Correlation between preoperative tomographic staging and definitive histopathologic results in gastric cancer at the Hospital Central Militar. / Correlación entre la estadificación tomográfica preoperatoria con los resultados histopatológicos definitivos en cáncer gástrico en el Hospital Central Militar.

BACKGROUND: In relation to the number of new cases diagnosed, gastric cancer is the fourth most common cancer worldwide, and the second cause of cancer death. The development of multidetector tomography has improved the preoperative staging of gastric cancer. AIM: To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system. METHODS: A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients. They all had upper endoscopy and preoperative multidetector tomography examinations, underwent surgical resection, and had the corresponding histopathology study. Statistical analysis was carried out with the SPSS version 15.0 software and the sensitivity and specificity calculations were made using the Excel 2011 program for Mac. RESULTS: The majority of the patients included in the case series had clinical stage iii and iv disease. When compared with the histopathologic result, the overall accuracy of multidetector CT was 83% (T0 96%, T1 94%, T2 93%, T3 67%, and T4 67%) for tumor size (T) and was 70% (N0 72%, N1 73%, N2 70%, and N3 66%) for lymph node involvement (N). Overall sensitivity was 48% (T0 100%, T1 0%, T2 33%, T3 44%, and T4 65%) for T and was 41% (N0 58%, N1 56%, N2 15%, and N3 35%) for N. A strong association between the multidetector CT results and the pathology results was demonstrated through the Spearman's correlation, especially in T4 and N3. CONCLUSIONS: Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results.

[Diverticular duodenal disease as incidental finding with computer tomography]. / La enfermedad diverticular duodenal como hallazgo incidental detectado por tomografía computarizada.

BACKGROUND: Duodenal diverticular disease is a frequent condition but clinical diagnosis can be chalenging. Less than 10% of the cases are symptomatic and symptoms are vague. Only between 1% to 2% will require surgical treatment. OBJECTIVE: To establish the prevalence of duodenal diverticulum (Dd) in patients who underwent abdominal computed tomography (CT). METHODS: A retrospective review of all cases with Dd identified incidentally during abdominal CT scan was performed. Clinical data regarding type, location, differential diagnosis and complications were recorded. RESULTS: During the study period 12,704 abdominal CT scans were performed and 50 patients with Dd were identified (prevalence 0.46%). Thirty patients were women (60%) and the mean patient age was 69 years (range: 23 - 93 years). In thirteen patients the Dd were located in the second portion (26%) and 24 in the third portion of the duodenum (48%). Three Dd were detected in the papillary region, one of them (2%) was complicated with hemorrhage and required surgical treatment. CONCLUSIONS: Dd were detected in the 0.46% of the abdominal CT scans. Most of them were incidentally detected (94%). The prevalence of these lesions increases with age. Dd may mimic a cystic neoplasm in the head of the pancreas in 28% of cases and produce complications as bleeding in 2% of the cases.

Imaging findings after minimally invasive nephron-sparing renal therapies.

With the trend towards minimally invasive and nephron-sparing surgery for renal masses, laparoscopic partial nephrectomy and energy ablative techniques have become common approaches to treat low-stage tumours. Complications following such techniques are occasional, especially for ablation techniques. This review illustrates the imaging of these complications and of tumour recurrence, with the conclusion that imaging plays an important role in their diagnosis, and in the infrequent situation that intervention is needed, helps to plan subsequent management.