Malrotación-vólvulo intestinal: hallazgos radiológicos / Intestinal malrotation - volvulus: imaging findings

El radiólogo debe ser capaz de reconocer los signos de la malrotación intestinal en la imagen al tratarse de una entidad patológica con complicaciones potencialmente letales, como el vólvulo de intestino medio. Para diagnosticarla correctamente, es tan importante que exista un índice de sospecha clínica elevado como que el radiólogo sepa reconocer los signos específicos de malrotación y las variantes de la normalidad que pueden conducir a un diagnóstico erróneo. Aunque la posición no retroperitoneal de la tercera porción duodenal en ecografía, TC o RM parece ser un signo fiable para el diagnóstico, el tránsito gastrointestinal continúa siendo el estándar de referencia para ver la unión duodeno-yeyunal en una posición anómala. Nuestro objetivo es revisar los principales signos radiológicos de esta enfermedad y hacer hincapié en el papel de la ecografía para diagnosticar el vólvulo de intestino medio (AU)

Radiologists must be able to recognize the imaging signs of intestinal malrotation because this condition can lead to potentially lethal complications such as midgut volvulus. The correct diagnosis depends on both high clinical suspicion and the radiologist's ability to recognize the specific signs of malrotation and the normal variants that can lead to the wrong diagnosis. Although the location of the third portion of the duodenum outside the retroperitoneal area on ultrasonography, CT, or MRI seems to be a reliable sign of malrotation, the gold standard for determining whether the duodenojejunal flexure is in an abnormal location continues to be the upper gastrointestinal series. In this article, we review the most important imaging signs of malrotation and emphasize the role of ultrasonography in diagnosing midgut volvulus (AU)

Intestinal malrotation--volvulus: imaging findings.

Radiologists must be able to recognize the imaging signs of intestinal malrotation because this condition can lead to potentially lethal complications such as midgut volvulus. The correct diagnosis depends on both high clinical suspicion and the radiologist's ability to recognize the specific signs of malrotation and the normal variants that can lead to the wrong diagnosis. Although the location of the third portion of the duodenum outside the retroperitoneal area on ultrasonography, CT, or MRI seems to be a reliable sign of malrotation, the gold standard for determining whether the duodenojejunal flexure is in an abnormal location continues to be the upper gastrointestinal series. In this article, we review the most important imaging signs of malrotation and emphasize the role of ultrasonography in diagnosing midgut volvulus.

Magnetic resonance imaging in the prenatal diagnosis of neural tube defects.

OBJECTIVE: To assess the role of magnetic resonance imaging (MRI) in the prenatal diagnosis of neural tube defects (NTDs). BACKGROUND: NTDs comprise a heterogeneous group of congenital anomalies that derive from the failure of the neural tube to close. Advances in ultrasonography and MRI have considerably improved the diagnosis and treatment of NTDs both before and after birth. Ultrasonography is the first technique in the morphological study of the fetus, and it often makes it possible to detect or suspect NTDs. Fetal MRI is a complementary technique that makes it possible to clear up uncertain ultrasonographic findings and to detect associated anomalies that might go undetected at ultrasonography. The progressive incorporation of intrauterine treatments makes an accurate diagnosis of NTDs essential to ensure optimal perinatal management. The ability of fetal MRI to detect complex anomalies that affect different organs has been widely reported, and it can be undertaken whenever NTDs are suspected. CONCLUSION: We describe the normal appearance of fetal neural tube on MRI, and we discuss the most common anomalies involving the structures and the role of fetal MRI in their assessment. KEY POINTS: • To learn about the normal anatomy of the neural tube on MRI • To recognise the MR appearance of neural tube defects • To understand the value of MRI in assessing NTDs.

Utilidad de la resonancia magnética en el estudio prenatal de las malformaciones de la cara y el cuello / Usefulness of magnetic resonance imaging in the prenatal study of malformations of the face and neck

La ecografía ha sido el pilar único y fundamental del diagnóstico fetal dado que, hasta hace relativamente poco tiempo, no existía ninguna otra técnica no invasiva, válida y fiable que permitiera una correcta valoración morfológica prenatal. A pesar del gran avance tecnológico en ecografía obstétrica no todas las anomalías son visibles mediante esta técnica. Respecto al estudio morfológico de la cara, la ecografía no siempre permite valorarla correctamente, circunstancia manifiesta en la evaluación del paladar, debido a la osificación de las estructuras adyacentes y a la superposición de la lengua. La resonancia magnética fetal ha evolucionado considerablemente desde que se describió hace 25 años y se ha convertido en una herramienta incuestionable para la valoración fetal. Ha demostrado ser complementaria a la ecografía añadiendo información útil sobre la anatomía orofacial y permitiendo así una valoración precisa tanto del paladar primario, como del secundario (AU)

Sonography has been the fundamental pillar of fetal diagnosis, and until relatively recently, no other valid and reliable noninvasive technique that could adequately determine fetal morphology was available. However, even after the technological advances in obstetric sonography, is still unable to detect some anomalies. One example of this shortcoming is the morphological study of the face and neck. Owing to the ossification of adjacent structures and interposition of the tongue, sonography is not accurate in the detection of some of the most common anomalies. Enormous advances have been made in fetal magnet resonance imaging since it was first described 25 years ago. The usefulness of this modality as a tool to complement sonography in fetal evaluation is now firmly established. MRI provides useful information about orofacial anatomy, enabling accurate evaluation of both the primary and secondary palates (AU)

[Usefulness of magnetic resonance imaging in the prenatal study of malformations of the face and neck]. / Utilidad de la resonancia magnética en el estudio prenatal de las malformaciones de la cara y el cuello.

Sonography has been the fundamental pillar of fetal diagnosis, and until relatively recently, no other valid and reliable noninvasive technique that could adequately determine fetal morphology was available. However, even after the technological advances in obstetric sonography, is still unable to detect some anomalies. One example of this shortcoming is the morphological study of the face and neck. Owing to the ossification of adjacent structures and interposition of the tongue, sonography is not accurate in the detection of some of the most common anomalies. Enormous advances have been made in fetal magnet resonance imaging since it was first described 25 years ago. The usefulness of this modality as a tool to complement sonography in fetal evaluation is now firmly established. MRI provides useful information about orofacial anatomy, enabling accurate evaluation of both the primary and secondary palates.

Enfermedad de Menkes: diagnóstico clínico, bioquímico y molecular / Menkes disease: its clinical, biochemical and molecular diagnosis

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[Diagnosis of malformations of the central nervous system using foetal magnetic resonance imaging]. / Diagnóstico mediante resonancia magnética fetal de las malformaciones del sistema nervioso central.

INTRODUCTION AND DEVELOPMENT: Ultrasonography is the preferred diagnostic imaging technique for studying the intrauterine foetus. Yet, occasionally certain circumstances arise where it is necessary to use other techniques in order to achieve a better analysis of the foetal structures. The development of ultra-high speed magnetic resonance imaging (MRI) has now been applied to the study of the foetus, since it allows images to be obtained in extremely short times and the effects of movements by the mother or the foetus have little influence on the results. It is a type of imaging that does not use ionising radiations and offers high contrast images in any plane without being influenced by the physical characteristics of the expectant mother or the position of the foetus. AIMS: To make the technique and the use of MRI in foetal studies more widely known, as well as to review the role played by MRI in the study and treatment of foetal deformations of the central nervous system detected within the uterus. CONCLUSIONS: Anomalies of the central nervous system constitute the most frequent cause of visits for prenatal diagnosis. They usually have a poor prognosis due to the likelihood of important sequelae and are a cause of great concern to the parents. They are often associated with genetic and chromosomal disorders.

Diagnóstico mediante resonancia magnética fetal de las malformaciones del sistema nervioso central / Diagnosis of malformations of the central nervous system using foetal magnetic resonance imaging

Introducción y desarrollo. La ecografía es la técnica dediagnóstico por imagen de elección para el estudio fetal intraútero;no obstante, existen circunstancias donde se hacen necesarias otrastécnicas de estudio para un mejor análisis de las estructuras fetales.La aparición de las secuencias ultrarrápidas en resonanciamagnética (RM) ha permitido que esta modalidad de imagen puedaaplicarse al estudio del feto, ya que posibilita la obtención de imágenesen tiempos extraordinariamente cortos, poco influidos porlos movimientos maternos o fetales. Es una modalidad que no utilizaradiaciones ionizantes y proporciona imágenes de alto contrastey en cualquier plano del espacio, sin verse influida por las característicasfísicas de la gestante ni la posición fetal. Objetivos.Dar a conocer la técnica y el uso de la RM en el estudio fetal y revisarel papel que desempeña la RM en el estudio y el tratamiento delas malformaciones fetales del sistema nervioso central detectadasintraútero. Conclusión. Las anomalías del sistema nervioso centralconstituyen la causa más frecuente de consulta de diagnóstico prenatal.Habitualmente tienen mal pronóstico por la probabilidad desecuelas importantes y causan gran preocupación a los padres.Muchas veces se asocian a trastornos genéticos y cromosomopatías

Introduction and development. Ultrasonography is the preferred diagnostic imaging technique for studying theintrauterine foetus. Yet, occasionally certain circumstances arise where it is necessary to use other techniques in order toachieve a better analysis of the foetal structures. The development of ultra-high speed magnetic resonance imaging (MRI) hasnow been applied to the study of the foetus, since it allows images to be obtained in extremely short times and the effects ofmovements by the mother or the foetus have little influence on the results. It is a type of imaging that does not use ionisingradiations and offers high contrast images in any plane without being influenced by the physical characteristics of the expectantmother or the position of the foetus. Aims. To make the technique and the use of MRI in foetal studies more widely known, aswell as to review the role played by MRI in the study and treatment of foetal deformations of the central nervous system detectedwithin the uterus. Conclusions. Anomalies of the central nervous system constitute the most frequent cause of visits for prenataldiagnosis. They usually have a poor prognosis due to the likelihood of important sequelae and are a cause of great concern tothe parents. They are often associated with genetic and chromosomal disorders

Pseudosubluxation of C2-C3 in childhood: a frequent clinico-radiological diagnostic error. / Pseudosubluxación C2-C3 en la infancia: un error frecuente de diagnóstico clínico-radiológico.

Although serious cervical injuries in pediatric patients are very infrequent, the may occur occasionally as a result of a strong blow to the head. Clinical records and radiological pictures, and in some cases computer tomography, help to provide the correct diagnosis. During childhood there are several normal radiological variants that may be interpreted as pathological findings, of which pseudosubluxation C2-C3 is the most frequent. We present two such cases and discuss the clinical and radiological criteria for the differential diagnosis between normal variants and injuries to the cervical spine in pediatric patients.