Role and usefulness of mr imaging in the assessment of peritoneal carcinomatosis.

BACKGROUND: For many years, peritoneal carcinomatosis (PC) entitled poor prognosis until the development of the cytoreductive surgery technique associated with hyperthermic intraperitoneal chemotherapy. Imaging of peritoneal carcinomatosis plays an essential role in the diagnosis and management of the patients being considered for cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC). MAIN BODY: The key role of imaging in patients with peritoneal malignancy is to aid surgical decision making. A standardized peritoneal magnetic resonance (MR) imaging protocol, including T2-weighted fat suppressed, diffusion-weighted and gadolinium-enhanced sequences, allows to detect small peritoneal tumours that are often missed on other imaging. A systematic approach to MR imaging and a close collaboration between the radiologist and the oncologic surgeon are key elements for an accurate evaluation of candidate patients for CRS and HIPEC. CONCLUSION: MR imaging provides a powerful tool for accurate preoperative imaging in patients considered for curative surgery and assists the surgeon in evaluating patients for CRS and HIPEC.

Clinical Risk Prediction in Patients With Left Ventricular Myocardial Noncompaction.

BACKGROUND: Left ventricular noncompaction (LVNC) is a heterogeneous entity with uncertain prognosis. OBJECTIVES: This study sought to develop and validate a prediction model of major adverse cardiovascular events (MACE) and to identify LVNC cases without events during long-term follow-up. METHODS: This is a retrospective longitudinal multicenter cohort study of consecutive patients fulfilling LVNC criteria by echocardiography or cardiovascular magnetic resonance. MACE were defined as heart failure (HF), ventricular arrhythmias (VAs), systemic embolisms, or all-cause mortality. RESULTS: A total of 585 patients were included (45 ± 20 years of age, 57% male). LV ejection fraction (LVEF) was 48% ± 17%, and 18% presented late gadolinium enhancement (LGE). After a median follow-up of 5.1 years, MACE occurred in 223 (38%) patients: HF in 110 (19%), VAs in 87 (15%), systemic embolisms in 18 (3%), and 34 (6%) died. LVEF was the main variable independently associated with MACE (P < 0.05). LGE was associated with HF and VAs in patients with LVEF >35% (P < 0.05). A prediction model of MACE was developed using Cox regression, composed by age, sex, electrocardiography, cardiovascular risk factors, LVEF, and family aggregation. C-index was 0.72 (95% confidence interval: 0.67-0.75) in the derivation cohort and 0.72 (95% confidence interval: 0.71-0.73) in an external validation cohort. Patients with no electrocardiogram abnormalities, LVEF ≥50%, no LGE, and negative family screening presented no MACE at follow-up. CONCLUSIONS: LVNC is associated with an increased risk of heart failure and ventricular arrhythmias. LVEF is the variable most strongly associated with MACE; however, LGE confers additional risk in patients without severe systolic dysfunction. A risk prediction model is developed and validated to guide management.

Diagnostic and prognostic value of cardiac imaging in amyloidosis.

Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years. Different types of amyloidosis can affect the heart. Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis. These entities have a poor prognosis, so accurate diagnostic techniques are imperative for determining an early therapeutic approach. Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to histological confirmation, such as endomyocardial biopsy. We performed a review on the diagnostic and prognostic implications of different cardiac imaging techniques in cardiac amyloidosis. We mainly focus on reviewing echocardiography, cardiac magnetic resonance, computed tomography and nuclear imaging techniques and the different safety measurements that can be done with each of them.

Síndromes de Jarcho-Levin y Rokitansky. Una excepcional asociación / Jarcho-Levin and Rokitansky syndromes. An excepcional association

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Surface primary bone tumors: Systematic approach and differential diagnosis.

Surface primary bone tumors may appear similar to their intramedullary counterpart, but because they are rare, they may pose diagnostic challenges when showing different characteristics compared to their intramedullary counterpart. It is important for radiologists to recognize the imaging findings for various uncommon surface primary bone tumors, which may help to reduce the differential diagnosis or to lead to a specific diagnosis. Radiography is typically used for first-line imaging. If necessary, it is followed by CT or MRI for evaluation and characterization of surface bone tumors. The aim of this article is to review the imaging findings and differential diagnosis for surface primary bone tumors.

Conocimientos básicos necesarios para realizar resonancia magnética en cardiología / Basic knowledge needed for using magnetic resonance imaging in cardiology

La resonancia magnética es ya una técnica diagnóstica utilizada de forma sistemática por los cardiólogos. Su demostrada utilidad y superioridad frente a otras técnicas de imagen en el estudio de la cardiopatía isquémica es, muy probablemente, la causa del gran interés que ha despertado en los últimos años. La cuantificación de la función ventricular global y segmentaria, de la perfusión miocárdica y de la viabilidad ha hecho que con una sola técnica pueda valorarse de forma completa al paciente con cardiopatía isquémica. Sin embargo, muchos aspectos básicos de la resonancia magnética siguen siendo desconocidos para una amplia mayoría. En este trabajo exponemos sus fundamentos, componentes del equipo, distintas secuencias, utilización de contrastes, seguridad y contraindicaciones (AU)

Magnetic resonance imaging is routinely employed for diagnosis in cardiology. Its proven usefulness and superior imaging ability in ischemic heart disease probably explain the increasing attention it has received in the last decade. Its ability to quantify global and regional ventricular function as well as myocardial perfusion and viability means that it is possible to carry out a thorough evaluation of the patient using just one technique. Nevertheless, many basic features of magnetic resonance imaging are unknown to clinicians. In this article, we describe the fundamental principles of the technique, technical details of the equipment, the different imaging sequences used, the use of contrast, safety, and contraindications (AU)

Guías de práctica clínica de la Sociedad Española de Cardiología en resonancia magnética / Guidelines of the Spanish Society of Cardiology on magnetic resonance

En este documento se ofrece una amplia perspectiva de las aplicaciones cardíacas de la resonancia magnética, incluyendo aspectos técnicos sobre su práctica, recomendaciones para el entrenamiento del personal médico, y una relación de indicaciones aceptadas, que son ampliamente comentadas en el texto (AU)