ABSTRACT
La patología benigna anorrectal comprende una amplio grupo de procesos de muy diversos orígenes, congénitos o adquiridos, inflamatorios o tumorales. Sin embargo, ha recibido en la bibliografía científica menor atención que el estudio de la patología tumoral maligna. Presentamos una revisión basada en imágenes de la patología benigna anorrectal más frecuente. En esta primera parte realizamos un recuerdo anatómico y una breve descripción de las peculiaridades del protocolo de alta resolución que empleamos con la RM de 3.0 T. Después describimos los principales tumores benignos anorrectales y lesiones quísticas del desarrollo junto con sus principales diagnósticos diferenciales y las anomalías congénitas y adquiridas del complejo esfinteriano anorrectal (AU)
Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex (AU)
Subject(s)
Humans , Anus Diseases/diagnosis , Diagnostic Imaging/methods , Rectal Diseases/diagnosis , Magnetic Resonance Spectroscopy/methods , Diagnosis, DifferentialABSTRACT
OBJECTIVE: To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot. MATERIAL AND METHODS: We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems. In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles' tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher's exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani. RESULTS: Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001). CONCLUSION: We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis.
Subject(s)
Flatfoot/diagnosis , Flatfoot/etiology , Magnetic Resonance Imaging , Posterior Tibial Tendon Dysfunction/complications , Posterior Tibial Tendon Dysfunction/diagnosis , Adult , Aged , Case-Control Studies , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex.
Subject(s)
Anus Diseases/diagnosis , Anus Neoplasms/diagnosis , Magnetic Resonance Imaging , Rectal Diseases/diagnosis , Rectal Neoplasms/diagnosis , Anal Canal/anatomy & histology , Clinical Protocols , Female , Humans , Magnetic Resonance Imaging/methods , Male , Rectum/anatomy & histologyABSTRACT
Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease.
Subject(s)
Magnetic Resonance Imaging/methods , Proctitis/diagnosis , Anus Diseases/diagnosis , Anus Diseases/surgery , Humans , Postoperative Complications/etiology , Proctitis/surgery , Rectal Diseases/diagnosis , Rectal Diseases/surgeryABSTRACT
La tractografía (TG) es la única técnica no invasiva que permite la disección in vivo de las fibras de la sustancia blanca. Esta técnica puede estudiar las fibras de proyección, de asociación y las fibras comisurales, y supone una mejora y un importante complemento a la imagen de la resonancia magnética convencional. La TG es una herramienta clave para la realización de mapeos subcorticales preoperatorios y existe una buena correlación entre la TG y la técnica de estimulación directa subcortical. La TG puede presentar falsos negativos en aquellas regiones infiltradas por el tumor o con efecto de masa. Además, una TG negativa no excluye la persistencia de fibras funcionales. La TG es capaz de mostrar alteraciones en otras afecciones (malformaciones congénitas, afección isquémica y enfermedades desmielinizantes) (AU)
Tractography (TG) is the only non-invasive technique that enables the fibres of the white substance to be dissected. This technique can study the projection, association, and commissural fibres, and is an improvement and an important complement to conventional MR imaging. TG is an important tool for preoperative sub-cortical mapping, and there is a good correlation between TG and the direct sub-cortical stimulation technique. TG can have false positives in regions infiltrated by the tumour or with a mass effect. Furthermore, a negative TG does not exclude functional fibre persistence. TG is capable of demonstrating changes in other pathologies (congenital malformations, ischaemic disease and demyelinating diseases) (AU)
Subject(s)
Humans , Male , Female , /instrumentation , /methods , Diagnostic Imaging/instrumentation , Diagnostic Imaging/methods , Diagnostic Imaging/standards , Diffusion Magnetic Resonance Imaging/instrumentation , Diffusion Magnetic Resonance Imaging/methods , /standards , /trends , Diagnostic Imaging/trends , Diagnostic ImagingABSTRACT
Tractography (TG) is the only non-invasive technique that enables the fibres of the white substance to be dissected. This technique can study the projection, association, and commissural fibres, and is an improvement and an important complement to conventional MR imaging. TG is an important tool for preoperative sub-cortical mapping, and there is a good correlation between TG and the direct sub-cortical stimulation technique. TG can have false positives in regions infiltrated by the tumour or with a mass effect. Furthermore, a negative TG does not exclude functional fibre persistence. TG is capable of demonstrating changes in other pathologies (congenital malformations, ischaemic disease and demyelinating diseases).
Subject(s)
Brain Diseases/diagnosis , Diffusion Tensor Imaging , HumansABSTRACT
La enfermedad de Crohn es una enfermedad crónica de curso imprevisible que requiere numerosos estudios radiológicos durante la vida. Afecta frecuentemente a pacientes jóvenes, más vulnerables a los efectos nocivos de las exploraciones repetidas con radiaciones ionizantes. La precisión diagnóstica de la enterografía por RM es similar a la de la tomografía computarizada por su alta resolución tisular, sin el inconveniente de la radiación. Los índices clínicos de valoración de la enfermedad son poco precisos y subjetivos por lo que las técnicas enterográficas de imagen se están incorporando cada vez más a la práctica clínica como medios objetivos de control de la gravedad de la enfermedad. En este artículo, describimos nuestra técnica enterográfica en RM para la valoración de la enfermedad de Crohn. Revisaremos los hallazgos más relevantes por imagen y los subtipos de la enfermedad, la literatura científica relacionada y los índices por RM en la valoración de la gravedad de la enfermedad (AU)
Crohn's disease is a chronic disease with an unpredictable course. Patients with Crohn's disease will have to undergo numerous imaging tests. Crohn's disease often affects young people, who are more vulnerable to the harmful effects of repeated exposure to ionizing radiation. The high resolution of tissues on MR enterography give it a diagnostic accuracy similar to that of CT; however, MR enterography does not have the drawback of ionizing radiation. The clinical indices used to assess Crohn's disease are subjective and not very accurate; thus, enterographic techniques are becoming more common in clinical practice as a means to follow up patients objectively. In this article, we describe the MR enterography technique we use to evaluate Crohn's disease. We illustrate the most relevant imaging findings, and we review the subtypes of the disease, the related scientific literature, and the MR indices used to assess the severity of Crohn's disease (AU)
Subject(s)
Humans , Male , Female , Crohn Disease , Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging/trends , /instrumentation , /methods , Gadolinium , /trends , Parasympatholytics/therapeutic use , Gastric Emptying , Gastric Emptying/physiologyABSTRACT
Crohn's disease is a chronic disease with an unpredictable course. Patients with Crohn's disease will have to undergo numerous imaging tests. Crohn's disease often affects young people, who are more vulnerable to the harmful effects of repeated exposure to ionizing radiation. The high resolution of tissues on MR enterography give it a diagnostic accuracy similar to that of CT; however, MR enterography does not have the drawback of ionizing radiation. The clinical indices used to assess Crohn's disease are subjective and not very accurate; thus, enterographic techniques are becoming more common in clinical practice as a means to follow up patients objectively. In this article, we describe the MR enterography technique we use to evaluate Crohn's disease. We illustrate the most relevant imaging findings, and we review the subtypes of the disease, the related scientific literature, and the MR indices used to assess the severity of Crohn's disease.
