Nuevos criterios ASAS para el diagnóstico de espondiloartritis. Diagnóstico de sacroileítis por resonancia magnética

Radiographic sacroiliitis has been included in the diagnostic criteria for spondyloarthropathies since the Rome criteria were defined in 1961. However, in the last ten years, magnetic resonance imaging (MRI) has proven more sensitive in the evaluation of the sacroiliac joints in patients with suspected spondyloarthritis and symptoms of sacroiliitis; MRI has proven its usefulness not only for diagnosis of this disease, but also for the follow-up of the disease and response to treatment in these patients. In 2009, The Assessment of SpondyloArthritis international Society (ASAS) developed a new set of criteria for classifying and diagnosing patients with spondyloarthritis; one important development with respect to previous classifications is the inclusion of MRI positive for sacroiliitis as a major diagnostic criterion.     

Hallazgos de imagen de las masas cardíacas (parte II): tumores malignos y lesiones pseudotumorales

Malignant heart tumors are less common than benign ones. They can be primary or secondary. Secondary or metastatic heart tumors are 20 to 40 times more common than primary malignant heart tumors, which have an estimated incidence of 0.05%. Non-neoplastic pseudotumors can present as cardiac masses, with imaging characteristics than can suggest the diagnosis of a tumor. The aim of this article is to describe and illustrate malignant heart tumors and pseudotumors, stressing the CT and MRI findings that make it possible to differentiate them from benign cardiac tumors.     

MRI of Takayasu's arteritis: typical appearances and complications

OBJECTIVE: Although Takayasu's arteritis (TA) is more common in Asian countries, it has a worldwide distribution. MRI is widely used for its diagnosis. Our purpose is to present a comprehensive pictorial review of its typical appearances and complications on MRI. CONCLUSION: MRI can effectively provide almost all anatomic information in patients with TA. MRI is very useful for accurate diagnosis of TA and its complications. Knowledge of MRI findings is essential for improving patient outcome.     

Artritis idiopática juvenil,peculiaridades de la imagen en la edad pediátrica con especial interés en la resonancia magnética

The term juvenile idiopathic arthritis (JIA) encompasses a heterogeneous group of arthritides with no known cause that begin before the age of 16 years and persist for at least 6 weeks. In recent decades, imaging techniques have acquired a fundamental role in the diagnosis and follow-up of JIA, owing to the unification of the different criteria for classification, which has strengthened the research in this field, and to the development of disease-modifying antirheumatic drugs. In this article, we briefly explain what JIA is. Moreover, we describe the role and limitations of plain-film radiography, ultrasonography, and magnetic resonance imaging (MRI). Finally, we review the MRI protocol and findings, and we comment on the differential diagnosis.     

Paget's disease of the nipple and differential diagnosis

Clinical evaluation of the nipple-areolar complex is a routine component of the breast screening examination. All persistent unilateral nipple lesion should be viewed with suspicion and Paget's disease of the nipple should be considered. The diagnosis is established by nipple scrape cytology. It is a rare variant of ductal carcinoma in situ. The breast imaging work-up should include a search for an underlying malignancy, present in over 80% of cases, not infrequently multifocal. Preoperative MRI is useful if breast conservative surgery is contemplated because of the high rate of occult malignancy on mammograms and ultrasound. Erosive adenomatosis of the nipple is a benign process that may simulate Paget's disease isolated to the nipple. Less frequently, pagetoid basal cell carcinoma, Bowen's disease and melanoma may be more difficult to differentiate clinically and share the unilateral and chronic features of Paget's disease. Biopsy is needed for diagnosis. Cutaneous extension of a breast cancer is rare but should be suspected in patients with retraction and/or fixed nipple. Eczema is characterized by the bilateral nature of the process, the absence of nipple deformity, the presence of flare-ups and the favorable response to local steroid therapy.     

Enfermedad valvular cardíaca. Valoración con tomografía computarizada multidetector

Heart valve disease is a clinical problem that has been studied with classical imaging techniques like echocardiography and MRI. Technological advances in CT make it possible to obtain static and dynamic images that enable not only a morphological but also a functional analysis in many cases. Although it is currently indicated only in patients with inconclusive findings at echocardiography and MRI or those in whom these techniques are contraindicated, multidetector CT makes it possible to diagnose stenosis or regurgitation through planimetry, to evaluate and quantify valvular calcium, and to show the functional repercussions of these phenomena on the rest of the structures of the heart. Given that multidetector CT is being increasingly used in the diagnosis of ischemic heart disease, we think it is interesting for radiologists to know its potential for the study of valvular disease.     

MRI在DDH研究与诊治中的应用进展

发育性髋关节发育不良（developmental dysplasia of the hip，DDH）是儿童常见的四肢畸形，发病率高，早期诊断意义重大。传统上，DDH的诊断和治疗主要依靠骨盆正位x线片来提供依据，但由于DDH病理变化复杂，三维立体的软骨及软组织的变化也越来越为人们所重视，在这方面，传统的X线片提供的依据有限。MRI作为一种无辐射的影像诊断方法，具有软组织对比优良，三维立体成像等优点，可以清晰地显示出髋关节内各种骨，软骨及软组织结构，为DDH的诊治和研究提供有力的依据，近年来得到了越来越多学者的重视。了解最新的MRI在DDH疾病中的应用进展，在认识疾病的病理变化及转归，早期诊断，合理治疗，疗效评估以及并发症的预防等诸多方面都具有非常重要的意义。     

磁共振成像在小肠病变诊疗评估中的应用进展

小肠是消化道中最长的部分,同时在人体消化吸收中起着至关重要的作用。小肠可以发生多种病变（功能性病变、炎症性病变、肿瘤性病变、血管畸形、外伤性病变及其继发病变等）,同时某些全身性疾病也可累及小肠。由于小肠肠管较长且常相互重叠,因此临床上对小肠病变的诊疗评估存在一定困难。本文拟从小肠病变磁共振成像（Magnetic resonance imaging ,M RI）方法的研究现状及今后发展方向进行综述,从而对M RI在小肠病变诊疗评估中有一个综合认识。     

Radiología en las tumoraciones palpables del paciente pediátrico Parte 1

Palpable tumors in children are a common reason for consulting a radiologist. The differential diagnosis is extensive and considerably different from that used in adults. Some of the etiologies of palpable tumors are little known outside of pediatrics.The most commonly used imaging test is ultrasonography, because in addition to being harmless and cost-effective, it is conclusive in most cases.Most palpable lesions in children are benign; it is estimated that only 1% are malignant. Knowing these lesions enables the correct diagnosis without the need to resort to unnecessary, sometimes invasive tests, thus avoiding delays in treatment when more severe disease is present.This article aims to review the clinical and radiological characteristics of the palpable lesions that are most common in pediatric patients, explaining the key features that enable accurate diagnosis.     

Disección aislada y espontánea de arterias viscerales

We present the cases of two men with isolated spontaneous dissection of visceral arteries diagnosed by multidetector CT. In the first patient, dissection of the celiac trunk was associated with periarterial changes. In the second patient, dissection of the superior mesenteric artery was associated with stenosis at the root of the celiac trunk. Both patients presented with acute pain, which was more intense and longer lasting in the first patient. Aortic dissection was suspected clinically in both patients.     

El radiodiagnóstico ante la violencia de género: un tema de actualidad a tener en cuenta

Domestic violence is currently an issue of great political and social importance. The real incidence of domestic violence is difficult to determine due to the environment where it takes place and the reluctance of victims to report abuse. On the other hand, all types of violence represent an important public health problem.     

Articular and periarticular tumors: differential diagnosis using magnetic resonance imaging

Most patients with articular or periarticular tumors present with chronic monoarthritis and nonspecific alterations on laboratory tests; thus, it is important to know the changes on magnetic resonance imaging (MRI) that can suggest their diagnosis and the differential diagnosis of these tumors. MRI defines the anatomic origin and the tissue characteristics of articular and periarticular tumors, making it possible to reach a specific diagnosis in most cases. It is important to evaluate the MRI findings together with the plain-film findings because this helps in the characterization of mineralized tumors.     

Magnetic resonance imaging of the gallbladder: spectrum of abnormalities

Various pathologies involving the gallbladder can manifest clinically, producing nonspecific clinical symptoms and making diagnosis difficult and challenging. Real-time sonography is the most widely used diagnostic study for the gallbladder and the primary screening examination of choice. With increasing use of magnetic resonance imaging (MRI) and MR cholangiopancreatography (MRCP), gallbladder pathology is frequently seen. Understanding the basic patterns of various disease manifestations and appearance on MRI is the key to making an accurate diagnosis. Given its inherent tissue contrast and contrast sensitivity, MRI in conjunction with MRCP can be a very valuable test in evaluating gallbladder pathology. Gallbladder pathology can be classified into congenital (such as absence), inflammatory (acute, hemorrhagic, and chronic cholecystitis), traumatic, benign (polyps) and malignant tumors (gallbladder carcinoma and lymphoma), and other disease processes can be seen in cholelithiasis, cholesterosis, thickened gallbladder wall, and Mirrizzi syndrome.     

乳腺疾病的MRI研究进展

MRI具有极佳的软组织分辨率,近年来,该技术越来越广泛的应用于乳腺疾病的诊断.乳腺动态增强成像和灌注加权成像可从不同角度反映乳腺组织及病灶的血供灌注情况,弥散加权成像和磁共振波谱分析则从分子水平提供乳腺病变组织信息,磁共振乳腺导管成像为导管内病变提供了新的影像诊断方法.随着MRI技术的成熟、软硬件的迅速发展,MRI在乳腺疾病的检出和诊断方面显示出其独到的优势.     

The role of MRI in the diagnosis of MS

Magnetic resonance imaging (MRI) is the most widely used imaging technique in the investigation of multiple sclerosis (MS). Although MS remains a clinical diagnosis, MRI has become an invaluable tool in understanding and monitoring the disease, and is commonly used to confirm the clinical diagnosis. Various imaging techniques can be used but T2-weighted brain imaging remains the standard tool. The officially endorsed imaging criteria for MS places greater emphasis on the spatial and temporal distribution of lesions than on their individual appearance. This review focuses on the more typical findings in MS, and considers the current role of MRI in the diagnosis.     

轻度认知功能障碍的磁共振成像研究

轻度认知功能障碍是指介于痴呆和正常健康老龄之间的以偶然发生的记忆减退为主要表现的一种功能损害状态。本文综述了近年来结构磁共振影像学和功能磁共振影像学在轻度认知功能障碍研究中的应用现状,旨在对其早期临床诊断和治疗提供参考,继而一定程度上延缓其向老年性痴呆的转化。     

Espondiloartropatía seronegativa en RM: ¿cuándo pensar en ella?

We describe the magnetic resonance imaging (MRI) findings for the spine in patients with seronegative spondyloarthropathy (SNS) and discuss the indications for MRI in the diagnosis and follow-up of this type of patients. We describe the pathological aspects of four patients diagnosed with SNS (Crohn's disease, ankylosing spondylitis, and psoriasis) with spinal involvement. The MRI findings in SNS vary in function of the type and stage of disease. Osteitis of the anterior vertebral bodies is a very early sign of spinal involvement in this group of diseases. Inflammatory involvement of the discovertebral complex that involves the adjacent vertebral bodies to a greater or lesser extent occurs later. MRI of the spine makes it possible to evaluate incipient signs of disease that are characteristic of these patients, so it is a useful tool for the diagnosis of SNS.     

椎体包虫病的MRI诊断

目的 :探讨脊椎包虫病影像学改变的病理学基础及其MRI临床诊断价值。材料和方法 :对 19例经手术及病理证实的脊椎包虫病的X线及MRI进行回顾性分析、分类。结果 :包虫的寄生生长方式决定了其膨胀性、多房性生长的影像特点 ,MRI上具有特征性。结论 :MRI对评价脊椎包虫病具有重要意义 ,尤其在显示脊椎包虫与邻近组织结构关系方面有独到之处。     

Diseminación perineural en tumores de cabeza y cuello

Perineural spread is the dissemination of some types of head and neck tumors along nervous structures. Perineural spread has negative repercussions on treatment because it requires more extensive resection and larger fields of irradiation. Moreover, perineural spread is associated with increased local recurrence, and it is considered an independent indicator of poor prognosis in the TNM classification for tumor staging. However, perineural spread often goes undetected on imaging studies. In this update, we review the concept of perineural spread, its pathogenesis, and the main pathways and connections among the facial nerves, which are essential to understand this process. Furthermore, we discuss the appropriate techniques for imaging studies, and we describe and illustrate the typical imaging signs that help identify perineural spread on CT and MRI. Finally, we discuss the differential diagnosis with other entities.