[Nephrotoxicity due to iodine contrasts in computerized tomography studies of diabetic outpatients on metformin]. / Nefrotoxicidad por contrastes yodados en estudios de tomografía computarizada a pacientes ambulatoriso diabéticos en tratamiento con metformina.

BACKGROUND: To determine the incidence of contrast-induced nephropathy (CIN) among diabetic patients treated with Metformin who underwent computerized tomography (CT) scan with iodinated contrast media. METHODS: Prospective study of diabetic patients enrolled in a lactic acidosis prevention protocol in whom clinical and analytical follow up after CT scan with intravenous contrast was performed. RESULTS: In this study, 98 cases were collected. The incidence of CIN in diabetic patients without prior renal failure was 0%. In patients with previous renal failure the incidence of CIN was 4.7%. CONCLUSIONS: The risk of CIN in diabetic patients with no renal failure undergoing intravenous contrast administration is minimal. Recommendations to stop Metformin to avoid lactic acidosis in patients undergoing intravenous contrast administration may be restricted to patients with abnormal renal function.

[Cerebral gliomatosis with development of multifocal glioblastoma]. / Gliomatosis cerebral con desarrollo de glioblastoma multifocal.

INTRODUCTION: Cerebral gliomatosis (CG) is a diffuse infiltrating glial neoplasia which may affect any part of the central nervous system (CNS). Its diffuse infiltrating growth leads to difficulty with clinical suspicion and imaging technique diagnosis. Magnetic resonance (MR) is more sensitive than computerized tomography (CT) for the detection of lesions. However, the extent of the infiltration may be roughly evaluated using current imaging techniques. OBJECTIVE: In this article we describe histological aspects of this rare condition, its biological behavior and correlation with radiological findings, and review the contribution of other techniques (positron emission tomography, immunohistochemical examination) in its diagnosis and delimitation. CLINICAL CASE: We present a case of CG in a 26 year old man. On CT no alterations were seen. On MR there was diffuse involvement of the white matter extending to the cortex. The patient worsened rapidly and later developed two focal masses of glioblastoma multiform in areas with the most neoplastic infiltration. CONCLUSIONS: MR is more useful than CT in establishing the diagnosis and extent of CG. Although it is a rare condition, it should be included in the differential diagnosis of conditions which affect the white matter in a diffuse manner. Poor delimitation between white and grey matter helps in diagnosis of this condition.

[Ganglion cell tumors]. / Tumores de células ganglionares.

INTRODUCTION: Tumours of ganglion cells are very rare. They include: gangliocytoma, ganglioneuroma, Lhermitte-Duclos disease and dysembryoplastic neuroepithelial tumour. All require microscope identification of well differentiated neurons for diagnosis. Their pathogenesis is not fully understood. Some workers consider them to be dysplasias rather than true neoplasias; others refer to them as malformations. OBJECTIVE: We aim to analyze the most characteristic findings of these tumours with regard to the elements of which they are composed, their epidemiology, behavior on imaging investigations (CT and MR) and treatment. CLINICAL CASES: We present two cases: one patient with a gangliocytoma and one with a ganglioglioma. Both were treated surgically, confirmed on histological study and had good clinical results.

[Magnetic resonance in the diagnosis of bladder pheochromocytoma]. / Resonancia magnética en el diagnóstico de feocromocitoma vesical.

OBJECTIVE: The present study describes the advantages of magnetic resonance imaging (MRI) in the diagnosis of bladder pheochromocytoma. METHODS/RESULTS: A case of bladder pheochromocytoma is described, with special reference to the diagnostic aspects and the usefulness of MRI in the evaluation of patients with this condition. CONCLUSIONS: Bladder pheochromocytoma is a rare tumor type. Since most of these are catecholamine-producing lesions, early diagnosis is warranted to avoid the severe complication of hypertensive episodes that may arise from unnecessary maneuvers. MRI is the diagnostic imaging method of choice in those cases with a clinical and analytical suspicion of pheochromocytoma.