Radiologia最新文献

{"title":"Tarsal tunnel ganglion cyst: intraneural or extraneural site?","authors":"J.J. Jover-Sánchez ,&nbsp;L. Cristóbal-Velasco ,&nbsp;E. Benza-Villarejo ,&nbsp;A.A. Maldonado-Morillo","doi":"10.1016/j.rxeng.2023.09.005","DOIUrl":"10.1016/j.rxeng.2023.09.005","url":null,"abstract":"<div><p><span>Intraneural ganglion cysts<span> are very uncommon lesions, whose diagnosis has increased since the articular theory and the description of the MRI findings were established. We present a case report of a 59-year-old man with symptoms of tarsal tunnel syndrome. Foot and ankle MRI demonstrated the presence of an intraneural cystic lesion in the posterior tibial neve and its connection with the </span></span>subtalar joint through an articular branch. The identification of the specific radiological signs like the «signet ring sign» allowed establishing an adequate preoperative diagnosis, differentiating it from an extraneural lesion and facilitating the articular disconnection of the nerve branch during surgery.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686891","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":"Advances in musculoskeletal radiology","authors":"F. Ruiz Santiago","doi":"10.1016/j.rxeng.2023.04.003","DOIUrl":"10.1016/j.rxeng.2023.04.003","url":null,"abstract":"","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686882","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":"Diagnostic accuracy of lumbar CT and MRI in the evaluation of chronic low back pain without red flag symptoms","authors":"J. Martel Villagrán ,&nbsp;R.T. Martínez-Sánchez ,&nbsp;E. Cebada-Chaparro ,&nbsp;A.L. Bueno Horcajadas ,&nbsp;E. Pérez-Fernández","doi":"10.1016/j.rxeng.2023.02.004","DOIUrl":"10.1016/j.rxeng.2023.02.004","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Low back pain (LBP) is one of the most frequent reasons for medical consultation. Most of the patients will have nonspecific LBP, which usually are self-limited episodes. It is unclear which of the diagnostic imaging pathways is most effective and costeffective and how the imaging impacts on patient treatment. </span>Imaging techniques are usually indicated if symptoms remain after 6 weeks. Magnetic resonance imaging (MRI) is the diagnostic imaging examination of choice in </span>lumbar spine evaluation of low back pain; however, availability of MRI is limited.</p></div><div><h3>Objectives</h3><p>To evaluate the diagnostic accuracy of computed tomography<span> (CT) with MRI (as standard of reference) in the evaluation of chronic low back pain (LBP) without red flags symptoms. To compare the results obtained by two radiologists with different grades of experience.</span></p></div><div><h3>Materials and methods</h3><p>Patients with chronic low back pain without red flags symptoms were retrospectively reviewed by two observers with different level of experience. Patients included had undergone a lumbar or abdominal CT and an MRI within a year. Once the radiological information was collected, it was then statistically reviewed. The aim of the statistical analysis is to identify the equivalence between both diagnostic techniques. To this end, sensitivity, specificity and validity index were calculated. In addition, intra and inter-observer reliability were measured by Cohen’s kappa values and also using the McNemar test.</p></div><div><h3>Results</h3><p>340 lumbar levels were evaluated from 68 adult patients with chronic low back pain or sciatica<span>. 63.2% of them were women, with an average age of 60.3 years (SD 14.7). CT shows high values of sensitivity and specificity (&gt;80%) in most of the items evaluated, but sensitivity was low for the evaluation of density of the disc (40%) and for the detection of disc herniation (55%). Moreover, agreement between MRI and CT in most of these items was substantial or almost perfect (Cohen’s kappa-coefficient &gt; 0’8), excluding Modic changes (kappa = 0.497), degenerative changes (kappa0.688), signal of the disc (kappa = 0.327) and disc herniation (kappa = 0.639). Finally, agreement between both observers is mostly high (kappa &gt; 0.8). Foraminal stenosis, canal stenosis and the grade of the canal stenosis were overdiagnosed by the inexperienced observer in the evaluation of CT images.</span></p></div><div><h3>Conclusions and significance</h3><p>CT is as sensitive as lumbar MRI in the evaluation of most of the items analysed, excluding Modic changes, degenerative changes, signal of the disc and disc herniation. In addition, these results are obtained regardless the experience of the radiologist. The rising use of diagnostic medical imaging and the improvement of image quality brings the opportunity of making a second look of abdominal CT in search of causes of LBP. T","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686885","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":"Can Achilles tendinosis be treated effectively with lidocaine and glucose infiltrations, and if so, is the effect lasting? A longitudinal, observational on 27 consecutive patients","authors":"A. Bello Baez ,&nbsp;M.L. Nieto Morales ,&nbsp;P. Mora Guanche ,&nbsp;A. Cavada Laza ,&nbsp;Lina Inmaculada Pérez Méndez","doi":"10.1016/j.rxeng.2022.05.002","DOIUrl":"10.1016/j.rxeng.2022.05.002","url":null,"abstract":"<div><h3>Objective</h3><p><span>Our aim was to add to the small but growing body of evidence on the effectiveness of ultrasound-guided Achilles intratendinous hyperosmolar dextrose prolotherapy and introduce a novel, preceding step of paratenon hydrodissection with lidocaine in patients with chronic </span>Achilles tendinosis resistant to rehabilitation therapy.</p></div><div><h3>Methods</h3><p><span><span><span>We conducted a longitudinal, observational study on 27 consecutive patients diagnosed with Achilles tendinosis, in whom conservative treatment, ie, physiotherapy or </span>shock wave therapy<span>, had failed. A 2% lidocaine paratenon anesthesia and hydrodissection was followed by ultrasound-guided, intratendinous injections<span> of 25% glucose every 5 weeks. Visual analogue scales (VAS) were used for pain assessment at rest, for </span></span></span>activities of daily living<span><span>, and after moderate exercise at the begining and at the end of the treatment. Moreover, tendon thickness and vascularisation were recorded at baseline and final treatment consultation. Effectiveness was estimated from scoring and relative pain reduction using a 95% CI. The non-parametric </span>Wilcoxon test and a general linear model for repeated measures were applied. Statistical significance was established as </span></span><em>p</em> &lt; 0.05.</p></div><div><h3>Results</h3><p>A median of 5 (1–11) injection consultations per patient were required. Pain scores decreased significantly in all three conditions (<em>p</em> &lt; 0.001). Relative reductions were 75% in pain at rest (95% CI;61–93%), 69% in pain with daily living activities (95% CI; 55–83%), and 70% in pain after moderate exercise (95% CI; 57–84%). Tendon neo-vascularisation was significantly reduced (<em>p</em> &lt; 0.001). We did not observe significant changes in tendon thickness (<em>p</em> = 0.083).</p></div><div><h3>Conclusions</h3><p>Achilles tendinosis treatment with paratenon lidocaine hydrodissection and subsequent prolotherapy with hyperosmolar glucose solution is safe, effective, inexpensive, and virtually painless with results maintained over time.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686883","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":"Emphysematous osteomyelitis: a rare and aggressive disease","authors":"I. Garrido Márquez ,&nbsp;Á. Moyano Portillo ,&nbsp;M.A. Acosta Martínez del Valle ,&nbsp;G. Rodríguez Madroñal ,&nbsp;E. Pérez Cuenca","doi":"10.1016/j.rxeng.2023.09.004","DOIUrl":"10.1016/j.rxeng.2023.09.004","url":null,"abstract":"<div><p><span><span>Emphysematous osteomyelitis is an extremely rare entity consisting of the presence of intraosseous gas that can extend to the joints and adjacent soft tissues. It is an aggressive infectious process associated with high mortality, especially </span>in patients<span><span> with risk factors such as tumors or diabetes mellitus. Because early diagnosis and immediate treatment are crucial to prevent the potentially devastating consequences of this condition, imaging tests such as </span>computed tomography<span> play a fundamental role in its diagnosis and management. Therefore, radiologists must be aware that intraosseous gas is a rare but alarming sign that is pathognomonic of emphysematous osteomyelitis, especially in the </span></span></span>axial skeleton.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686887","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":"Myxoid liposarcoma: MRI features with histological correlation","authors":"V.M. Encinas Tobajas ,&nbsp;C. Almeida González ,&nbsp;D. Marcilla ,&nbsp;M. Vallejo ,&nbsp;A. Cano Rodríguez ,&nbsp;J.I. Reina Sánchez de Movellán ,&nbsp;J.M. Morales Pérez","doi":"10.1016/j.rxeng.2021.01.006","DOIUrl":"10.1016/j.rxeng.2021.01.006","url":null,"abstract":"<div><h3>Background and aims</h3><p><span><span>Myxoid liposarcoma is classified in the group of </span>sarcomas with </span>adipose differentiation, which is the second most common group of sarcomas. However, myxoid liposarcoma is not a homogeneous entity, because the behavior and clinical course of these tumours can vary widely. This study aimed to describe the magnetic resonance imaging (MRI) features of myxoid liposarcomas and to determine whether the MRI features are associated with the histologic grade and can differentiate between low-grade and high-grade tumours and thus help in clinical decision making.</p></div><div><h3>Material and methods</h3><p>We studied 36 patients with myxoid liposarcomas treated at our centre between 2010 and 2018. We analysed clinical variables (age, sex, and tumour site) and MRI features (size, depth, borders, fatty component, myxoid component, non-fatty/non-myxoid component, apparent diffusion coefficient (ADC), and type of enhancement after the administration of intravenous contrast material). We correlated the MRI features with the histologic grade and the percentage of round cells.</p></div><div><h3>Results</h3><p>In our series, patients with myxoid liposarcomas were mainly young adults (median age, 43 years). There were no differences between sexes; 97.2% were located in the lower limbs, 86.1% were deep, and 77.8% had well-defined borders. Of the 23 myxoid liposarcomas that contained no fat, 16 (69.6%) were high grade (p = 0.01). All the tumors with a myxoid component of less than 25% were high grade (p = 0.01); 83.3% of those with a non-fatty/non-myxoid component greater than 50% were high grade (p = 0.03) and 61.5% had more than 5% round cells (p = 0.01). Diffusion sequences were obtained in 14 of the 36 patients; ADC values were high (median, 2 × 10⁻³ mm²/s), although there were no significant associations between low-grade and high-grade tumours. Contrast-enhanced images were available for 30 (83.3%) patients; 83.3% of the tumours with heterogeneous enhancement were high grade (p = 0.01).</p></div><div><h3>Conclusions</h3><p>MRI can be useful for differentiating between high- and low-grade myxoid liposarcomas and can help in clinical decision making.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686889","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":"Acute muscle loss and early effects of COVID-19 on skeletal muscle in adult patients: A retrospective cohort study","authors":"Y. Akturk ,&nbsp;S. Ozbal Gunes ,&nbsp;E. Soyer Guldogan ,&nbsp;I. Sencan ,&nbsp;B. Hekimoğlu","doi":"10.1016/j.rxeng.2022.12.009","DOIUrl":"10.1016/j.rxeng.2022.12.009","url":null,"abstract":"<div><h3>Objectives</h3><p><span>It is known that COVID-19 has multisystemic effects. However, its early effects on muscle tissue have not been clearly elucidated. The aim of this study is to investigate early changes in the pectoral muscle </span>in patients with COVID-19 infection.</p></div><div><h3>Materials and methods</h3><p><span>The pectoral muscle areas (PMA) and pectoral muscle index (PMI) of 139 patients diagnosed with COVID-19 were measured from chest CTs taken at the time of the first diagnosis and within 6 months after the diagnosis. The effect of the infection on the muscle area was investigated by evaluating whether there was a change between the two measurements. Lung involvement of the infection in the first CT was scored with the CT severity score (CT-SS). In addition, the effects of patients' clinics, CT-SS, length of hospital stay, and </span>intubation history on changes in the muscle area were investigated.</p></div><div><h3>Results</h3><p>When the PMA and PMI values were compared, there was a statistically significant decrease in the values in the control CT group compared to the first diagnosis CT group. The difference was found higher in intubated patients. CT-SS was associated with a decrease in PMI.</p></div><div><h3>Conclusion</h3><p><span>COVID-19 is one of the causes of acute sarcopenia. Pectoralis muscle is part of the </span>skeletal muscle, and there may be a decrease in the muscle area in the early period of the disease.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686881","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":"Treatment of calcific tendinopathy of the rotator cuff with ultrasound-guided puncture and aspiration","authors":"I. Sánchez Lite ,&nbsp;B. Toribio Calvo ,&nbsp;S. Osorio Aira ,&nbsp;C. Romera de Blas ,&nbsp;N. Andrés García","doi":"10.1016/j.rxeng.2022.10.001","DOIUrl":"10.1016/j.rxeng.2022.10.001","url":null,"abstract":"<div><h3>Objective</h3><p><span>Calcific tendinopathy of the </span>rotator cuff<span> is a common condition caused by the deposition of calcium crystals in the tendons of the rotator cuff. This study aimed to analyze the effectiveness of ultrasound-guided puncture and aspiration in calcific tendinopathy of the should in 86 patients treated at our center and to determine the factors associated with poor prognosis after this treatment.</span></p></div><div><h3>Material and methods</h3><p>This retrospective descriptive study included 86 patients with calcific tendinopathy of the rotator cuff treated with ultrasound-guided puncture and aspiration between 2015 and 2019 for whom clinical and radiological variables were collected 1, 3, 6, and 12 months after the procedure.</p></div><div><h3>Results</h3><p>One year after treatment, 81.4% patients showed clinical improvement and 96.5% showed radiological improvement. Complications were observed in 34.9%; all complications were mild.</p></div><div><h3>Conclusions</h3><p>Ultrasound-guided puncture and aspiration is an effective treatment for calcific tendinopathy of the shoulder, resulting in a high rate of clinical and radiological improvement and a low rate of minor complications. This technique has additional advantages, such as interaction with the patient and the lack of ionizing radiation.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686892","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":"Medication-related osteonecrosis of the jaw: the radiologist’s role","authors":"R. Alemán Millares,&nbsp;E. Santos Armentia,&nbsp;S. Del Campo Estepar,&nbsp;M. Novoa Ferro","doi":"10.1016/j.rxeng.2021.10.005","DOIUrl":"10.1016/j.rxeng.2021.10.005","url":null,"abstract":"<div><p><span>In recent decades, the dreaded adverse effect of bisphosphonates, </span>osteonecrosis of the jaw<span><span>, has been widely reported and described in detail. Osteonecrosis of the jaw consists of the destruction of part of the maxilla as a consequence of these antiresorptive </span>drugs<span>. In recent years, new drugs that can also cause osteonecrosis of the jaw (e.g., some monoclonal antibodies or antiangiogenic drugs) have come on the market. For this reason, the term “bisphosphonate-related osteonecrosis of the jaw” has been replaced with “medication-related osteonecrosis of the jaw (MRONJ).</span></span></p><p>This review aims to describe the radiologic characteristics of MRONJ that, although nonspecific, radiologists need to recognize in the appropriate clinical context.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180176","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":"Patient safety in magnetic resonance imaging","authors":"P. Fraga Rivas,&nbsp;J. de Miguel Criado,&nbsp;L. García del Salto Lorente,&nbsp;L. Gutiérrez Velasco,&nbsp;P. Quintana Valcarcel","doi":"10.1016/j.rxeng.2023.01.009","DOIUrl":"10.1016/j.rxeng.2023.01.009","url":null,"abstract":"<div><p>Image acquisition involves the use of static magnetic fields, field gradients and radiofrequency waves. These elements make the MRI a different modality. More and more centers work with 3.0 T equipment that present higher risks for the patient, compared to those of 1.5 T.</p><p>Therefore, there is a need for updating for radiology staff that allows them to understand the risks and reduce them, since serious and even fatal incidents can occur.</p><p>The objective of this work is to present a review and update of the risks to which patients are subjected during the performance of a magnetic resonance imaging (MRI) study.</p></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159942","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}