[Evaluation of prostate cancer progression]. / Ocena zaawansowania raka gruczolu krokowego.

Prostate cancer occures in male, especially over 65 year old. It develops usually in the peripheral zone, less commonly in central or transitional ones. The neoplasm screening bases on clinical digital rectal examination and serum level of prostate-specific antigen (PSA). Among patients with increase PSA concentration, transrectal ultrasound usually with multiple core biopsies is performed. The obtained bioptates are histologically evaluated using Gleason's grading system. However, the method of choice to examine the entire pelvis is a magnetic resonance. According to current principles, the obtained images are evaluated using five-step PI-RADS classification based on T2-weithed, diffusion weighted and dynamic contrast enhancement images. Spectroscopy is also suggested especially in case of prostatic carcinoma. Such procedures allow precise evaluation of cancer progression, and is helpful in treatment planning and response monitoring.

Incidence of spinal perineurial (Tarlov) cysts among East-European patients.

The spinal perineurial cyst (Tarlov) is a dilatation between the perineurium and endoneurium of spinal nerve roots, located at level of the spinal ganglion and filled with cerebrospinal fluid but without communication with the perineurial subarachnoid space. The aim of the study was to evaluate it incidence among East-European patients. The retrospective data collected during various magnetic resonance spinal examinations and stored on the picture archiving and communication system was analyzed for an incidence of perineurial cysts. From among 842 patients that underwent examination, 75 cases perineurial cysts were revealed. In 22 cases single anomalies were found. In remaining 53 cases, multiple uni- or less frequently bilateral changes were noted. The most common position was the sacral canal, particularly the level of S2 and S3. Occasionally, cysts were also visible on the cervical, thoracic and lumbar level. Incidence of sacral perineurial cysts was significantly higher in females than in males. Similar data was found for single and multiple changes despite of their localization. Insignificant changes were seen for patient age and cyst size. Perineurial spinal cysts were the most frequently observed on the sacral level and such changes were more common in females.

[Epidemiology and risk factors of the prostate cancer]. / Epldemiologia oraz crynniki ryzyka rozwoju raka gruczolu krokowego.

Prostate cancer is the most common malignancy of male genital organs. The etiology of the disease is complex and remains mainly unclear. The only established risk factors are advancing age, ethnicity and genetics, including changing in expression of ELAC2, RNASEL, MSR1 and HOXB13 genes as well as low number of CAG repeats in the androgen receptor gene. There are number of coexisting environmental risk factors, such as eating habits mostly diet reach in animal fats. An early sexual initiation and sexually transmitted infections, both viral (HSV-2, HPV-18 and -16, CMV) and bacterial (Neisseria gonorrhoea, Treponema pallidum, Chlamydia trachomatis) were also included. The etiology of prostate cancer also involves the influence of hormones - androgens and estrogens, as well as chronic inflammation of the prostate. In contrast to the incidence rate, which varies significantly depending on the geographic region, the incidence of the malignancy at autopsy is similar.

Diagnostic difficulties resulting from morphological image variation in spondylodiscitis MR imaging.

BACKGROUND: Spinal infection (discitis; spondylodiscitis) presents a wide spectrum of pathologies. The method of choice for spondylodiscitis imaging is magnetic resonance (MR). It provides detailed anatomical information, especially concerning epidural space and spinal cord. The main aim of this article is the description and evaluation of spondylodiscitis morphological variation visible in magnetic resonance imaging. MATERIAL/METHODS: In this article we retrospectively analysed the patients diagnosed at the Department of Radiology of the Provincial Hospital No 2 in Rzeszów between October 2009 and October 2011. The subjects involved a group of five women aged 41-74 (mean 56.3 years) and eight men aged 46-69 (mean 61,3 years). All patients had spondylodiscitis symptoms. All patients underwent MRI examination before and after the contrast enhancement. In three patients additional CT examination was performed. RESULTS: Following the MRI procedure all patients were diagnosed with typical symptoms of spondylodiscitis. It also revealed a number of pathologies resulting from morphological spondylodiscitis variation. Other pathologies found on the MR images of the study group patients involved epidural intra-canal spinal pathological masses causing spinal cord compression, lung abscess, pyothorax, paravertebral abscesses and epidural empyemas, abscess between adjacent vertebral bodies, abscesses beneath anterior longitudinal ligament, and iliopsoas muscle abscesses. In all cases a destruction of vertebral bodies with end plates loss restriction and cortical layer discontinuity was observed. Moreover, one person was diagnosed with pathological vertebral body fractures and liquefactive necrosis of the vertebral body. CONCLUSIONS: Spondylodiscitis manifests itself in a great number of morphological variations visible on the radiological images. Apart from ordinary features of vertebral bodies and discs, progressive spinal destruction is observed together with reactive bone changes and soft tissue infiltration. The latter leads to a number of complications e.g. abscesses or even fistulas and also to the formation of obstacles in radiological images. The knowledge of radiological images together with overall evaluation of clinical and laboratory features enables a proper diagnosis.

[Epidemiology and risk factors of the cervical squamous cell carcinoma]. / Epidemiologia i czynniki ryzyka rozwoju raka plaskonablonkowego szyjki macicy.

Neoplasm of the cervix, especially squamous cell cancer, is one of the most common malignancy of female genital organs. It etiology is complex; however, human papilloma virus (mostly HPV type 18, 16 and 45) infection seems to be the most important one. Other risk factors include: early sexual initiation, multiple pregnancies and labors, concomitant infections (Chlamydia trachomatis, Neisseria gonorrhea, HSV2 - herpes simplex virus) of the genital tract, AIDS, immunosuppressive therapy, smoking and low socioeconomic status. The incidence of cervical cancer is particularly high in developing countries, while in countries where government founding for the prevention and health education is high, the diseases is significantly less likely to occur. The incidence and mortality rate of the cervical cancer can be substantially reduced by systematic screening cytological examinations. For such reason a liquid-based cytology is currently preferred. Implementation of HPV vaccines decrease the risk of infection, but effect on rate of the cervical cancer has to be confirmed in long-time prospective clinical and epidemiological studies.

Usefulness of magnetic resonance in evaluation of cervical cancer progression.

Magnetic resonance belongs to a group of modern diagnostic methods which, together with classic gynecological, transvaginal ultrasound and histopathological examinations, should be routinely used in patients with suspicion or diagnosed cervical malignancies. The procedure allows precise localization and staging of the tumor as well as evaluation of the volume of the local lymph nodes. Obtained data are useful in selection of optimal therapy and evaluation of cancer progression. Intravenous injection of the paramagnetic contrast media significantly increases diagnosis accuracy especially of small lesions. It is also helpful in differentiation of post-radiotherapy changes and malignant infiltration. The new applications, such as diffusion weighted imaging, magnetic resonance spectroscopy and fat or water saturation are also widely used to improve final diagnosis. The endovaginal receiver coil allows high spatial resolution imaging of the cervix, which is particularly useful in very small, controversial lesions.

[Diagnostic imaging of the prostate cancer]. / Diagnostyka obrazowa raka gruczolu krokowego.

Diagnosis of the prostate cancer is based on clinical, biochemical and histological examinations, as well as various imaging techniques. From the last listed group, magnetic resonance imaging (MRI) provides precise identification of focal areas and local staging of the cancer. It improves evaluation of the local extracapsular extension and involvement of regional lymph nodes, which has significant implications for a patient management. MRI, supplemented by dynamic contrast enhanced and diffusion-weighted imaging (DWI), is especially useful in detection of small focal lesions. MRI also plays an important role in the evaluation of a local recurrence and monitoring of the early and late response to treatment. Whole-body MRI should be performed in patients with a disseminated disease. In patients with an increased level of prostate specific antigen (PSA), small lesions, local recurrence and distant metastases, not detected by other imaging techniques, a positron emission tomography (PET) should be also performed. Computed tomography (CT) does not play a significant role in the diagnosis of the primary prostate cancer, however new CT scanners improve the accuracy of prostate cancer staging. Diagnostic imaging is also widely used in the screening process. Transrectal ultrasound (TRUS) examination of the organ is applied to obtain systematic core biopsies for a histological examination.