RESUMO
INTRODUCTION: High-grade adenocarcinoma of the prostate tends to have denser glandular structures and a prominent desmoplastic reaction, which could be detected by magnetic resonance imaging (MRI) with a super-high b-value in diffusion-weighted imaging (DWI) sequence, to differentiate it from low-grade carcinomas. OBJECTIVE: To evaluate the diagnostic validity of the diffusion sequence with values ââof b4000 s/mm2 for the diagnosis of high-grade prostate cancer (Gleason score ≥ 7). MATERIALS AND METHODS: It is a retrospective analytical study of male patients who have undergone a prostate biopsy and count with a prostate MRI with a DWI sequence of a super-high b-value (4000 s/mm2). RESULTS: The sensitivity of the diffusion sequence with b4000 s/mm2 values ââto classify as positive for prostate cancer was 57.14% as compared to biopsy. The specificity of the diffusion sequence with b4000 s/mm2 values ââclassifying patients with prostate carcinoma as negative was 84.62%. The probability that the diffusion sequence with b4000 s/mm2 values ââclassifies patients with prostate cancer was 80%. The probability that the diffusion sequence with b4000 s/mm2 values ââdoes not classify patients with prostate cancer was 64.71%. The proportion of patients adequately classified with prostate cancer using the diffusion sequence with b4000 s/mm2 values ââwas 70.37%. CONCLUSIONS: The study shows that using the diffusion sequence with values of b4000 s/mm2 is an optimal value that serves as a tool to be able to decant those high-risk carcinomas with those of low risk; however, it is not a definitive method of diagnosis that could replace the performance of a biopsy. Since the study sample was limited, these results cannot be interpreted as reliable for diagnosing high-grade prostate cancer and should encourage future studies on a larger scale population to obtain significant evidence for a non-invasive diagnostic tool with a better cost-benefit for the patient.
RESUMO
Endometrial polyps are a common cause of abnormal vaginal bleeding and infertility, which can be identified with different imaging methods. A lack of distention of the endometrial cavity is not a common presentation of endometrial polyps and is associated with endometrial carcinoma. In this article, we present a case of a 30-year-old patient with previous history of infertility and abnormal vaginal bleeding. During a hysterosalpingography (HSG), we were not able to distend the endometrial cavity. Therefore, we performed a transvaginal ultrasound (TVUS) and a pelvic magnetic resonance study, which showed an obstructive endometrial polyp adjacent to the internal cervical os. This structure was successfully removed through hysteroscopy by the gynecology department.
RESUMO
A 16-year-old female patient showed up at the orthopaedics unit complaining of intolerable pain on her left hip. While being questioned and her clinical history written down, she shared that as part of her daily exercise routine, she ran 10 miles (16 km) daily at a speed of 9.5-10.5 mph (15-17 km/hour). MRI was consequently ordered, confirming the presence of a stress fracture. Therefore, immediate suspension of physical activity was indicated, followed by the prescription of crutches as well as restricted weight bearing. Gradually, she recovered complete functionality and approximately a month after she had entirely healed. While on a skiing trip, again she abruptly developed an acute pain on her right hip. Another MRI was ordered; its result confirmed a new stress fracture. Her previous treatment has proved so successful, a conservative approach was once again prescribed for her, showing optimum results 6 months later.
