Strengths, weaknesses, opportunities, and threat analysis of dual-energy CT in head and neck imaging.

Technological development of dual-energy computed tomography (DECT) can play an important role in head and neck area. Multiple innovative applications have evolved, optimizing images, achieving metallic artifact reduction, differentiating materials with better primary tumor delineation, thyroid cartilage and bone invasion. Furthermore, quantification algorithms allow measuring iodine concentration, reflecting the blood supply of a lesion indirectly. DECT enables acquiring images with lower radiation doses and iodine intravenous contrast load to obtain the same CT values.. However, DECT uses ionizing radiation, which does not occur with MRI, and requires long post-processing times. Artifacts on iodine maps may be a potential source of pseudolesions. Besides, photon-counting CT scanners are a promising technique that may displace some DECT advantages. A review analyzing the current status of DECT applied to head and neck imaging from the scope of strengths, weaknesses, opportunities, and threatsanalysis would be very interesting to facilitate a realistic, fact-based, data-driven look of this technique.

Análisis de las fortalezas, oportunidades, debilidades y amenazas de la tomografía computarizada de doble energía en el diagnóstico por la imagen de la cabeza y el cuello / Strengths, weaknesses, opportunities, and threat analysis of dual-energy CT in head and neck imaging

El desarrollo tecnológico de la tomografía computarizada de energía dual (TCED) en el área de la cabeza y el cuello ha supuesto un avance importante, ya que se han desarrollado múltiples aplicaciones para optimizar las imágenes y reducir los artefactos metálicos, así como para diferenciar los materiales, permitiendo una mejor delineación del tumor primario, del cartílago tiroideo y la invasión ósea. Además, los algoritmos de cuantificación permiten medir la concentración de yodo, lo que refleja el flujo de sangre que llega a una lesión de forma indirecta. Permite adquirir imágenes con menores dosis de radiación y menor cantidad de contraste yodado para obtener los mismos valores de TC. Sin embargo, utiliza radiaciones ionizantes y el posprocesamiento de las imágenes consume tiempo, y los artefactos en los mapas de yodo pueden suponer una fuente potencial de pseudolesiones. Además, los escáneres de TC con tecnología de recuento de fotones son una técnica prometedora que puede desplazar algunas de las ventajas de la TCED.Esta revisión hace un análisis de la TCED aplicada a las imágenes de cabeza y cuello desde el ámbito del análisis de las fortalezas, oportunidades, debilidades y amenazas para facilitar una visión realista, basada en datos, de esta técnica.(AU)

Technological development of dual-energy computed tomography (DECT) can play an important role in head and neck area. Multiple innovative applications have evolved, optimizing images, achieving metallic artifact reduction, differentiating materials with better primary tumor delineation, thyroid cartilage and bone invasion. Furthermore, quantification algorithms allow measuring iodine concentration, reflecting the blood supply of a lesion indirectly.DECT enables acquiring images with lower radiation doses and iodine intravenous contrast load to obtain the same CT values. However, DECT uses ionizing radiation, which does not occur with MRI, and requires long post-processing times. Artifacts on iodine maps may be a potential source of pseudolesions. Besides, photon-counting CT scanners are a promising technique that may displace some DECT advantages.A review analyzing the current status of DECT applied to head and neck imaging from the scope of strengths, weaknesses, opportunities, and threatsanalysis would be very interesting to facilitate a realistic, fact-based, data-driven look of this technique.(AU)

Nódulo pulmonar incidental: caracterización y manejo / Incidental pulmonary nodules: characterization and management

En esta actualización se aborda el manejo de los nódulos pulmonares, solitarios o múltiples, detectados incidentalmente en estudios radiológicos que se realizan por otros motivos. Se describe la técnica de tomografía computarizada más adecuada para su evaluación, y cómo se clasifican y se miden los diferentes tipos de nódulos. También se revisan los criterios que permiten establecer el riesgo de malignidad, tanto asociados al paciente como a las características del nódulo, y, por último, las recomendaciones de manejo y seguimiento para cada tipo de nódulo en función del tamaño y el riesgo de malignidad, siguiendo fundamentalmente las guías recientemente publicadas por la Sociedad Fleischner

This update covers the management of solitary or multiple pulmonary nodules detected incidentally in imaging studies done for other reasons. It describes the most appropriate computed tomography technique for the evaluation of these nodules, how they are classified, and how the different types of nodules are measured. It also reviews the patient-related and nodule-related criteria for determining the risk of malignancy. It discusses the recommendations in the guidelines recently published by the Fleischner Society for the management and follow-up of each type of nodules according to its size and risk of malignancy

Seudocavitación en las neoplasias de pulmón. ¿Permite predecir el diagnóstico de adenocarcinoma con crecimiento lepídico? / Can pseudocavitation in lung tumors predict the diagnosis of adenocarcinoma with lepidic growth?

OBJETIVO: Evaluar la prevalencia de seudocavitación en las neoplasias de pulmón y si permite predecir el diagnóstico del adenocarcinoma con crecimiento lepídico. MATERIAL Y MÉTODOS: Revisión retrospectiva de las tomografías computarizadas (TC) de tórax de 212 neoplasias de pulmón consecutivas incluidas en una base de datos de perfusión por TC y de 351 adenocarcinomas consecutivos diagnosticados entre julio de 2007 y septiembre de 2017. Dos radiólogos recogieron la presencia o ausencia de quistes aéreos en el tumor sin conocer los resultados de anatomía patológica, excluyendo las lesiones con necrosis, rodeadas de bullas o enfisema. Se analizó si la presencia de seudocavitación tenía relación con el tipo histológico, el tamaño de la lesión y la positividad para el receptor del factor de crecimiento epidérmico (EGFR) del tumor, la edad y el sexo del paciente. También se valoró la relación con el subtipo histológico del adenocarcinoma en aquellos pacientes sometidos a cirugía. Se utilizó la prueba de la χ2 para variables cualitativas y el modelo de regresión logística para variables cuantitativas. RESULTADOS: El 15% de las neoplasias presentaron seudocavitación, que fue significativamente más frecuente en los adenocarcinomas (24,1%), p = 0,003, si bien también se observó en el 9,8% de los carcinomas epidermoides y en el 3% de los carcinomas microcíticos. Presentó una especificidad del 92,4% para predecir el diagnóstico del adenocarcinoma, con una sensibilidad del 24%, un valor predictivo positivo (VPP) del 73,3%, un valor predictivo negativo del 58,4% y una precisión del 37,6%. En los adenocarcinomas resecados, el 65% de los tumores con seudocavitación presentaron crecimiento lepídico con una prevalencia del 40,6% en lepídicos, 31,5% en acinares y 33% en papilares. Fue significativamente más frecuente en mujeres (29%) y no se encontraron diferencias en función de la edad, tamaño y positividad para EGFR. CONCLUSIONES: La seudocavitación es más frecuente en los adenocarcinomas con crecimiento lepídico y en mujeres

OBJECTIVE: To determine the prevalence of pseudocavitation in lung tumors and whether its presence makes it possible to predict the diagnosis of adenocarcinoma with lepidic growth. MATERIAL AND METHODS: We retrospectively reviewed chest CT studies for 212 consecutive lung tumors included in a CT perfusion database and for 351 consecutive adenocarcinomas diagnosed between July 2007 and September 2017. Two radiologists blinded to the pathology report determined whether air cysts were present in the tumors, excluding lesions with necrosis and those surrounded by bullae or emphysema. We analyzed whether the presence of pseudocavitation was associated with the histologic type, size, or EGFR positivity of the tumor as well as with the age or sex of the patient. We also evaluated the relationship with the histologic subtype of the tumor in patients who underwent surgery. We used the chi-square test for categorical variables and logistic regression for continuous variables. RESULTS: Pseudocavitation was present in 15% of the tumors and was significantly more common in adenocarcinomas (24.1%), p = 0.003, although it was also observed in 9.8% of the epidermoid carcinomas and in 3% of the microcytic carcinomas. For the diagnosis of adenocarcinoma, the presence of pseudocavitation yielded 92.4% specificity, 24% sensitivity, 73.3% PPV, 58.4% NPV, and 37.6% accuracy. In the resected adenocarcinomas, 65% of the tumors with pseudocavitation had lepidic growth; the prevalence of pseudocavitation was 40.6% in tumors with lepidic growth, 31.5% in those with acinar growth, and 33% in those with papillary growth. Pseudocavitation was significantly more common in women (29%); no differences were found with respect to age, size, or EGFR positivity. CONCLUSIONS: Pseudocavitation is more common in adenocarcinomas with lepidic growth and in women

Incidental pulmonary nodules: characterization and management. / Nódulo pulmonar incidental: caracterización y manejo.

This update covers the management of solitary or multiple pulmonary nodules detected incidentally in imaging studies done for other reasons. It describes the most appropriate computed tomography technique for the evaluation of these nodules, how they are classified, and how the different types of nodules are measured. It also reviews the patient-related and nodule-related criteria for determining the risk of malignancy. It discusses the recommendations in the guidelines recently published by the Fleischner Society for the management and follow-up of each type of nodules according to its size and risk of malignancy.

Can pseudocavitation in lung tumors predict the diagnosis of adenocarcinoma with lepidic growth? / Seudocavitación en las neoplasias de pulmón. ¿Permite predecir el diagnóstico de adenocarcinoma con crecimiento lepídico?

OBJECTIVE: To determine the prevalence of pseudocavitation in lung tumors and whether its presence makes it possible to predict the diagnosis of adenocarcinoma with lepidic growth. MATERIAL AND METHODS: We retrospectively reviewed chest CT studies for 212 consecutive lung tumors included in a CT perfusion database and for 351 consecutive adenocarcinomas diagnosed between July 2007 and September 2017. Two radiologists blinded to the pathology report determined whether air cysts were present in the tumors, excluding lesions with necrosis and those surrounded by bullae or emphysema. We analyzed whether the presence of pseudocavitation was associated with the histologic type, size, or EGFR positivity of the tumor as well as with the age or sex of the patient. We also evaluated the relationship with the histologic subtype of the tumor in patients who underwent surgery. We used the chi-square test for categorical variables and logistic regression for continuous variables. RESULTS: Pseudocavitation was present in 15% of the tumors and was significantly more common in adenocarcinomas (24.1%), p=0.003, although it was also observed in 9.8% of the epidermoid carcinomas and in 3% of the microcytic carcinomas. For the diagnosis of adenocarcinoma, the presence of pseudocavitation yielded 92.4% specificity, 24% sensitivity, 73.3% PPV, 58.4% NPV, and 37.6% accuracy. In the resected adenocarcinomas, 65% of the tumors with pseudocavitation had lepidic growth; the prevalence of pseudocavitation was 40.6% in tumors with lepidic growth, 31.5% in those with acinar growth, and 33% in those with papillary growth. Pseudocavitation was significantly more common in women (29%); no differences were found with respect to age, size, or EGFR positivity. CONCLUSIONS: Pseudocavitation is more common in adenocarcinomas with lepidic growth and in women.

Defectos de perfusión en el mapa de iodo pulmonar: causas y semiología / Perfusion defects in pulmonary perfusion iodine maps: causes and semiology

Objetivo: Describir la utilidad de la tomografía computarizada con energía dual (TCED) en la obtención de mapas de perfusión pulmonar para aportar información morfológica y funcional en el tromboembolismo pulmonar (TEP). Revisar la semiología de los defectos de perfusión debidos a TEP y diferenciarlos de los defectos no debidos a TEP que son alteraciones que quedan fuera del rango utilizado en el mapa de iodo y están causados por otras enfermedades del parénquima pulmonar o por artefactos. Conclusión: La angiografía por TC de las arterias pulmonares es la técnica de elección en el diagnóstico de TEP. Las nuevas TC con energía dual son útiles para detectar defectos de perfusión secundarios a obstrucción completa o parcial de las arterias pulmonares, y tiene su mayor utilidad en la detección de TEP en ramas subsegmentarias

Objective: to describe the usefulness of dual-energy CT for obtaining pulmonary perfusion maps to provide morphological and functional information in patients with pulmonary embolisms. To review the semiology of perfusion defects due to pulmonary embolism so they can be differentiated from perfusion defects due to other causes: alterations outside the range used in the iodine map caused by other diseases of the lung parenchyma or artifacts. Conclusion: CT angiography of the pulmonary arteries is the technique of choice for the diagnosis of pulmonary embolisms. New dual-energy CT scanners are useful for detecting perfusion defects secondary to complete or partial obstruction of pulmonary arteries and is most useful for detecting pulmonary embolisms in subsegmental branches

Perfusion defects in pulmonary perfusion iodine maps: causes and semiology. / Defectos de perfusión en el mapa de iodo pulmonar: causas y semiología.

OBJECTIVE: to describe the usefulness of dual-energy CT for obtaining pulmonary perfusion maps to provide morphological and functional information in patients with pulmonary embolisms. To review the semiology of perfusion defects due to pulmonary embolism so they can be differentiated from perfusion defects due to other causes: alterations outside the range used in the iodine map caused by other diseases of the lung parenchyma or artifacts. CONCLUSION: CT angiography of the pulmonary arteries is the technique of choice for the diagnosis of pulmonary embolisms. New dual-energy CT scanners are useful for detecting perfusion defects secondary to complete or partial obstruction of pulmonary arteries and is most useful for detecting pulmonary embolisms in subsegmental branches.

Tomografía computarizada de pitch alto en estudios de triple descarte: dosis de radiación y calidad de la imagen comparada con la de la tomografía computarizada multidetector / High pitch CT in triple rule-out studies: radiation dose and image quality compared to multidetector CT

Objetivo. Comparar la calidad de imagen y dosis de radiación de la TC de doble fuente (128-TCDF) con pitch alto y la adquisición retrospectiva con TC de 64 filas de detectores (64-TCMD) en estudios de triple descarte. Material y métodos. Estudiamos retrospectivamente 60 pacientes con dolor torácico agudo: 30 con una adquisición ECG-retrospectiva con 64-TCMD y 30 con 128-TCDF y pitch alto. Analizamos cuantitativamente la calidad de la imagen calculando la densidad vascular (DV), densidad muscular (DM), ruido y cocientes densidad vascular/ruido (CDVR) y contraste/ruido (CCR). Valoramos cualitativamente los artefactos en la vena cava, aorta y coronarias. Calculamos la dosis de radiación efectiva estimada (DRE) con el producto dosis-longitud. Resultados. No hubo diferencias significativas en la DV. Con 128-TCDF los CDVR y CCR fueron mayores en la aorta (CDVR: 28,9 ± 11,7 y 20 ± 5,5; CCR: 24,4 ± 10,9 y 16,8 ± 5,4; p < 0,01), arterias pulmonares (CDVR: 25,5 ± 10 y 20,6 ± 6,5; CCR: 24,5 ± 5,4 y 17,4 ± 6,4; p < 0,01) y coronarias (CDVR: 25,9 ± 8,2 y 18,9 ± 4,9; CCR: 24,9 ± 8,2 y 15,6 ± 4,6; p < 0,01). Los artefactos coronarios (3 y 34 segmentos no diagnósticos p < 0,001) y la DRE (13,77 ± 4 y 2,77 ± 0,6 mSv; p < 0,001) fueron menores con 128-TCDF. Conclusión. El pitch alto en el triple descarte disminuye la dosis de radiación y mejora la calidad de la imagen con respecto a la adquisición retrospectiva con 64-TCMD (AU)

Objective. To compare the image quality and radiation dose from high pitch dual source CT (128-DSCT) versus those from retrospective acquisition with 64-row multidetector CT (64-MDCT) in triple rule-out studies. Material and methods. We retrospectively studied 60 patients with acute chest pain: 30 with a retrospective EKG acquisition with 64-MDCT and 30 with high pitch 128-DSCT. We quantitatively analyzed the image quality by calculating the vascular density, muscular density (DM), noise, vascular density/noise ratio (VDNR), and contrast/noise ratio (CNR). We qualitatively evaluated the artifacts in the vena cava, aorta, and coronary arteries. We estimated the effective dose (ED) of radiation by means of the dose-length product. Results. There were no significant differences between 128-DSCT and 64-MDCT in the vascular density. The VDNR and CNR were higher on 128-DSCT than on 64-MDCT in the aorta (VDNR: 28.9 ± 11.7 vs. 20 ± 5.5; CNR: 24.4 ± 10.9 vs. 16.8 ± 5.4; P < .01), in the pulmonary arteries (VDNR: 25.5 ± 10 vs. 20.6 ± 6.5; CNR: 24.5 ± 5.4 vs. 17.4 ± 6.4; P < .01), and in the coronary arteries (VDNR: 25.9 ± 8.2 vs. 18.9 ± 4.9; CNR: 24.9 ± 8.2 vs. 15.6 ± 4.6; P < .01). There were fewer artifacts in the coronary arteries on 128-DSCT than on 64-MDCT (3 vs. 34 nondiagnostic segments; P < .001), and the ED in 128-DSCT was lower than in 64-MDCT (13.77 ± 4 vs. 2.77 ± 0.6 mSv; P < .001). Conclusion. In triple rule-out studies, high pitch 128-DSCT delivers a lower dose of radiation and provides better image quality than retrospective acquisition with 64-MDCT (AU)

High pitch CT in triple rule-out studies: Radiation dose and image quality compared to multidetector CT.

OBJECTIVE: To compare the image quality and radiation dose from high pitch dual source CT (128-DSCT) versus those from retrospective acquisition with 64-row multidetector CT (64-MDCT) in triple rule-out studies. MATERIAL AND METHODS: We retrospectively studied 60 patients with acute chest pain: 30 with a retrospective EKG acquisition with 64-MDCT and 30 with high pitch 128-DSCT. We quantitatively analyzed the image quality by calculating the vascular density, muscular density (DM), noise, vascular density/noise ratio (VDNR), and contrast/noise ratio (CNR). We qualitatively evaluated the artifacts in the vena cava, aorta, and coronary arteries. We estimated the effective dose (ED) of radiation by means of the dose-length product. RESULTS: There were no significant differences between 128-DSCT and 64-MDCT in the vascular density. The VDNR and CNR were higher on 128-DSCT than on 64-MDCT in the aorta (VDNR: 28.9 ± 11.7 vs. 20 ± 5.5; CNR: 24.4 ± 10.9 vs. 16.8 ± 5.4; P<.01), in the pulmonary arteries (VDNR: 25.5 ± 10 vs. 20.6 ± 6.5; CNR: 24.5 ± 5.4 vs. 17.4 ± 6.4; P<.01), and in the coronary arteries (VDNR: 25.9 ± 8.2 vs. 18.9 ± 4.9; CNR: 24.9 ± 8.2 vs. 15.6 ± 4.6; P<.01). There were fewer artifacts in the coronary arteries on 128-DSCT than on 64-MDCT (3 vs. 34 nondiagnostic segments; P<.001), and the ED in 128-DSCT was lower than in 64-MDCT (13.77 ± 4 vs. 2.77 ± 0.6 mSv; P<.001). CONCLUSION: In triple rule-out studies, high pitch 128-DSCT delivers a lower dose of radiation and provides better image quality than retrospective acquisition with 64-MDCT.

Comparación de la calidad de imagen y dosis de radiación en angio-tomografía computarizada de arterias periféricas con 80 y 100 kV / Comparison of image quality and radiation dose in computed tomography angiography of the peripheral arteries using tube voltage of 80 kV versus 100 kV

Objetivo. Comparar la calidad de imagen y la dosis de radiación en 2 grupos de pacientes a los que se realiza angio-TC de extremidades inferiores con 80 y 100 kV. Material y métodos. Se realizó angio-TC de miembros inferiores a 60 pacientes con sospecha de enfermedad arterial periférica aleatorizados en 2 grupos, en uno la TC se realizó con 80 kV y en el otro con 100 kV. Los demás parámetros de adquisición se mantuvieron constantes. Se analizaron las imágenes cuantificando la densidad vascular (DV) y el ruido (R), y se calcularon los cocientes densidad vascular/ruido (CDVR) y contraste/ruido (CCR). Dos radiólogos evaluaron independientemente la calidad subjetiva de las imágenes. Se calculó la dosis efectiva estimada (DEE) basada en el producto dosis-longitud (DLP). Resultados. El grupo de 80 kV presentó valores significativamente más elevados de la DV (462,5 UH ± 95,6 vs. 372 UH ± 100,9; p < 0,001) y del CDVR (241,9 ± 48,1 vs. 194,3 ± 49,6; p < 0,001) y diferencias no significativas del R (21,3 UH ± 13 vs. 16,3 UH ± 3,5; p = 0,098) y el CCR (21,4 ± 12,1 vs. 22,9 ± 9,1; p = 0,15). No hubo diferencias significativas en la calidad subjetiva de la imagen y la dosis efectiva fue significativamente menor en el grupo de 80 kV (4,73 mSv ± 1,1 vs. 9,6 mSv ± 2,2; p < 0,001). Conclusión. La utilización de 80 kV en el estudio de angio-TC de miembros inferiores disminuye la dosis de radiación sin afectar a la eficacia diagnóstica del estudio respecto a la utilización de 100 kV (AU)

Objective. To compare the image quality and dose of radiation in two groups of patients undergoing CT angiography of the lower limbs, one with tube voltage of 80 kV and the other with tube voltage of 100 kV. Material and methods. We performed CT angiography of the lower limbs in 60 patients with suspected peripheral arterial disease. Patients were randomly assigned to one of two groups; in one group, CT angiography was performed using a tube voltage of 80 kV, whereas in the other it was performed using 100 kV. The remaining acquisition parameters were the same in both groups. The images were analyzed by quantifying vascular density (VD) and noise (N) and by calculating the quotients density/noise (QVDN) and contrast/noise (QCN). Two radiologists working independently evaluated the subjective quality of the images. We calculated the estimated effective dose (EED) based on the dose-length product (DLP). Results. In the group studied at 80 kV, VD was significantly higher (462.5 UH ± 95.6 vs. 372 UH ± 100.9; P <. 001), QVDN was significantly higher (241.9 ± 48.1 vs. 194.3 ± 49.6; P < .001), and there were trends toward higher N (21.3 UH ± 13 vs. 16.3 UH ± 3.5; P = .098) and toward higher QCN (21.4 ± 12.1 vs. 22.9 ± 9.1; P = .15). No significant differences were found in the subjective quality of the images. The EED was significantly lower in the group studied at 80 kV (4.73 mSv ± 1.1 vs. 9.6 mSv ± 2.2; P <. 001). Conclusion. Using 80 kV instead of 100 kV for CT angiography of the lower limbs reduces the dose of radiation without affecting the diagnostic efficacy of the study (AU)

Comparison of image quality and radiation dose in computed tomography angiography of the peripheral arteries using tube voltage of 80 kV versus 100 kV.

OBJECTIVE: To compare the image quality and dose of radiation in two groups of patients undergoing CT angiography of the lower limbs, one with tube voltage of 80 kV and the other with tube voltage of 100 kV. MATERIAL AND METHODS: We performed CT angiography of the lower limbs in 60 patients with suspected peripheral arterial disease. Patients were randomly assigned to one of two groups; in one group, CT angiography was performed using a tube voltage of 80kV, whereas in the other it was performed using 100 kV. The remaining acquisition parameters were the same in both groups. The images were analyzed by quantifying vascular density (VD) and noise (N) and by calculating the quotients density/noise (QVDN) and contrast/noise (QCN). Two radiologists working independently evaluated the subjective quality of the images. We calculated the estimated effective dose (EED) based on the dose-length product (DLP). RESULTS: In the group studied at 80 kV, VD was significantly higher (462.5 UH ± 95.6 vs. 372 UH ± 100.9; P<.001), QVDN was significantly higher (241.9 ± 48.1 vs. 194.3 ± 49.6; P<.001), and there were trends toward higher N (21.3 UH ± 13 vs. 16.3 UH ± 3.5; P=.098) and toward higher QCN (21.4 ± 12.1 vs. 22.9 ± 9.1; P=.15). No significant differences were found in the subjective quality of the images. The EED was significantly lower in the group studied at 80 kV (4.73 mSv ± 1.1 vs. 9.6 mSv ± 2.2; P<.001). CONCLUSION: Using 80 kV instead of 100 kV for CT angiography of the lower limbs reduces the dose of radiation without affecting the diagnostic efficacy of the study.

Silicosis pulmonar: hallazgos radiológicos en la tomografía computarizada / Silicosis: computed tomography findings

La silicosis es una enfermedad pulmonar ocupacional, causada por la inhalación de sílice, que afecta a un amplio abanico de profesiones. Existen varias formas clínicas. La silicosis aguda, que resulta de la exposición a cantidades muy grandes de sílice en un período inferior a 2 años. La silicosis crónica simple, el tipo más frecuente que podemos ver en la actualidad, resulta de la exposición a bajas cantidades de sílice durante un período de entre 2 y 10 años. La silicosis crónica complicada, con conglomerados silicóticos. En muchos casos el diagnóstico se realiza por los datos epidemiológicos y radiológicos, sin confirmación histológica. Es importante conocer las distintas manifestaciones radiológicas de la silicosis para diferenciarla de otras enfermedades pulmonares y reconocer sus posibles complicaciones concomitantes. El objetivo de este trabajo es describir los hallazgos radiológicos, típicos y atípicos, de la silicosis y sus complicaciones en la TC de tórax helicoidal y de alta resolución (TCAR) (AU)

Silicosis is an occupational lung disease, which is caused by the inhalation of silica and affects a wide range of jobs. There are many clinical forms of silicosis: acute silicosis, results from exposure to very large amounts of silica dust over a period of less than 2 years. Simple chronic silicosis, the most common type that we see today, results from exposure to low amounts of silica between 2 and 10 years. Chronic silicosis complicated, with silicotic conglomerates. In many cases the diagnosis of silicosis is made according to epidemiological and radiological data, without a histological confirmation. It is important to know the various radiological manifestations of silicosis to differentiate it from other lung diseases and to recognize their complications. The objective of this work is to describe typical and atypical radiological findings of silicosis and their complications in helical and high resolution (HRCT) thorax CT (AU)

La tomografía computarizada de doble energía: ¿para qué la quiero? / Dual-energy computed tomography: what is it useful for?

La tomografía computarizada con energía dual (TCED) es uno de los campos más novedosos y atractivos en la radiología actual. La posibilidad que tienen los equipos de última generación de adquirir estudios con distintos espectros de rayos X facilita la caracterización de determinados elementos químicos y, se adentra en el campo del análisis funcional al permitir detectar alteraciones funcionales en ausencia de anomalías morfológicas o densitométricas. La capacidad de caracterizar estos elementos está permitiendo generar nuevas aplicaciones en la práctica clínica y modificar nuestra forma de trabajar. El objetivo de este artículo es explicar en qué consisten los estudios de TCED, qué tipos de técnicas existen para realizarlos, cuáles son sus ventajas e inconvenientes y qué se espera de ellos en un futuro (AU)

Dual-energy CT is one of the newest and most attractive fields in radiology today. New generation scanners can acquire datasets with different X-ray spectra, which facilitates the characterization of certain chemical elements, making it possible to detect functional alterations in the absence of morphologic or densitometric anomalies. The capability of characterizing these elements is enabling new applications to be developed for clinical practice and changing the way we work. The aim of this article is to explain what dual-energy CT studies are, the techniques available for performing them, the advantages and disadvantages of these studies, and what we might expect from this field in the future (AU)

[Silicosis: computed tomography findings]. / Silicosis pulmonar: hallazgos radiológicos en la tomografía computarizada.

Silicosis is an occupational lung disease, which is caused by the inhalation of silica and affects a wide range of jobs. There are many clinical forms of silicosis: acute silicosis, results from exposure to very large amounts of silica dust over a period of less than 2 years. Simple chronic silicosis, the most common type that we see today, results from exposure to low amounts of silica between 2 and 10 years. Chronic silicosis complicated, with silicotic conglomerates. In many cases the diagnosis of silicosis is made according to epidemiological and radiological data, without a histological confirmation. It is important to know the various radiological manifestations of silicosis to differentiate it from other lung diseases and to recognize their complications. The objective of this work is to describe typical and atypical radiological findings of silicosis and their complications in helical and high resolution (HRCT) thorax CT.

[Dual-energy computed tomography: what is it useful for?]. / La tomografía computarizada de doble energía: ¿para qué la quiero?

Dual-energy CT is one of the newest and most attractive fields in radiology today. New generation scanners can acquire datasets with different X-ray spectra, which facilitates the characterization of certain chemical elements, making it possible to detect functional alterations in the absence of morphologic or densitometric anomalies. The capability of characterizing these elements is enabling new applications to be developed for clinical practice and changing the way we work. The aim of this article is to explain what dual-energy CT studies are, the techniques available for performing them, the advantages and disadvantages of these studies, and what we might expect from this field in the future.

[Polymyalgia syndrome and atrial myxoma]. / Síndrome polimiálgico y mixoma auricular.

We present a case of polymyalgia-like syndrome in a 62-years-old woman with four month history of severe headache, muscular claudication, asthenia, normochromic, normocytic anaemia and elevation of erytrocyte sedimentation rate. A diagnosis of giant left atrial myxoma was made brought about by thoracoabdominal magnetic resonance. Their surgical exeresis was followed by gradual disappearance of symptoms and normalization of laboratory parameters.