ABSTRACT
Foreign-body (FB) ingestion is less common in adults than in children, but still occurs. Diagnostic management of patients with suspected FB ingestion in emergency departments depends on FB type and location, both of which are related to the patient profile. In adults, fish and chicken bones are the most common FB types, and the oropharynx and cricopharyngeal muscle are the most common locations. Once accidentally swallowed, an FB may become lodged in the oropharynx, and in such cases indirect or fiberoptic laryngoscopy is the first clinical management option. For FBs that have passed beyond this location, radiologic study is recommended, including anteroposterior and lateral neck radiographs (LNRs) using the soft-tissue technique. This is a quick and simple imaging method that in emergency departments achieves detection rates of 70%-80% in assessing FBs in the hypopharynx and upper cervical esophagus. Careful initial evaluation using LNRs can determine the presence and nature of an FB, which helps with predicting the location and risk assessment, making further imaging-including computed tomography-unnecessary. Prevertebral soft-tissue swelling is a nonspecific indirect sign, which in the appropriate clinical context raises suspicion of a radiolucent FB or related complications. LNRs can sometimes be difficult to interpret due to the presence of multiple overlapping soft-tissue structures and variable patterns of laryngeal cartilage calcification in adults. Adequate performance in interpreting LNRs along with familiarity with the full diagnostic process in these patients will enable radiologists to use the right imaging technique for the right patient, as described in the clinical algorithm proposed by the authors. ©RSNA, 2017.
Subject(s)
Bezoars/diagnostic imaging , Diagnostic Errors/prevention & control , Neck Injuries/diagnostic imaging , Patient Positioning/methods , Radiographic Image Enhancement/methods , Soft Tissue Injuries/diagnostic imaging , Adult , Artifacts , Female , Humans , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Adenoma malignum (AM) is considered a rare subtype of cervical adenocarcinoma. Although previous reports have described magnetic resonance findings, none of these reports evaluated the utility of diffusion-weighted imaging in the differential diagnosis of AM and other multicystic cervical lesions. We present a case report of an AM that did not show restriction on the apparent diffusion coefficient map, which can be explained by the low cellularity of the tumor. This is consistent with the proper correlation between the diffusion imaging and histopathology of the tumor. In this way, AM can present with high apparent diffusion coefficient values, as in benign cervical lesions. Therefore, the combination of a solid multicystic lesion that invades the cervical stroma on T2-weighted magnetic resonance images and the absence of restriction on the apparent diffusion coefficient map are very suggestive of AM.
ABSTRACT
Spinal arachnoid cysts (AC) are intraspinal extramedullary loculated cerebral spinal fluid collections. They are relatively uncommon lesions. Spinal AC often cause symptoms such as pain, weakness and radiculopathy. In this pictorial essay we demonstrate the main radiological features of spinal AC, as well as symptoms and complications associated with them. We also describe the main differential diagnoses.
Subject(s)
Arachnoid Cysts/diagnostic imaging , Magnetic Resonance Imaging , Spinal Cord Diseases/diagnostic imaging , Tomography, X-Ray Computed , Diagnosis, Differential , HumansABSTRACT
La clasificación molecular del cáncer de mama ha permitido predecir su comportamiento biológico, proporcionando información de importancia diagnóstica y terapéutica. El desarrollo de esquemas específicos en terapia primaria sistémica ha aumentado el porcentaje de cirugías conservadoras, manteniendo unas tasas de supervivencia libre de enfermedad y supervivencia global equivalentes a las de la terapia adyuvante. En este ámbito, la resonancia magnética mamaria se ha consolidado como la técnica de imagen de elección para la valoración de la respuesta del cáncer de mama tratado con terapia primaria sistémica, presentando una buena correlación radiopatológica y con capacidad para discriminar diferentes niveles de respuesta en función del perfil molecular (AU)
Molecular classification of breast cancer has allowed us to predict its biological behaviour, providing important diagnostic and therapeutic information. The development of specific treatments in primary systemic therapy has increased the percentage of conservative surgery, with disease-free survival and overall survival rates equivalent to adjuvant therapy. In this setting, breast magnetic resonance imaging has become the imaging modality of choice to evaluate the response of breast cancer treated with primary systemic therapy. This technique has a good radiologic-pathologic correlation and allows discrimination of different types of response according to the molecular profile (AU)
Subject(s)
Female , Humans , Breast Neoplasms/diagnosis , Breast Neoplasms , Immunohistochemistry/methods , Immunohistochemistry , Molecular Biology/methods , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy/methodsABSTRACT
Peritoneal tuberculosis (TB) is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.
Subject(s)
Peritonitis, Tuberculous/diagnostic imaging , Peritonitis, Tuberculous/diagnosis , Adult , Biopsy , Female , HIV Infections/complications , Hepatitis C/complications , Humans , Male , Mycobacterium tuberculosis , Peritonitis, Tuberculous/microbiology , Tomography, X-Ray Computed , Young AdultABSTRACT
La tuberculosis (TBC) peritoneal es una de las formas de presentación extrapulmonar de la tuberculosis. La infección por VIH es uno de los principales factores de riesgo para esta enfermedad. El diagnóstico requiere una confirmación microbiológica o histopatológica, además de pruebas radiológicas que lo apoyen. En el diagnóstico radiológico son útiles la ecografía y la TC abdominal, los hallazgos característicos son el engrosamiento peritoneal difuso, la presencia de ascitis en cantidades variables, adenopatías y nódulos caseificantes. Presentamos 2 casos de pacientes con ascitis y engrosamiento nodular del peritoneo en las pruebas de imagen y un CA 125 elevado en las pruebas de laboratorio. En ambos casos se llegó al diagnóstico de tuberculosis peritoneal después de realizar biopsia peritoneal guiada por ecografía (AU)
Peritoneal tuberculosis (TB) is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy (AU)
