Radiation myelopathy in over-irradiated patients: MR imaging findings.

The objective of this work is to report the MRI findings in patients with radiation myelopathy due to accidental local over-irradiation syndrome. Eight patients (seven males and one female) were suffering from over-irradiation syndrome as a result of treatments from a malfunctioning linear electron accelerator. The mean accidental estimated dose was 136 Gy delivered to the "open-neck" (seven cases) and to the thoracic wall (one case), during a mean of 5.4 sessions (range 1-9 sessions). Paresthesia and weakness in the upper extremities were the earliest symptoms (87.5 %), with evolution to paralysis in all patients. No patient is alive (mean survival time 64 days). In all cases MRI was negative for neurologic lesions in the acute phase ( < 90 days from irradiation; Radiation Therapy Oncology Group scoring system). Late signs of radiation myelitis manifested as high-intensity signals on T2-weighted images in three patients, and as Gd-DTPA enhancement of T1-weighted images in one case. Autopsies performed on four patients who died in acute phase showed morphologic alterations in white matter: edema in 75 %, and necrosis and glial reaction as well as obliterative vasculitis in all cases. In cases of over-irradiation, MRI may be normal in acute phase even if the patients have severe neurologic deficit, as positive MRI findings appear only in delayed radiation myelitis.

[The long-term clinical and imaging follow-up of inferior vena cava filters. A cross-sectional study]. / Seguimiento clínico y por medios de imagen a largo plazo de los filtros de vena cava inferior. Estudio transversal.

We carried out a cross-sectional study to assess morphological findings and incidence of complications in 77 inferior vena cava filters (IVC) implanted in 75 patients between April 1990 and January 1994. Follow-up ranged from 3 to 61 months (mean, 38.5 months) and was carried out by telephone interview, clinical examination, X-rays of the ilium/vena cavum and, in some cases, by Doppler sonogram and computed tomography. Findings revealed IVC thrombosis in 38% of patients, edema in the lower extremities in 63.4%, angling > 15 degrees in 8 patients, defective opening in 4, fibrosis of the vena cava with stenosis in 2 and perforation of the IVC in 3. Although our study shows that the incidence of IVC thrombosis after implantation of filters is higher than suspected, its clinical importance is slight.

[Werner's syndrome. Clinical and radiologic manifestations. Apropos of 2 new cases]. / Síndrome de Werner. Manifestaciones clínico radiológicas. A propósito de dos nuevos casos.

In this work we present two cases of Werner's Syndrome. Its typical manifestations, the clinical and radiological aspects and diagnostic criteria are mainly commented.

[Periosteal desmoid]. / Desmoide perióstico.

A case of periosteal desmoid is studied. Being of a rather often incidence in children it might be confused with others lesions located on distal femoral metaphysis and which sometimes form part of pathology typical of the developing skeleton as cortical defects and non osteogenic fibromas and the others which might be a question of malignant process. Periosteal desmoid is characterized by appearing as a radiolucent lesion with periosteal speculation of the dorsomedial cortical wall of the medial femoral condyle, on adductor insertion zone. Simple radiology study in these lesions must be emphasized, without necessity to use more cruel techniques.