Radiología

Introduction: the most common surgical cause of abdominal pain is appendicitis; its diagnosis is affected by anatomical variations of the vermiform appendix, because this is the most variable abdominal organ in terms of position and organ relations.
Objective: to determine the characteristics of the normal appendix in computed tomography scans, including length, diameter, wall thickness, and the location of the base and the appendicular tip.
Methods: abdominal computed tomography scans with UroCT scan protocol images were studied to measure length, width, and diameter of the appendix, and to identify the locations of its base and tip. The appendicular tip location was categorized as anterior or posterior and subdivided into: pelvic, retrocaecal/retrocolic, postileal, paracolic, subcaecal, subhepatic or midline. The appendicular base location was defined in three planes in relation to the ileocaecal valve: anterior-posterior, medial-lateral, or superior-inferior.
Results: were included the abdominal tomography images of 83 patients in which general characteristics of the appendix were determined: a mean length of 78 mm (SD = ±23.41) and a mean diameter of 6.55 mm (SD =± 1.77) were observed. The bases were more frequently located inferior posterior, lateral and medial, to the ileocaecal valve, and the tips were more frequently located in the pelvic cavity, followed by the retrocaecal and paracaecal location.
Conclusions: the locations of the base of the appendix were correlated with overall reports. There was no correlation between the tip location and the length of the appendix, this means that, even if the appendix is long, it is not associated with a tip location further from the ileocaecal valve.

Breast magnetic resonance imaging is a modality that is being progressively integrated into the breast radiologist's daily clinical practice. There is consensus on the minimal technical requirements that a breast MR exam should have in order to attain diagnostic quality. Diagnostic criteria are mainly based on the American College of Radiology's BI-RADS magnetic resonance imaging categories. Breast cancer staging is a main clinical application, but it is not universally accepted. Other applications are: response evaluation in patients treated with chemotherapy, screening in high-risk patients, cancer of unknown origin, assessment of a possible relapse and breast implant evaluation.

This article reviews new mammography technologies resulting from advances in digital detectors and processing techniques. Most are just starting to be commercialized or are in the clinical trial phase. The results of clinical trials with the new 2D techniques (contrast-enhanced techniques or stereotactic techniques) show they are useful for diagnosing cancer. However, the greater complexity of the image acquisition process suggests that their use will be limited to particular cases such as inconclusive lesions or women with high risk for developing breast cancer. Among the 3D technologies (breast tomography and breast tomosynthesis), only breast tomosynthesis has been implemented in clinical practice, so it is the only technique for which it is possible to know the sensitivity, specificity, and radiation dose delivered. This article describes the principles underlying the way breast tomosynthesis works and the techniques used for image acquisition and reconstruction. It also summari...

Introducción: La tomografía por emisión de positrones/tomografía computada (PET/CT) con Fluor18-fluorodeoxiglucosa (18 F-FDG) posee un amplio uso, específicamente en pacientes oncológicos para: estadificar la patología neoplásica, vigilar la aparición de recurrencias, valorar la respuesta al tratamiento y predecir pronóstico. La glándula tiroides es uno de los órganos que más hallazgos incidentales imagenológicos presenta. Por ello, el objetivo de este estudio fue explorar las captaciones y el valor máximo estandarizado de captación (SUVmáx) en incidentalomas tiroideos mediante PET/CT con 18 F-FDG y evaluar su utilidad diagnóstica comparado con estudios citológicos (biopsia por aspiración con aguja fina, BAAF). Metodología: Estudio transversal retrospectivo analítico. Se revisó el archivo histórico del departamento de Imagenología del Centro Médico Dalinde de enero de 2016 a marzo de 2020. Se incluyeron pacientes con incidentalomas tiroideos detectados por PET/CT con 18 F-FDG; el muestreo empleado fue por conveniencia. Resultados: Se revisaron 1,283 expedientes; 102 correspondieron a incidentalomas tiroideos: 83 mujeres (81.37%) y 19 hombres (18.63%). Se encontró captación focal en 66 pacientes (64.7%) y difusa en 36 (35.3%). La media de SUVmax fue 7.9±9.1653, mediana 4.6 (2-55); no se encontraron diferencias entre SUVmax y el tipo de captación (p=0.6). Del total de la muestra, únicamente 35 casos contaron con reporte de BAAF; se observaron mayores cifras de SUVmáx en neoplasias malignas (p=0.028). Conclusiones: Los valores altos de SUVmáx se relacionaron con neoplasias tiroideas malignas; es necesario que cada institución de salud determine los parámetros de SUVmáx con base en su población.

Introduction: Positron emission tomography/computed tomography (PET/CT) with Fluor18-fluorodeoxyglucose (18F-FDG) is widely used, specifically in cancer patients to: stage neoplastic pathology, monitor the appearance of recurrences, assess the response to treatment and predict prognosis. The thyroid gland is one of the organs with the most incidental imaging findings. Therefore, the objective of this study was to explore the uptakes and the standardized maximum uptake value (SUVmax) in thyroid incidentalomas by PET/CT with 18F-FDG and to evaluate its diagnostic utility compared with cytological studies (fine needle aspiration biopsy, FNAB). Methodology: Analytical retrospective cross-sectional study. The historical archive of the Centro Médico Dalinde Imaging department was reviewed from January 2016 to March 2020. Patients with thyroid incidentalomas detected by PET/CT with 18F-FDG were included; the sampling used was for convenience. Results: 1,283 files were reviewed; 102 corresponded to thyroid incidentalomas: 83 women (81.37%) and 19 men (18.63%). Focal uptake was found in 66 patients (64.7%) and diffuse in 36 (35.3%). The mean of SUVmax was 7.9 ± 9.1653, median 4.6 (2 -55); no differences were found between SUVmax and the type of uptake (p=0.6). Only 35 cases had a FNAB report; higher SUVmax were observed in malignant neoplasms (p=0.028). Conclusion: High SUVmax values were related to thyroid malignancies; It is necessary for each health institution to determine the SUVmax parameters based on its population.