La patología benigna de ano y recto con RM 3.0T. 2.a Parte: patología inflamatoria ano-rectal. Anatomía postquirúrgica y complicaciones postratamiento / 3.0T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part 2: anorectal inflammatory disease. Postsurgical anatomy and complications after treatment

La patología benigna anorrectal comprende una vasta cantidad de entidades de muy diversos orígenes, congénitas o adquiridas, inflamatorias o tumorales. Sin embargo, ha recibido menos atención en la bibliografía científica que el estudio de la patología tumoral maligna. En esta segunda entrega de la revisión basada en imágenes de la patología benigna anorrectal describimos la patología inflamatoria y fistulosa más frecuente, la anatomía posquirúrgica y las complicaciones secundarias al tratamiento quirúrgico o radioterápico de la patología anorrectal (AU)

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease (AU)

Disfunción del tendón tibial posterior: ¿qué otras estructuras están implicadas en el desarrollo del pie plano adquirido del adulto? / Posterior tibial tendon dysfunction: what other structures are involved in the development of acquired adult flat foot?

Objetivo: Valorar la asociación entre disfunción del tendón tibial posterior (DTTP), las lesiones de diversas estructuras del tobillo diagnosticadas por RM, y los signos radiológicos del pie plano. Material y método: Realizamos un estudio retrospectivo comparando 29 pacientes con DTTP, todos examinados por RM (21 de ellos con un estudio radiológico en carga) y un grupo control de 28 pacientes elegidos aleatoriamente entre aquellos estudiados por otras afecciones del tobillo mediante RM y estudio radiológico en carga. En los estudios de RM revisamos la existencia de espolón calcáneo, pico talar, fascitis plantar, edema óseo calcáneo, tendinopatía del Aquiles, lesión del ligamento Spring, afección del seno del tarso y coalición tarsiana. En los estudios radiológicos en carga se valoraron el ángulo de Costa-Bertani y los signos radiológicos de pie plano. Analizamos las diferencias entre los grupos en los hallazgos con RM y presencia de pie plano mediante el test exacto de Fisher y del ángulo de Costa-Bertani mediante el análisis de lavarianza. Resultados: La presencia de espolón calcáneo, pico talar, afección del seno del tarso y del ligamento Spring fue más frecuente en el grupo con DTTP, de forma estadísticamente significativa (p < 0,05). También existieron diferencias significativas en la presencia del pie plano radiológico y valores anómalos en el ángulo de Costa-Bertani, más frecuentes (p < 0,001) en el grupo con DTTP. Conclusión: Corroboramos la asociación entre la lesión de estas estructuras diagnosticada por RM y los signos del pie plano radiológico con DTTP. Conocer esta asociación puede ser de utilidad para establecer un diagnóstico preciso (AU)

Objective: To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot. Material and methods: We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems. In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles’ tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher’s exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani. Results: Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001). Conclusion: We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis (AU)

La patología benigna de ano y recto con Resonancia Magnética 3.0T. 1 a Parte: Protocolo de alta resolución, revisión anatómica, tumores benignos y alteraciones congénitas o adquiridas del complejo esfinteriano / 3.0 T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part one: High resolution protocol for 3.0 T MRI, anatomic review, benign tumors, and congenital or acquired alterations of the sphincter complex

La patología benigna anorrectal comprende una amplio grupo de procesos de muy diversos orígenes, congénitos o adquiridos, inflamatorios o tumorales. Sin embargo, ha recibido en la bibliografía científica menor atención que el estudio de la patología tumoral maligna. Presentamos una revisión basada en imágenes de la patología benigna anorrectal más frecuente. En esta primera parte realizamos un recuerdo anatómico y una breve descripción de las peculiaridades del protocolo de alta resolución que empleamos con la RM de 3.0 T. Después describimos los principales tumores benignos anorrectales y lesiones quísticas del desarrollo junto con sus principales diagnósticos diferenciales y las anomalías congénitas y adquiridas del complejo esfinteriano anorrectal (AU)

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex (AU)

[Posterior tibial tendon dysfunction: what other structures are involved in the development of acquired adult flat foot?]. / Disfunción del tendón tibial posterior: ¿qué otras estructuras están implicadas en el desarrollo del pie plano adquirido del adulto?

OBJECTIVE: To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot. MATERIAL AND METHODS: We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems. In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles' tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher's exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani. RESULTS: Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001). CONCLUSION: We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis.

[3.0 T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part one: High resolution protocol for 3.0 T MRI, anatomic review, benign tumors, and congenital or acquired alterations of the sphincter complex]. / La patología benigna de ano y recto con Resonancia Magnética 3.0T. 1a Parte: Protocolo de alta resolución, revisión anatómica, tumores benignos y alteraciones congénitas o adquiridas del complejo esfinteriano.

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex.

[3.0T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part 2: Anorectal inflammatory disease. Postsurgical anatomy and complications after treatment]. / La patología benigna de ano y recto con RM 3.0T. 2.(a) Parte: patología inflamatoria ano-rectal. Anatomía postquirúrgica y complicaciones postratamiento.

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease.

Papel de las técnicas de imagen en la nueva clasificación TNM del carcinoma broncogénico no microcítico / Role of imaging techniques in the TNM classification of non-small cell bronchogenic carcinoma

La séptima edición de la clasificación TNM para los carcinomas broncogénicos no microcíticos incluye una serie de cambios en los descriptores T y M, particularmente una reclasificación de los derrames malignos pleurales y pericárdicos y de los nódulos tumorales separados, nuevos valores de corte de tamaño tumoral y subdivisiones de las categorías T1-T2 y M1. Revisamos estas correcciones, que generan cambios en el sistema de estadificación que afectan a los estadios II-III. Además, describimos e ilustramos el papel de las diferentes técnicas de imagen en la estadificación tumoral (TC, PET, PET-TC y RM), resaltando sus respectivas indicaciones, ventajas y desventajas, así como su función complementaria (AU)

The Seventh Edition of the TNM Classification for non-small cell bronchogenic carcinomas include a series of changes in the T and M descriptor, in particular a re-classification of malignant pleural and pericardial effusions and of separated tumour nodes, new tumour size cut-off values and sub-divisions of the T1-T2 and M1 categories. We review these corrections that led to the changes in the staging system that affects stages II-III. Furthermore, we describe and illustrate the role of the different imaging techniques in tumour staging (CT, PET, PET-CT and MRI), highlighting their respective indications, advantages and disadvantages, as well their complementary function (AU)

[Role of imaging techniques in the TNM classification of non-small cell bronchogenic carcinoma]. / Papel de las técnicas de imagen en la nueva clasificación TNM del carcinoma broncogénico no microcítico.

The Seventh Edition of the TNM Classification for non-small cell bronchogenic carcinomas include a series of changes in the T and M descriptor, in particular a re-classification of malignant pleural and pericardial effusions and of separated tumour nodes, new tumour size cut-off values and sub-divisions of the T1-T2 and M1 categories. We review these corrections that led to the changes in the staging system that affects stages II-III. Furthermore, we describe and illustrate the role of the different imaging techniques in tumour staging (CT, PET, PET-CT and MRI), highlighting their respective indications, advantages and disadvantages, as well their complementary function.

Entero-resonancia magnética: revisión de la técnica para el estudio de la enfermedad de Crohn / Magnetic resonance enterography: review of the technique for the study of Crohn's disease

La enfermedad de Crohn es una enfermedad crónica de curso imprevisible que requiere numerosos estudios radiológicos durante la vida. Afecta frecuentemente a pacientes jóvenes, más vulnerables a los efectos nocivos de las exploraciones repetidas con radiaciones ionizantes. La precisión diagnóstica de la enterografía por RM es similar a la de la tomografía computarizada por su alta resolución tisular, sin el inconveniente de la radiación. Los índices clínicos de valoración de la enfermedad son poco precisos y subjetivos por lo que las técnicas enterográficas de imagen se están incorporando cada vez más a la práctica clínica como medios objetivos de control de la gravedad de la enfermedad. En este artículo, describimos nuestra técnica enterográfica en RM para la valoración de la enfermedad de Crohn. Revisaremos los hallazgos más relevantes por imagen y los subtipos de la enfermedad, la literatura científica relacionada y los índices por RM en la valoración de la gravedad de la enfermedad (AU)

Crohn's disease is a chronic disease with an unpredictable course. Patients with Crohn's disease will have to undergo numerous imaging tests. Crohn's disease often affects young people, who are more vulnerable to the harmful effects of repeated exposure to ionizing radiation. The high resolution of tissues on MR enterography give it a diagnostic accuracy similar to that of CT; however, MR enterography does not have the drawback of ionizing radiation. The clinical indices used to assess Crohn's disease are subjective and not very accurate; thus, enterographic techniques are becoming more common in clinical practice as a means to follow up patients objectively. In this article, we describe the MR enterography technique we use to evaluate Crohn's disease. We illustrate the most relevant imaging findings, and we review the subtypes of the disease, the related scientific literature, and the MR indices used to assess the severity of Crohn's disease (AU)

[Magnetic resonance enterography: review of the technique for the study of Crohn's disease]. / Entero-resonancia magnética: revisión de la técnica para el estudio de la enfermedad de Crohn.

Crohn's disease is a chronic disease with an unpredictable course. Patients with Crohn's disease will have to undergo numerous imaging tests. Crohn's disease often affects young people, who are more vulnerable to the harmful effects of repeated exposure to ionizing radiation. The high resolution of tissues on MR enterography give it a diagnostic accuracy similar to that of CT; however, MR enterography does not have the drawback of ionizing radiation. The clinical indices used to assess Crohn's disease are subjective and not very accurate; thus, enterographic techniques are becoming more common in clinical practice as a means to follow up patients objectively. In this article, we describe the MR enterography technique we use to evaluate Crohn's disease. We illustrate the most relevant imaging findings, and we review the subtypes of the disease, the related scientific literature, and the MR indices used to assess the severity of Crohn's disease.

Herniación medular idiopática: una entidad poco frecuente / Idiopathic spinal cord herniation: a rare condition

La hernia medular idiopática es una entidad rara, causante de mielopatía progresiva. Es el resultado de una hernia de la médula espinal a través de un defecto de la duramadre, de etiología no conocida. La forma de presentación clínica más habitual es como un síndrome de Brown-Séquard. La importancia de un diagnóstico radiológico precoz radica en que es causa reversible de mielopatía, ya que el defecto dural es corregible quirúrgicamente con una alta tasa de recuperación funcional. La resonancia magnética es la técnica de imagen de elección para el diagnóstico. A continuación se presentan 2 casos de hernia medular idiopática donde se muestran los hallazgos radiológicos que nos permiten reconocer y diagnosticar esta entidad (AU)

Idiopathic spinal cord hernia, in which the reason that spinal cord protrudes through a defect in the dura mater is unknown, is a rare cause of progressive myelopathy. The most common clinical presentation is Brown-Séquard syndrome. Spinal cord herniation is a reversible cause of myelopathy: surgery to correct the defect in the dura mater has a high rate of functional recovery. Thus, early imaging detection is crucial. Magnetic resonance imaging is the technique of choice for the diagnosis. We present two cases of idiopathic spinal cord herniation and show the imaging findings that make it possible to recognize and diagnose this condition (AU)

[Idiopathic spinal cord herniation: a rare condition]. / Herniación medular idiopática: una entidad poco frecuente.

Idiopathic spinal cord hernia, in which the reason that spinal cord protrudes through a defect in the dura mater is unknown, is a rare cause of progressive myelopathy. The most common clinical presentation is Brown-Séquard syndrome. Spinal cord herniation is a reversible cause of myelopathy: surgery to correct the defect in the dura mater has a high rate of functional recovery. Thus, early imaging detection is crucial. Magnetic resonance imaging is the technique of choice for the diagnosis. We present two cases of idiopathic spinal cord herniation and show the imaging findings that make it possible to recognize and diagnose this condition.