Estudio de las enfermedades de las trompas de Falopio mediante resonancia magnética / Fallopian tube disease on magnetic resonance imaging

Conocer las enfermedades de las trompas de Falopio es esencial para valorar la pelvis ginecológica. Las alteraciones primarias y secundarias de las trompas, cursen o no con alteraciones ováricas asociadas, son muy variadas. Pese a que la ecografía, por su gran sensibilidad y disponibilidad, es la técnica inicial para estudiar las alteraciones anexiales, la RM es muy útil en el diagnóstico de las enfermedades tubáricas porque su elevada resolución tisular y el detalle anatómico que proporciona le confieren una mayor especificidad. Los hallazgos morfológicos y las características del contenido tubárico con la RM posibilitan un diagnóstico más preciso o limitan el diagnóstico diferencial y permiten orientar el tratamiento más adecuado en cada caso(AU)

Knowledge about fallopian tube disease is essential in the assessment of the pelvis in female patients. Primary and secondary changes in the tubes vary widely, regardless of whether associated changes in the ovaries are present. Ultrasonography is the initial technique in the study of adnexal disease because it is very sensitive and widely available; however, MRI is also very useful in this context because its high tissue resolution and anatomic detail make it more specific. The morphologic findings and the characteristics of the contents of the tubes on MRI enable a more accurate diagnosis or limit the differential diagnosis, helping to ensure that the most appropriate treatment is provided in each case(AU)

[Fallopian tube disease on magnetic resonance imaging]. / Estudio de las enfermedades de las trompas de Falopio mediante resonancia magnética.

Knowledge about fallopian tube disease is essential in the assessment of the pelvis in female patients. Primary and secondary changes in the tubes vary widely, regardless of whether associated changes in the ovaries are present. Ultrasonography is the initial technique in the study of adnexal disease because it is very sensitive and widely available; however, MRI is also very useful in this context because its high tissue resolution and anatomic detail make it more specific. The morphologic findings and the characteristics of the contents of the tubes on MRI enable a more accurate diagnosis or limit the differential diagnosis, helping to ensure that the most appropriate treatment is provided in each case.

Mastopatía diabética: clínica, hallazgos radiológicos y anatomopatológicos y tratamiento / Diabetic mastopathy: clinical presentation, imaging and histologic findings, and treatment

Objetivo. La mastopatía diabética (MD) es una complicación infrecuente de la diabetes mellitus de larga evolución, que plantea el diagnóstico diferencial con el cáncer de mama. Se estudian la presentación clínica y evolución de la MD, los hallazgos radiológicos, la histología y el tratamiento en los pacientes diagnosticados en nuestro hospital. Material y métodos. Se incluyen 6 pacientes diabéticos insulinodependientes con MD, 5 mujeres y un varón, diagnosticados en un periodo de 11 años. El estudio radiológico se realiza con mamografía, ecografía y resonancia magnética (RM). Se obtiene en todos los casos un diagnóstico anatomopatológico definitivo con biopsia con aguja gruesa o quirúrgica. No se recurre en ningún caso a punción-aspiración con aguja fina. Se lleva a cabo un seguimiento clínico en un periodo medio de 7 años. Resultados. La presentación clínica más frecuente es el nódulo palpable (67%). Los hallazgos radiológicos son: en la mamografía, la asimetría de densidad (50%), en la ecografía un nódulo/masa sólido, hipoecoico, de 1-5cm, mal definido, con sombra acústica y sin señal Doppler (50%) y en la RM el realce tras la administración de contraste (66%). El hallazgo anatomopatológico más frecuente es la mastitis linfocítica en estadios iniciales (83%). Se realiza un tratamiento quirúrgico en todos los pacientes (100%). Conclusiones. La MD es una enfermedad poco frecuente que plantea el diagnóstico diferencial con el cáncer de mama. Su diagnóstico es complejo, pues requiere el conocimiento de los antecedentes personales del paciente, la clínica, la exploración física y los hallazgos radiológicos e histológicos. El tratamiento quirúrgico conservador es de elección, porque no se obtiene respuesta con el tratamiento médico (AU)

Objective. Diabetic mastopathy is an uncommon complication of longstanding diabetes mellitus that must be considered in the differential diagnosis with breast cancer. We report the clinical presentation and course, the imaging and histologic findings, and the treatment of the patients diagnosed with diabetic mastopathy at our hospital. Material and methods. In an 11-year period, we studied six insulin-dependent diabetic patients (five women and one man) with diabetic mastopathy. Imaging studies included mammography, ultrasonography, and magnetic resonance imaging. A definitive histologic diagnosis was reached after core needle or surgical biopsy in all cases. Fine-needle aspiration cytology was not used in any of the cases. The mean follow-up period was 7years. Results. The most common clinical presentation was a palpable nodule (67%). The imaging findings were a) at mammography: asymmetrical density (50%), b) at ultrasonography: a solid, hypoechoic nodule measuring between 1cm and 5cm in diameter, with ill-defined margins, acoustic shadowing, and no Doppler signal (50%), and c) at MRI: enhancement after the administration of contrast media (66%). The most common histologic finding was lymphocytic mastitis in the initial stages (83%). All patients underwent surgical treatment (100%). Conclusions. Diabetic mastopathy is an uncommon disease that should be included in the differential diagnosis with breast cancer in diabetic patients. The diagnosis is complex because it requires knowledge of the patient's history, clinical presentation, and the imaging and histologic findings, Conservative surgery is the treatment of choice because the condition does not respond to medical treatment (AU)

[Diabetic mastopathy: clinical presentation, imaging and histologic findings, and treatment]. / Mastopatía diabética: clínica, hallazgos radiológicos y anatomopatológicos y tratamiento.

OBJECTIVE: Diabetic mastopathy is an uncommon complication of longstanding diabetes mellitus that must be considered in the differential diagnosis with breast cancer. We report the clinical presentation and course, the imaging and histologic findings, and the treatment of the patients diagnosed with diabetic mastopathy at our hospital. MATERIAL AND METHODS: In an 11-year period, we studied six insulin-dependent diabetic patients (five women and one man) with diabetic mastopathy. Imaging studies included mammography, ultrasonography, and magnetic resonance imaging. A definitive histologic diagnosis was reached after core needle or surgical biopsy in all cases. Fine-needle aspiration cytology was not used in any of the cases. The mean follow-up period was 7 years. RESULTS: The most common clinical presentation was a palpable nodule (67%). The imaging findings were a) at mammography: asymmetrical density (50%), b) at ultrasonography: a solid, hypoechoic nodule measuring between 1cm and 5cm in diameter, with ill-defined margins, acoustic shadowing, and no Doppler signal (50%), and c) at MRI: enhancement after the administration of contrast media (66%). The most common histologic finding was lymphocytic mastitis in the initial stages (83%). All patients underwent surgical treatment (100%). CONCLUSIONS: Diabetic mastopathy is an uncommon disease that should be included in the differential diagnosis with breast cancer in diabetic patients. The diagnosis is complex because it requires knowledge of the patient's history, clinical presentation, and the imaging and histologic findings, Conservative surgery is the treatment of choice because the condition does not respond to medical treatment.