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Contrast-enhanced ultrasound fundamentals: the pharmacodynamics and pharmacokinetics of contrast. Basics of contrast-enhanced ultrasound imaging 造影剂增强超声基础：造影剂的药效学和药代动力学。对比增强超声成像基础知识
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.10.003
M.T. Fontanilla Echeveste , T. Ripollés González , E. Aguirre Pascual
{"title":"Contrast-enhanced ultrasound fundamentals: the pharmacodynamics and pharmacokinetics of contrast. Basics of contrast-enhanced ultrasound imaging","authors":"M.T. Fontanilla Echeveste ,&nbsp;T. Ripollés González ,&nbsp;E. Aguirre Pascual","doi":"10.1016/j.rxeng.2024.10.003","DOIUrl":"10.1016/j.rxeng.2024.10.003","url":null,"abstract":"<div><div>Contrast-enhanced ultrasound (CEUS) is a medical imaging technique that offers multiple advantages over other modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). These advantages include portability, no ionising radiation and no renal toxicity, with the great advantage of real-time imaging. CEUS has numerous established applications for the study of different pathologies, both intravenous and intracavitary administration. The contrast used is different in composition and function from CT or MRI contrast. It is a purely intravascular contrast and, therefore, the enhancement of the lesions may have some differences with respect to CT or MRI in the equilibrium phase. Ultrasound contrast has a very good safety profile, with infrequent, generally mild and immediate adverse reactions in intravascular use and no adverse reactions reported in intracavitary use. It is important to know the basics of contrast-enhanced ultrasound, the different ways to optimise the image and the different artefacts.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S36-S50"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704586","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}
引用次数: 0
Ways of analysing extracellular gadolinium enhancement 分析细胞外钆增强的方法
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.11.001
C. Casillas Meléndez
{"title":"Ways of analysing extracellular gadolinium enhancement","authors":"C. Casillas Meléndez","doi":"10.1016/j.rxeng.2024.11.001","DOIUrl":"10.1016/j.rxeng.2024.11.001","url":null,"abstract":"<div><div>The use of extracellular gadolinium-based contrast agents provides valuable information in magnetic resonance studies, thus increasing diagnostic confidence. These contrast agents make it easier to detect and define injuries, and narrow down the differential diagnosis. They are indicated for several different reasons, both for diagnostic purposes and for evaluating the response to treatment. Morphological analysis can assess the type of uptake, the qualitative and semiquantitative study of the signal intensity vs time curves in multiphase sequences, and the quantitative analysis of the uptake with T1 or T2* perfusion studies associated with pharmacokinetic models.</div><div>Multiphase dynamic studies with 3D sequences contain valuable information that is not exploited by a simple visual analysis of 2D images. To take advantage of this information and the imaging biomarkers provided, computational analysis should be used. To this end, the future role of artificial intelligence is increasingly evident.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S65-S74"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704588","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}
引用次数: 0
Hepatobiliary contrast agents for Liver Magnetic Resonance Imaging 用于肝脏磁共振成像的肝胆造影剂
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.05.002
A. Perez-Girbes , J.M. Lee , L. Martí-Bonmatí
{"title":"Hepatobiliary contrast agents for Liver Magnetic Resonance Imaging","authors":"A. Perez-Girbes ,&nbsp;J.M. Lee ,&nbsp;L. Martí-Bonmatí","doi":"10.1016/j.rxeng.2024.05.002","DOIUrl":"10.1016/j.rxeng.2024.05.002","url":null,"abstract":"<div><div>The use of hepatobiliary-specific contrast agents in liver MRI is a crucial diagnostic tool for evaluating liver disease, enabling the detection and characterisation of focal lesions and vascular alterations, as well as the assessment and grading of chronic hepatopathy. Paramagnetic hepatobiliary-specific contrast agents are gadolinium-based, partially taken up by hepatocytes, and excreted via both renal and biliary pathways. There are two linear ionic molecules that are currently commercially available: gadobenic acid (Gd-BOPTA) and gadoxetic acid (Gd-EOB-DTPA). Their main clinical indications include distinguishing and characterising focal liver lesions on healthy liver tissue, diagnosing and staging hepatocellular carcinoma in patients with chronic hepatopathy, and increasing reliability in the detection of hepatic metastases in oncology patients, especially prior to surgery. They are also useful in the evaluation of the biliary tract and in assessing complications of hepatic surgery such as bile leaks.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S75-S88"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704589","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}
引用次数: 0
Optimising the use of iodinated contrast agents in CT scans: Vascular, visceral, multiphasic and split-bolus examinations 优化 CT 扫描中碘造影剂的使用：血管、内脏、多相和分波段检查
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.10.001
J.J. Arenas-Jiménez , J.M. Bernabé García , G. Fernández Suárez , J. Calvo Blanco
{"title":"Optimising the use of iodinated contrast agents in CT scans: Vascular, visceral, multiphasic and split-bolus examinations","authors":"J.J. Arenas-Jiménez ,&nbsp;J.M. Bernabé García ,&nbsp;G. Fernández Suárez ,&nbsp;J. Calvo Blanco","doi":"10.1016/j.rxeng.2024.10.001","DOIUrl":"10.1016/j.rxeng.2024.10.001","url":null,"abstract":"<div><div>Iodinated contrast is administered when carrying out computed tomography (CT) scans to define anatomical structures and detect pathologies. The contrast is administered according to different protocols which vary significantly and include vascular, visceral, multiphasic and split-bolus injection studies. Each protocol has its own indications and particularities to optimise the use of the contrast medium in each situation. There are numerous factors that influence the degree of contrast enhancement obtained, including the patient’s weight, cardiac output, study delay, the technical characteristics used for acquisition—mainly kilovoltage—, and variables related to the administration and dosage of the contrast medium, such as iodine delivery rate and load. This article will discuss how each of these variables affects the level of enhancement achieved and the parameters that can be modified in order to optimise the results of the different types of scans performed with iodinated contrast.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S15-S28"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705218","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}
引用次数: 0
Multi-energy CT and iodinated contrast 多能 CT 和碘化造影剂
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.03.011
A. Villanueva Campos, E. Canales Lachén, C. Suevos Ballesteros, J. Alarcón Rodríguez
{"title":"Multi-energy CT and iodinated contrast","authors":"A. Villanueva Campos,&nbsp;E. Canales Lachén,&nbsp;C. Suevos Ballesteros,&nbsp;J. Alarcón Rodríguez","doi":"10.1016/j.rxeng.2024.03.011","DOIUrl":"10.1016/j.rxeng.2024.03.011","url":null,"abstract":"<div><div>Spectral CT acquires images with the emission or detection of two separate energy spectra. This enables material decomposition due to the photoelectric effect (prevalent in low-energy photons) and Compton scattering (prevalent in high-energy photons).</div><div>Iodine and other materials with high atomic numbers appear more hyperdense on low-energy monoenergetic images because of the direct relation between the photoelectric effect and the Z value.</div><div>Given the way iodine behaves on spectral maps, radiologists can optimise the use of contrast media in these CTs, thus allowing lower doses of radiation and lower volumes of contrast media while achieving the same CT values and even enabling lower contrast flow rates, which is especially helpful in patients with poor vascular access. Moreover, in suboptimal diagnostic cases caused by poor contrast opacification, the resolution can be improved, thus avoiding the need to repeat the study.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S29-S35"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705215","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}
引用次数: 0
Adverse reactions to radiological contrast media: Prevention and treatment 放射造影剂的不良反应：预防和治疗
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.03.012
F. Vega
{"title":"Adverse reactions to radiological contrast media: Prevention and treatment","authors":"F. Vega","doi":"10.1016/j.rxeng.2024.03.012","DOIUrl":"10.1016/j.rxeng.2024.03.012","url":null,"abstract":"<div><div>Radiological contrast media, both iodinated and gadolinium-based, can lead to adverse reactions. Type A reactions are related to the pharmacological characteristics of the contrast, including side, secondary and toxic effects. Post-contrast acute kidney injury is the most frequent adverse reaction to iodinated contrast media. Less frequently, thyroid, neurological, cardiovascular, haematological, and salivary gland effects are also detected. With gadolinium-based contrast agents, nausea is the most frequent reaction, but there is also a risk of producing nephrogenic systemic fibrosis and cerebral deposits of uncertain significance.</div><div>The most effective way of avoiding type A reactions is to decrease the dose and frequency of contrast media administration, especially in patients with pre-existing renal insufficiency. To prevent post-contrast acute kidney injury, adequate hydration of the patient should be maintained orally or intravenously, avoiding prolonged periods of liquid fasting.</div><div>On the other hand, hypersensitivity reactions are dose-independent and clinically can range from mild cutaneous reactions to anaphylaxis. This article proposes an algorithm that differentiates between nonspecific reactions and true hypersensitivity reactions, as well as levels of severity. It also provides a treatment scheme for immediate reactions adjusted to the severity level, with a focus on the management of anaphylaxis and an early intramuscular administration of adrenaline. Finally, it sets out recommendations for the management of patients with previous hypersensitivity reactions who require elective or urgent contrast administration, favouring the use of alternative contrast media with confirmed tolerance instead of the indiscriminate use of premedication.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S98-S109"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704596","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}
引用次数: 0
Responsibility of the radiologist in the management of contrast medias. Informed consent and other controversies 放射科医生在造影剂管理中的责任。知情同意和其他争议
Radiologia Pub Date : 2024-10-01 DOI: 10.1016/j.rxeng.2024.04.005
P. Rodríguez Carnero , C. Sebastià Cerqueda , L. Oleaga Zufiria
{"title":"Responsibility of the radiologist in the management of contrast medias. Informed consent and other controversies","authors":"P. Rodríguez Carnero ,&nbsp;C. Sebastià Cerqueda ,&nbsp;L. Oleaga Zufiria","doi":"10.1016/j.rxeng.2024.04.005","DOIUrl":"10.1016/j.rxeng.2024.04.005","url":null,"abstract":"<div><div>Radiological contrast media play an essential role in radiology departments by facilitating more precise and detailed images. It is important to note that for radiologists the use of these contrast agents implies several legal responsibilities and ethical considerations towards patients. This article will explore the main issues related to responsibility and complication management for radiologists, referring physicians and other related professionals, as well as issues around informed consent, contraindications for their use and the benefit-risk balance assessed when deciding if a contrast-enhanced test should be carried out. In addition, we will address the crucial role of the radiologist in effective communication with patients and in obtaining informed consent. This research relates to Spanish legislation in the context of medical practice.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 ","pages":"Pages S124-S131"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704593","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}
引用次数: 0
Myofibroblastoma of the breast: 3 case reports and review of literature 乳腺肌纤维母细胞瘤：3 个病例报告和文献综述
Radiologia Pub Date : 2024-09-01 DOI: 10.1016/j.rxeng.2023.03.008
C. Sitges , B. Úbeda , S. Ganau , M. Macedo , E. Sanfeliu , X. Bargalló
{"title":"Myofibroblastoma of the breast: 3 case reports and review of literature","authors":"C. Sitges ,&nbsp;B. Úbeda ,&nbsp;S. Ganau ,&nbsp;M. Macedo ,&nbsp;E. Sanfeliu ,&nbsp;X. Bargalló","doi":"10.1016/j.rxeng.2023.03.008","DOIUrl":"10.1016/j.rxeng.2023.03.008","url":null,"abstract":"<div><div>Myofibroblastoma (MFB) is a rare, benign mesenchymal tumor of the breast. Three cases of breast MFB diagnosed in our clinical institution are presented, aiming to describe its clinical and radiologic characteristics, with a short literature review.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 5","pages":"Pages 479-484"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445716","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}
引用次数: 0
Optic neuropathy in imaging 成像中的视神经病变
Radiologia Pub Date : 2024-09-01 DOI: 10.1016/j.rxeng.2023.06.011
P. Sobral Viñas, E. Santos Armentia, N. Silva Priegue, S. del Campo Estepar, R. Alemán Millares, A. Pérez Fernández
{"title":"Optic neuropathy in imaging","authors":"P. Sobral Viñas,&nbsp;E. Santos Armentia,&nbsp;N. Silva Priegue,&nbsp;S. del Campo Estepar,&nbsp;R. Alemán Millares,&nbsp;A. Pérez Fernández","doi":"10.1016/j.rxeng.2023.06.011","DOIUrl":"10.1016/j.rxeng.2023.06.011","url":null,"abstract":"<div><div>The aim of this work is to provide a diagnostic approach to the potential causes of optic neuropathy, focusing on the radiological findings associated with this pathology. Various etiologies have been identified, including inflammatory and demyelinating optic neuritis, developmental and hereditary diseases, neurodegenerative disorders, infectious conditions, post-traumatic causes, ischemic optic neuropathy (with anterior ischemic optic neuropathy being the most common form), and neoplastic etiologies. Optical coherence tomography and magnetic resonance imaging play a fundamental role in the diagnosis of optic neuropathy, allowing to distinguish patterns of optic nerve involvement. These studies are essential to locate and characterize the different pathologies, increasing the precision of the diagnosis in diseases presenting optic neuropathy as the main symptom. In conclusion, the findings obtained from magnetic resonance imaging are essential in the differential diagnosis of optic nerve diseases, aiding in the localization and characterization of various pathologies affecting either the optic pathway alone or multiple levels of the central nervous system and thereby increasing diagnostic accuracy.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 5","pages":"Pages 459-470"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445714","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}
引用次数: 0
Diffuse idiopathic skeletal hyperostosis: Imaging findings with special focus on extraspinal involvement 弥漫性特发性骨骼增生症：以脊柱外受累为重点的影像学发现
Radiologia Pub Date : 2024-09-01 DOI: 10.1016/j.rxeng.2023.06.009
D. Herrán de la Gala , A.B. Barba Arce , A. Lamagrande Obregón , R.M. Landeras Álvaro , T. Cobo Ruiz , E.C. Gallardo Agromayor
{"title":"Diffuse idiopathic skeletal hyperostosis: Imaging findings with special focus on extraspinal involvement","authors":"D. Herrán de la Gala ,&nbsp;A.B. Barba Arce ,&nbsp;A. Lamagrande Obregón ,&nbsp;R.M. Landeras Álvaro ,&nbsp;T. Cobo Ruiz ,&nbsp;E.C. Gallardo Agromayor","doi":"10.1016/j.rxeng.2023.06.009","DOIUrl":"10.1016/j.rxeng.2023.06.009","url":null,"abstract":"<div><div>Diffuse Idiopathic Skeletal Hyperostosis (IDHS) is a multifactorial disease with a high prevalence and that is frequently detected incidentally in imaging tests. Most of its diagnostic criteria are focused on axial involvement and more specifically the spine. However, peripheral involvement in DISH is less well known despite its non insignificant frequency. DISH can be associated with serious complications, the most severe being vertebral fractures in low energy trauma and dysphagia or airway obstruction in cervical involvement. Knowing how to identify the patterns of peripheral involvement of DISH and its complications helps in the radiological and clinical management of patients with this disease.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"66 5","pages":"Pages 447-458"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445713","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}
引用次数: 0
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