Valoración radiológica de los tumores congénitos / Radiological evaluation of congenital tumors

Los tumores congénitos son aquellos tumores diagnosticados durante el embarazo y los tres primeros meses de vida. Constituyen un grupo heterogéneo de neoplasias con unas características biológicas y epidemiológicas especiales que los diferencian del resto de los tumores pediátricos y de la edad adulta. Su detección prenatal ha aumentado en las dos últimas décadas debido a la generalización del cribado ecográfico prenatal. El desarrollo de las técnicas de imagen, especialmente la resonancia magnética (RM) fetal, ha permitido mejorar el diagnóstico, el seguimiento y el manejo clínico y terapéutico perinatal de estos tumores. Presentamos una revisión basada en imágenes de los tumores congénitos más frecuentes, describiendo los tipos histológicos, localizaciones y sus características en las distintas técnicas de imagen empleadas (AU)

In this article, we consider tumors that are diagnosed during pregnancy or in the first three months of life. This is a heterogeneous group of neoplasms with special biological and epidemiological characteristics that differentiate them from tumors arising in children or adults. In the last two decades, the prenatal detection of congenital tumors has increased due to the generalized use of prenatal sonographic screening. Advances in imaging techniques, especially in fetal magnetic resonance imaging, have enabled improvements in the diagnosis, follow-up, clinical management, and perinatal treatment of these tumors. This image-based review of the most common congenital tumors describes their histologic types, locations, and characteristics on the different imaging techniques used (AU)

[Radiological evaluation of congenital tumors]. / Radiografía del abdomen en Urgencias. ¿Una exploración para el recuerdo?

In this article, we consider tumors that are diagnosed during pregnancy or in the first three months of life. This is a heterogeneous group of neoplasms with special biological and epidemiological characteristics that differentiate them from tumors arising in children or adults. In the last two decades, the prenatal detection of congenital tumors has increased due to the generalized use of prenatal sonographic screening. Advances in imaging techniques, especially in fetal magnetic resonance imaging, have enabled improvements in the diagnosis, follow-up, clinical management, and perinatal treatment of these tumors. This image-based review of the most common congenital tumors describes their histologic types, locations, and characteristics on the different imaging techniques used.

[Nutcracker's syndrome: demostration with helicoidal TC with volumetric reconstruction "3D"]. / Síndrome "Nutcracker" o Cascanueces: demostración mediante TAC Helicoidal con reconstrucción "3D" (VR).

The nutcracker's syndrome or phenomenom is defined as the left renal vein compression between the aorta and the superior mesenteric artery. Diagnosis is uncommon, not only due to its low frequency but for the dificulty to be suspected in usual findings as lumbar pain or hematuria. We present the case of a patient to whom we were able to show mentioned pathology with the helicoidal TC with volumetric reconstruction "3D" (VR).

Síndrome “nutcracker” o cascanueces: demostración mediante TAC helicoidal con reconstrucción “3D” (VR) / Nutcracker’s syndrome: demostration with helicoidal tc with volumetric reconstruction “3D”

El síndrome o fenómeno de Nutcracker o Cascanueces se define como la compresión de la vena renal izquierda a su paso por la pinza u horquilla vascular formada por la aorta y la mesentérica superior. Su diagnóstico es poco frecuente, tanto por su baja frecuencia como por la dificultad de sospecharlo ante hallazgos tan frecuentes como el dolor lumbar o la hematuria. Presentamos el caso de una paciente en la cual pudimos demostrar dicha patología mediante el apoyo diagnóstico del TAC helicoidal con reconstrucción volumétrica o “3D” (VR)

The nutcracker’s syndrome or phenomenom is defined as the left renal vein compression between the aorta and the superior mesenteric artery. Diagnosis is uncommon, not only due to its low frequency but for the dificulty to be suspected in usual findings as lumbar pain or hematuria. We present the case of a patient to whom we were able to show mentioned pathology with the helicoidalTC with volumetric reconstruction “3D” (VR)

[Usefulness of computed tomography for the staging and management of post-traumatic renal lesions]. / Utilidad de la tomografía computarizada para la estadificación y manejo de la lesión renal postraumática.

OBJECTIVE: Use of computerized tomography (CT) criteria for the staging of 50 cases of renal trauma diagnosed in the Hospital General Universitario "Gregorio Marañón" over the 1989-1995 period. CT is used as the choice technique to diagnose renal lesions of traumatic etiology in patients haemodynamically stable. MATERIAL AND METHODS: Retrospective study of 50 patients (age range: 16-73 years; sex distribution: 39 male/11 female) with a history of abdominal trauma and CT-confirmed renal injury. Following Hodges-Federle criteria for patients with no underlying renal disease (n = 44), lesions are staged into 4 categories or grades according to CT findings. The traumatic mechanism is correlated to clinical semiology, staging and associated extrarenal lesions. Also, traumatic renal lesions in patients with previously diseased kidneys (n = 6) are analyzed separately. RESULTS AND CONCLUSIONS: Percentile distribution of lesions was as follows: grade I: 50% (n = 22), grade II: 29.5% (n = 13): grade III: 11.4% (n = 5): grade IV: 9.1% (n = 4). Compared to others, our series shows a decreased percentage of mild or grade I lesions. It is confirmed that CT is a very valuable imaging method for an adequate staging of post-traumatic renal lesions, the diagnosis of associated extra-renal lesions and, therefore, for the subsequent therapeutical management.

[Stress fractures in children: clinico-radiologic diagnosis]. / Las fracturas de estrés en el niño: diagnóstico clínicorradiológico.

The authors present 4 children with stress bone fractures and review this entity. The most significant aspects in the mechanism of production of stress fractures are considered along with the appropriate steps for the diagnosis after careful history and physical examination, with special emphasis to the imaging diagnosis.

[Subcapsular hepatic hematoma in the neonatal period: echographic diagnosis]. / El hematoma subcapsular hepático en el período neonatal: diagnóstico ecográfico.

We report a case of Subcapsular Hematoma in a preterm neonate. The etiology, clinical findings and therapeutic features of this entity are reviewed and emphasis is made on the importance of radiographic and sonographic images in early diagnosis. We also discuss the absence of intestinal air in the premature, as well as possible etiologies and differential diagnosis.