss type. The potential lesions of its components will be assessed; In each case the most appropriate imaging technique will be suggested and the findings will be described and depicted. CONCLUSION: In postraumatic hearing loss, computed tomography is the initial technique of choice and will allow the detection of alterations that cause conductive hearing loss; magnetic resonance imaging will be useful in the evaluation of sensorineural hearing loss.

Malformaciones del oído interno: una aproximación diagnóstica práctica / Inner ear malformations: a practical diagnostic approach

La hipoacusia neurosensorial pediátrica es una causa mayor de discapacidad. Pese a que solo en el 20-40% de los casos se identifica una malformación del oído interno, su detección es de vital importancia para el tratamiento de estos pacientes. En este artículo se repasan la anatomía y la embriogénesis del oído interno. Se valora el papel de la neuroimagen en la hipoacusia neurosensorial pediátrica y en el estudio preimplante coclear. Se destaca la necesidad de la utilización de un sistema universal de clasificación de las malformaciones del oído interno con implicaciones pronósticas y terapéuticas. Por último, se describen e ilustran de forma concisa los hallazgos radiológicos clave de cada tipo de malformación. La tomografía computarizada y la resonancia magnética desempeñan un papel crucial en la caracterización de las malformaciones del oído interno y permiten la valoración de las estructuras anatómicas que posibilitan la selección del tratamiento y del abordaje quirúrgico idóneos (AU)

Pediatric sensorineural hearing loss is a major cause of disability; although inner ear malformations account for only 20-40% of all cases, recognition and characterization will be vital for the proper management of these patients. In this article relevant anatomy and development of inner ear are surveyed. The role of neuroimaging in pediatric sensorineural hearing loss and cochlear preimplantation study are assessed. The need for a universal system of classification of inner ear malformations with therapeutic and prognostic implications is highlighted. And finally, the radiological findings of each type of malformation are concisely described and depicted. Computed tomography and magnetic resonance imaging play a crucial role in the characterization of inner ear malformations and allow the assessment of the anatomical structures that enable the selection of appropriate treatment and surgical approach (AU)

Inner ear malformations: a practical diagnostic approach. / Malformaciones del oído interno: una aproximación diagnóstica práctica.

Pediatric sensorineural hearing loss is a major cause of disability; although inner ear malformations account for only 20-40% of all cases, recognition and characterization will be vital for the proper management of these patients. In this article relevant anatomy and development of inner ear are surveyed. The role of neuroimaging in pediatric sensorineural hearing loss and cochlear preimplantation study are assessed. The need for a universal system of classification of inner ear malformations with therapeutic and prognostic implications is highlighted. And finally, the radiological findings of each type of malformation are concisely described and depicted. Computed tomography and magnetic resonance imaging play a crucial role in the characterization of inner ear malformations and allow the assessment of the anatomical structures that enable the selection of appropriate treatment and surgical approach.

Radiología del oído externo: indicaciones, anatomía normal y procesos patológicos / Radiology of external ear: indications, normal anatomy, and pathological processes

El oído externo (OE) es accesible al examen directo. En la mayor parte de las enfermedades, la historia clínica y la otoscopia son suficientes para su diagnóstico y tratamiento. Nuestro objetivo es describir la anatomía normal del OE, especificar las indicaciones de pruebas de imagen y revisar las manifestaciones clínicas y radiológicas de las enfermedades más frecuentes, que clasificaremos según su origen en patología congénita, inflamatoria e infecciosa, tumoral ósea benigna, traumática y tumoral maligna. Las pruebas de imagen no desempeñan un papel importante en la patología del OE, pero en determinados escenarios clínicos pueden ser cruciales para alcanzar el diagnóstico concreto y establecer el tratamiento idóneo. La tomografía computarizada es la técnica de elección para la mayor parte de las enfermedades. La resonancia magnética es complementaria, permite discriminar tejidos de diferente naturaleza y evaluar con precisión la extensión de la enfermedad (AU)

The external ear is accessible to direct examination; the clinical history and otoscopy are sufficient to diagnose and treat most diseases of the external ear. We aim to describe the normal anatomy of the external ear, specify the indications for imaging tests, and review the clinical and radiological manifestations of the most common diseases affecting the external ear. We classify these diseases according to their origin into congenital, inflammatory, infectious, or traumatic disease or benign bone tumors or malignant tumors. Imaging does not play an important role in diseases of the external ear, but in certain clinical scenarios it can be crucial for reaching a concrete diagnosis and establishing the best treatment. Computed tomography is the first-choice technique for most diseases. Magnetic resonance imaging complements computed tomography and makes it possible to differentiate among different tissue types and to evaluate the extension of disease accurately (AU)

Radiology of external ear: indications, normal anatomy, and pathological processes. / Radiología del oído externo: indicaciones, anatomía normal y procesos patológicos.

The external ear is accessible to direct examination; the clinical history and otoscopy are sufficient to diagnose and treat most diseases of the external ear. We aim to describe the normal anatomy of the external ear, specify the indications for imaging tests, and review the clinical and radiological manifestations of the most common diseases affecting the external ear. We classify these diseases according to their origin into congenital, inflammatory, infectious, or traumatic disease or benign bone tumors or malignant tumors. Imaging does not play an important role in diseases of the external ear, but in certain clinical scenarios it can be crucial for reaching a concrete diagnosis and establishing the best treatment. Computed tomography is the first-choice technique for most diseases. Magnetic resonance imaging complements computed tomography and makes it possible to differentiate among different tissue types and to evaluate the extension of disease accurately.

Dental flat panel conebeam CT in the evaluation of patients with inflammatory sinonasal disease: Diagnostic efficacy and radiation dose savings.

BACKGROUND AND PURPOSE: CT is the imaging modality of choice to study the paranasal sinuses; unfortunately, it involves significant radiation dose. Our aim was to assess the diagnostic validity, image quality, and radiation-dose savings of dental conebeam CT in the evaluation of patients with suspected inflammatory disorders of the paranasal sinuses. MATERIAL AND METHODS: We prospectively studied 40 patients with suspected inflammatory disorders of the sinuses with dental conebeam CT and standard CT. Two radiologists analyzed the images independently, blinded to clinical information. The image quality of both techniques and the diagnostic validity of dental conebeam CT compared with the reference standard CT were assessed by using 3 different scoring systems. Image noise, signal-to-noise ratio, and contrast-to-noise ratio were calculated for both techniques. The absorbed radiation dose to the lenses and thyroid and parotid glands was measured by using a phantom and dosimeter chips. The effective radiation dose for CT was calculated. RESULTS: All dental conebeam CT scans were judged of diagnostic quality. Compared with CT, the conebeam CT image noise was 37.3% higher (P < .001) and the SNR of the bone was 75% lower (P < .001). The effective dose of our conebeam CT protocol was 23 µSv. Compared with CT, the absorbed radiation dose to the lenses and parotid and thyroid glands with conebeam CT was 4%, 7.8%, and 7.3% of the dose delivered to the same organs by conventional CT (P < .001). CONCLUSIONS: Dental conebeam CT is a valid imaging procedure for the evaluation of patients with inflammatory sinonasal disorders.

Angiopatía amiloide inflamatoria / Inflammatory amyloid angiopathy

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Large choledochocoele: difficulties in radiological diagnosis.

BACKGROUND: A choledochocoele is a dilatation of the intramural portion of the distal common bile duct within the duodenal wall. It usually presents with recurrent crises of right upper quadrant pain, hyperamylasaemia or jaundice. MATERIALS AND METHODS: We present a 12-year-old boy with a choledochocoele that was missed on several US examinations despite its large size. RESULTS: Findings on US, IV cholangiography, upper gastrointestinal contrast studies, ERCP and surgery are shown. The histological findings as well as the usual differential diagnosis are discussed.

Idiopathic progressive osteolysis of craniofacial bones.

We present the case report of a diabetic 51-year-old male, who presented with painless mobilization of the superior incisor teeth. The X-ray study showed osteolysis, without any soft tissue mass, in craniofacial and orbital bones. In the control X-ray studies performed during the 2 years' evolution, a progressive increase in the intensity and extension of the osteolysis was observed. The diagnosis of progressive idiopathic osteolysis is one of exclusion, based mainly on clinico-radiological findings, evolution and compatible histological findings.

Plasma cell granuloma of the lung in childhood: atypical radiologic findings and association with hypertrophic osteoarthropathy.

Three cases of pulmonary plasma cell granuloma in the pediatric age group are presented. Although rare, it is the most frequent primary lung tumor in childhood. In two of the cases, there was a close adherence between the tumor and the surrounding mediastinal structures and diaphragm, a very uncommon feature in these tumors. In the other case, plasma cell granuloma of the lung was seen in association with a clinical-radiological picture of hypertrophic osteoarthropathy, which resolved after excision of the mass. Such an association has not, to date, been reported in the literature, and could constitute an additional finding useful in the differential diagnosis of primary lung tumors in childhood. The literature concerning this issue has been reviewed.