Estudio del ventrículo derecho mediante resonancia magnética / Study of the right ventricle using magnetic resonance imaging

La resonancia magnética (RM) es una técnica de probada eficacia en el estudio del corazón. Sus aplicaciones clínicas se dirigen preferentemente al estudio del ventrículo izquierdo, quedando el ventrículo derecho relegado a un segundo plano. Este artículo ofrece una revisión de la anatomía y fisiología del ventrículo derecho, así como de las manifestaciones de la afección más frecuente en esta cámara cardíaca: infarto, miocardiopatías, masas y fallo cardíaco derecho. El conocimiento de los rasgos diferenciales del ventrículo derecho con respecto al izquierdo y de las particularidades del protocolo de estudio mediante RM, consigue un mayor rendimiento de la técnica en aquellos casos en que el motivo de petición o los hallazgos de imagen apuntan al ventrículo derecho. La RM reúne características para apoyar desde la imagen el protagonismo creciente que los clínicos están otorgando al ventrículo derecho en el manejo de las enfermedades cardiopulmonares (AU)

Magnetic resonance (MR) imaging has proven efficacy in the study of the heart. Its clinical applications are directed primarily at the study of the left ventricle, and the right ventricle is relegated to the background. This article reviews the anatomy and physiology of the right ventricle, as well as the manifestations of most common diseases affecting this chamber of the heart: infarction, cardiomyopathy, masses, and right heart failure. Knowing the distinctive features of the right ventricle with respect to the left and the particularities of the MR imaging protocol results in better technical performance in cases in which the reason for the examination or imaging findings point to the right ventricle. The importance of the right ventricle in the management of cardiopulmonary disease is growing and MR imaging can provide clinicians with the support they need (AU)

[Study of the right ventricle using magnetic resonance imaging]. / Estudio del ventrículo derecho mediante resonancia magnética.

Magnetic resonance (MR) imaging has proven efficacy in the study of the heart. Its clinical applications are directed primarily at the study of the left ventricle, and the right ventricle is relegated to the background. This article reviews the anatomy and physiology of the right ventricle, as well as the manifestations of most common diseases affecting this chamber of the heart: infarction, cardiomyopathy, masses, and right heart failure. Knowing the distinctive features of the right ventricle with respect to the left and the particularities of the MR imaging protocol results in better technical performance in cases in which the reason for the examination or imaging findings point to the right ventricle. The importance of the right ventricle in the management of cardiopulmonary disease is growing and MR imaging can provide clinicians with the support they need.

Hipointensidad subcortical reversible en secuencia T2 en crisis convulsivas secundarias a cetoacidosis diabética / Subcortical reversible T2-weighed hypointensities in seizures secondary to diabetic ketoacidosis

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[The indications for the appropriate use of magnetic resonance. The Health Technologies Evaluation Service of the Department of Health of the Basque Government, Osteba]. / Indicaciones de uso apropiado de resonancia magnética. Servicio de Evaluación de Technologías Sanitarias del Departamento de Sanidad del Gobierno Vasco, Osteba.

Magnetic resonance imaging (MRI) allows the non-invasive obtention of diagnostic images, with no ionizing radiation emission and in any space plane. It has a great capacity to differentiate anatomic structures, and it is very useful for planning surgery or radiotherapy. It is the first choice diagnostic technique in conditions involving the central nervous system, useful for establishing diagnosis, surgery planning, and following lesions involving the spinal cord and spine. In the musculoskeletal system it may become and appropriate alternative to arthroscopy. Nevertheless, it is of limited use for the diagnosis of chest, abdominal and pelvic pathology.

[Usefulness of magnetic resonance angiography in the diagnosis of polar vessel in stenosis of the pyeloureteral junction]. / Utilidad de la angioresonancia magnética en el diagnóstico del vaso polar en la estenosis de la unión pieloureteral.

OBJECTIVES: To present the results of a prospective study that had been conducted to determine the accuracy of magnetic resonance angiography (MRA) in the detection of accessory or polar vessels associated with ureteropelvic junction (UPJ) stricture, in order to utilize the most appropriate surgical procedure in the management of this condition. METHODS: From October, 1994 to September, 1996, 30 MRA procedures were done in 12 males and 18 females, aged 14 to 73 years (mean 38.12), with symptomatic UPJ obstruction. When the MRA was positive for polar vessels, the patients underwent open dismembered pyeloplasty; surgical correlation and a true positive result could be established. Percutaneous endopyelotomy was offered when the MRA was negative. The findings at open surgery and an unremarkable clinical course and radiological findings at one year follow-up established a true negative result. RESULTS: Accessory or polar vessels (11 arteries; 4 veins) were found in 11 patients (36.4%). MRA had a sensitivity of 92.3% (15/16) for detection of accessory vessels. Fourteen patients underwent open surgery (11 dismembered pyeloplasties; 3 nephrectomies) and the MRA findings were confirmed in each case (8 positive; 6 negative). Surgery disclosed an accessory vein that had not been detected on MRA in only one patient. This patient also had a polar artery that had been observed on MRA and demonstrated at surgery; thus, the sensitivity of MRA for detection of UPJ stenosis with polar vessel is 100% (11/11). Each vessel described on MRA was confirmed at surgery; there were therefore no false positives and the specificity was 100%. CONCLUSIONS: Although this is a preliminary study with a short follow-up and with some limitations, the results indicate that MRA is a simple, non-invasive technique with a high sensitivity and specificity for detection of polar vessels associated with UPJ stenosis, and appears to be a useful preoperative diagnostic procedure due to the surgical implications.