RADIOLOGIA最新文献

{"title":"Implantación de un protocolo de angio-TC coronaria basado en el índice de masa corporal: reducción de dosis, calidad de imagen y rendimiento diagnóstico","authors":"H. Cuellar-Calabria ,&nbsp;G. Burcet ,&nbsp;M.S. Juarez-Garcia ,&nbsp;J.L. Reyes-Juárez ,&nbsp;M.N. Pizzi ,&nbsp;S. Aguadé-Bruix ,&nbsp;A. Roque","doi":"10.1016/j.rx.2022.01.016","DOIUrl":"https://doi.org/10.1016/j.rx.2022.01.016","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the relation between the coronary calcium score and the posterior choice of kilovoltage according to radiologists’ criteria in a standard coronary CT angiography protocol to rule out coronary disease.</p><p>To quantify the reduction in ionizing radiation after linking kilovoltage to patients’ body mass index in a low-dose protocol with iterative model reconstruction.</p><p>To evaluate the image quality and diagnostic performance of the low-dose protocol.</p></div><div><h3>Material and methods</h3><p>We compared anthropometric characteristics, calcium score, kilovoltage levels, size-specific dose estimates (SSDE), and the dose-length product (DLP) between a group of 50 patients who were prospectively recruited to undergo coronary CT angiography with a low-dose protocol and a historical group of 50 patients who underwent coronary CT angiography with the standard protocol. We correlated these parameters, the number of coronary segments that could not be evaluated with and without temporal padding, the attenuation, and the signal-to-noise ratio in the ascending aorta in the low-dose protocol with excellent imaging quality according to a semiquantitative scale. To calculate the diagnostic performance per patient, we used 24-month clinical follow-up including all tests as the gold standard.</p></div><div><h3>Results</h3><p>In the standard protocol, the presence of coronary calcium correlated with the selection of high kilovoltage (P<!--> <!-->=<!--> <!-->0.02); this correlation was not found in the low-dose protocol (P<!--> <!-->=<!--> <!-->0.47). Median values of SSDE and DLP were significantly (P&lt;<!--> <!-->0.001) lower and less dispersed in the low-dose protocol [9.22 mGy (IQR 7.84-12.1 mGy) vs. 26.5 mGy (IQR 21.3-36.3 mGy) in the standard protocol] and [97<!--> <!-->mGy*cm (IQR 78-134<!--> <!-->mGy*cm) vs. 253<!--> <!-->mGy*cm (IQR 216-404<!--> <!-->mGy*cm) in the standard protocol], respectively.</p><p>The overall quality of the images obtained with the low-dose protocol was considered good or excellent in 96% of the studies. The parameters associated with image quality in a multivariable model (C statistic<!--> <!-->=<!--> <!-->0.792) were heart rate (estimated coefficient, -0,12 [95% confidence interval: -0.2, -0.04]; P&lt;<!--> <!-->0.01) and the SSDE (estimated coefficient, -0,26 [95% confidence interval: -0.51, -0.01]; P&lt;<!--> <!-->0.05).</p><p>The CAD-RADS modifier for a not fully evaluable or diagnostic study was used on two occasions (4%); the final measures for the diagnosis of coronary disease were sensitivity 100%, specificity 94%, and efficacy 94%.</p></div><div><h3>Conclusions</h3><p>In the standard protocol, the radiologist selects higher kilovoltage for CT angiography studies for patients whose previous calcium score indicates the presence of coronary calcium. In the low-dose protocol, linking kilovoltage with body mass index enables the dose of radiation to be reduced by 65% while obtain","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139419343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteraciones pulmonares persistentes tras 18 meses de neumonía por SARS-CoV-2","authors":"C. Valenzuela ,&nbsp;L. de la Fuente ,&nbsp;S. Hernández ,&nbsp;M.J. Olivera ,&nbsp;C. Molina ,&nbsp;N. Montes ,&nbsp;C. Benavides ,&nbsp;P. Caballero","doi":"10.1016/j.rx.2023.10.002","DOIUrl":"10.1016/j.rx.2023.10.002","url":null,"abstract":"<div><h3>Objective</h3><p>To describe persistent pulmonary abnormalities detected on HRCT after 18<!--> <!-->months of SARS-CoV-2 pneumonia, and to determine their extension and correlation with pulmonary function.</p></div><div><h3>Patients and methods</h3><p>A prospective cross-sectional study with an initial cohort of 90 patients in follow-up due to persisting lung abnormalities on imaging, functional respiratory impairment and/or respiratory symptoms. Of these, 31 (34%) were selected for analysis due to the persistence of their lung abnormalities on HRCT at 18 months after infection. A double reading was performed for each HRCT (62 observations).</p></div><div><h3>Results</h3><p>Of the 31 patients included: 20 (65%) were men; mean age was 67<!--> <!-->years; 17 (55%) were smokers/ex-smokers. The mean hospitalisation time was 38<!--> <!-->days. Eighteen (58%) patients were admitted to intensive care units. Five patients (16%) suffered an acute pulmonary thromboembolism and three (9.7%) had a pneumothorax. The mean time between the onset of pneumonia and the follow-up HRCT was 20.34 months. Extension of total pulmonary abnormalities, ground-glass opacities and reticulation was 19%, 12% and 4.5% respectively. The findings of the 62 readings were: ground-glass opacities (100%), reticulation (83%), subpleural curvilinear lines (62%), parenchymal bands (34%), traction bronchiectasis (69%), displacement of vessels/fissures (46%) and honeycombing (4.9%). Pulmonary function 18<!--> <!-->months after the acute episode revealed a mean FVC of 92% of predicted value, with an FVC &lt;<!--> <!-->80% of predicted value in 11 patients (35.4%). Mean DLCO was 71% of predicted value, with a DLCO &lt;<!--> <!-->80% in 22 patients (70%). We observed a statistically significant relationship between total extension of abnormalities on HRCT and FVC (<em>P</em> <!-->&lt;<!--> <!-->.05), and a trend towards statistical significance with DLCO (<em>P</em> <!-->=<!--> <!-->.051); there was a statistically significant relationship between the presence of ground-glass opacities and FEV1/FVC (<em>P</em> <!-->&lt;<!--> <!-->.01). The relationships between reticulation and FVC, FVC%, FEV1, FEV1% and DLCO% were also considered statistically significant (<em>P</em> <!-->&lt;<!--> <!-->.05).</p></div><div><h3>Conclusion</h3><p>Persistent interstitial lung abnormalities are seen on HRCT for a subset of patients infected with SARS-CoV-2 pneumonia. Seventy percent of these patients suffered a slight decrease in DLCO.</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138989720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La situación actual de la formación de Radiología en los estudios de medicina en España","authors":"F. Sendra Portero ,&nbsp;D. Domínguez Pinos ,&nbsp;M. Souto Bayarri","doi":"10.1016/j.rx.2023.07.003","DOIUrl":"https://doi.org/10.1016/j.rx.2023.07.003","url":null,"abstract":"<div><p>Radiology is now an essential part of clinical medicine, but undergraduate training does not reflect its importance in medical practice. In the current course, there are 46 medical schools in our country. According to the information published on the institutional websites, the study plans are very different in terms of the presence of diagnostic radiology and the organization of teaching. The estimated number of teaching hours in diagnostic radiology (mean ±<!--> <!-->standard deviation) is 61.3<!--> <!-->±<!--> <!-->22.2<!--> <!-->h (range from 26<!--> <!-->h to 137<!--> <!-->h). There is a great shortage of clinical university professors, and a generational change is essential. The current situation poses various challenges, including adapting to new teaching methods and technologies and promoting the presence of radiology in medical study plans, paying special attention to hospital practices, the final degree project (FDP) and the objective structured clinical examination (OSCE).</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71762003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentación de la serie «Los retos en la formación de radiología en pregrado»","authors":"F. Sendra Portero ,&nbsp;J.D. Aquerreta Beola","doi":"10.1016/j.rx.2023.04.004","DOIUrl":"https://doi.org/10.1016/j.rx.2023.04.004","url":null,"abstract":"","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71761999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Casos prácticos del Diploma Europeo en Radiología (EDiR)","authors":"","doi":"10.1016/j.rx.2023.09.003","DOIUrl":"https://doi.org/10.1016/j.rx.2023.09.003","url":null,"abstract":"","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71762002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Qué veo cuando no veo la vejiga? Revisión de las principales cirugías derivativas urinarias y sus complicaciones","authors":"A. Salgado-Parente,&nbsp;E. Antolinos-Macho,&nbsp;A. González-Huete,&nbsp;R. García-Latorre,&nbsp;E. Canales-Lachén,&nbsp;M.C. González-Gordaliza","doi":"10.1016/j.rx.2023.04.008","DOIUrl":"https://doi.org/10.1016/j.rx.2023.04.008","url":null,"abstract":"<div><h3>Objective</h3><p>To review the different types of urinary diversion surgeries (UDS) in order to recognize the expected findings in a postoperative study, using different imaging techniques. To recognize the main postoperative complications, both early and late.</p></div><div><h3>Conclusion</h3><p>UDS are surgical procedures whose purpose is to redirect urine flow after cystectomy, generally in an oncologic context. The imaging evaluation of urological surgeries is often a radiological challenge, with CT being the most commonly used image modality. Therefore, it is essential to know the main surgical techniques, the expected postoperative findings and the optimization of imaging techniques for early diagnosis and correct evaluation of postoperative complications.</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71761997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clasificadores de aprendizaje supervisado no lineales basados en radiómica de la TC cerebral sin contraste para predecir el pronóstico funcional en pacientes con hematoma intracerebral espontáneo","authors":"E. Serrano ,&nbsp;J. Moreno ,&nbsp;L. Llull ,&nbsp;A. Rodríguez ,&nbsp;C. Zwanzger ,&nbsp;S. Amaro ,&nbsp;L. Oleaga ,&nbsp;A. López-Rueda","doi":"10.1016/j.rx.2023.08.001","DOIUrl":"https://doi.org/10.1016/j.rx.2023.08.001","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate if nonlinear supervised learning classifiers based on non-contrast cerebral CT can predict functional prognosis at discharge in patients with spontaneous intracerebral hematoma (HIE).</p></div><div><h3>Methods</h3><p>Retrospective, single-center, observational analysis of patients with a diagnosis of spontaneous intracerebral hematoma confirmed by non-contrast CT between January 2016 and April 2018. Patients with HIE &gt;<!--> <!-->18<!--> <!-->years and with non-contrast CT performed within the first 24<!--> <!-->hours of symptom onset were included. Patients with secondary spontaneous intracerebral hematoma and in whom radiomic variables were not available were excluded. Clinical, demographic and admission variables were collected. Patients were classified according to the Modified Rankin Scale (mRS) at discharge into good (mRS<!--> <!-->0-2) and poor prognosis (mRS<!--> <!-->3-6). After manual segmentation of each spontaneous intracerebral hematoma, the radiomics variables were obtained. The sample was divided into a training and testing cohort and a validation cohort (70-30%, respectively). Different methods of variable selection and dimensionality reduction were used, and different algorithms were used for model construction. Stratified 10-fold cross-validation were performed on the training and testing cohort and the mean area under the curve (AUC) were calculated. Once the models were trained, the sensitivity of each was calculated to predict functional prognosis at discharge in the validation cohort.</p></div><div><h3>Results</h3><p>105 patients with spontaneous intracerebral hematoma were analyzed. 105 radiomic variables were evaluated for each patient. P-SVM, KNN-E and RF-10 algorithms, in combination with the ANOVA variable selection method, were the best performing classifiers in the training and testing cohort (AUC: 0.798, 0.752 and 0.742, respectively). The predictions of these models, in the validation cohort, had a sensitivity of 0.897 (95%<!--> <!-->CI: 0.778-1), with a false-negative rate of 0% for predicting poor functional prognosis at discharge.</p></div><div><h3>Conclusion</h3><p>The use of radiomics-based nonlinear supervised learning classifiers are a promising diagnostic tool for predicting functional outcome at discharge in HIE patients, with a low false negative rate, although larger and balanced samples are still needed to develop and improve their performance.</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71762069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia de la capacidad y la eficiencia pronósticas de la herramienta de inteligencia artificial Thoracic Care Suite de GE aplicada a la radiografía torácica de pacientes con neumonía COVID-19","authors":"Juana María Plasencia-Martínez ,&nbsp;Rafael Pérez-Costa ,&nbsp;Mónica Ballesta-Ruiz ,&nbsp;José María García-Santos","doi":"10.1016/j.rx.2022.11.012","DOIUrl":"https://doi.org/10.1016/j.rx.2022.11.012","url":null,"abstract":"<div><h3>Objective</h3><p>Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit Insight CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays.</p></div><div><h3>Methods</h3><p>Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorable clinical course, were collected. The number of affected lung fields for the 2<!--> <!-->CXRs was assessed using the AI tool.</p></div><div><h3>Results</h3><p>One hundred fourteen patients (57.4<!--> <!-->±<!--> <!-->14.2 years; 65 of them were men, 57%) were retrospectively collected; and 15 (13.2%) required ventilatory support. Progression of pneumonic extension ≥ 0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26<!--> <!-->seconds of radiological time.</p></div><div><h3>Conclusions</h3><p>Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71761995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cementación percutánea (femoroplastia) de prótesis de cadera con aflojamiento aséptico","authors":"X. Tomas Batlle ,&nbsp;J.C. Soler-Perromat ,&nbsp;J. Blasco Andaluz ,&nbsp;J.A. Fernández-Valencia","doi":"10.1016/j.rx.2023.06.006","DOIUrl":"https://doi.org/10.1016/j.rx.2023.06.006","url":null,"abstract":"<div><p>Progressive population aging and improved healthcare have led to a significant increase in patients with hip arthroplasty (HA). In this patient group, the proportion of those who require a new arthroplasty (prosthetic replacement or secondary revision of the hip), has also increased. For this subgroup of patients in whom surgical prosthetic replacement should be considered but is contraindicated, a new technique has been developed since 2010: percutaneous injection of periprosthetic cement under fluoroscopic or CT control (“femoroplasty; FMP”) as an alternative and less invasive treatment compared to surgery to stabilize the HA without replacing it, with excellent results on patients’ quality of life. In this brief communication, we describe our positive experience regarding FMP, which we have performed for the first time in Spain on 4<!--> <!-->patients (age range between 74-83 years, 2 female and 2 male patients, 3 right HA and 1 left HA), without post-complications. We highlight both the relative simplicity of this technique, which can be incorporated into radiological intervention even in regional hospitals, and the significant clinical improvement observed in all patients. In conclusion, we hope that our experience can contribute to the increased adoption of this innovative technique within the scientific community.</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71761996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El espectro de placenta acreta en la etapa temprana y final del embarazo. Un repaso a través de la imagen","authors":"B. Moradi ,&nbsp;J. Azadbakht ,&nbsp;S. Sarmadi ,&nbsp;M. Gity ,&nbsp;E. Shirali ,&nbsp;M. Azadbakht","doi":"10.1016/j.rx.2023.02.005","DOIUrl":"https://doi.org/10.1016/j.rx.2023.02.005","url":null,"abstract":"<div><p>Placenta accreta spectrum (PAS) disorders (with increasing order of the depth of invasion: accreta, increta, percreta) are quite challenging for the purpose of diagnosis and treatment. Pathological examination or imaging evaluation are not very dependable when considered as stand-alone diagnostic tools. On the other hand, timely diagnosis is of great importance, as maternal and fetal mortality drastically increases if patient goes through the third phase of delivery in a not well-suited facility. A multidisciplinary approach for diagnosis (incorporating clinical, imaging, and pathological evaluation) is mandatory, particularly in complicated cases. For imaging evaluation, the diagnostic modality of choice in most scenarios is ultrasound (US) exam; patients are referred for MRI when US is equivocal, inconclusive, or not visualizing placenta properly. Herewith, we review the reported US and MRI features of PAS disorders (mainly focusing on MRI), going over the normal placental imaging and imaging pitfalls in each section, and lastly, covering the imaging findings of PAS disorders in the first trimester and cesarean section pregnancy (CSP).</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71762066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}