Amyloidosis is a systemic disorder produced by the deposition of insoluble protein fibrils that fold and deposit in the myocardium. Patients with amyloidosis and cardiac involvement have higher mortality than patients without cardiac involvement. The two most prevalent forms of amyloidosis associated with cardiac involvement are AL amyloidosis, due to the deposition of immunoglobulin light chains, and ATTR amyloidosis, due to the deposition of the transthyretin (TTR) protein in mutated or senile form. This article aims to review the different cardiac imaging modalities (echocardiography, cardiac magnetic resonance imaging, nuclear medicine and tomography) that allow to determine the severity of cardiac involvement in patients with amyloidosis, the type of amyloidosis and its prognosis. Finally, we suggest a diagnostic algorithm to determine cardiac involvement in amyloidosis adapted to locally available diagnostic tools, with a practical and clinical approach.
In the present research work, we investigated the use of the image intensifier in the extraction of radiopaque foreign bodies in traumatology. First of all, it is necessary to clarify that this method constitutes an essential component of practically generalized use, in which low current level radiation is used, that is, fluoroscopic radiation, so that it can be applied for a considerably longer time than that of the longest radiographic exposure. This tool works with a tube intended for this purpose, which is known as fluoroscopy. The radiations from the tube pass through the patient and reach the serigraph, on which the image intensifier or fluoroscopic screen is mounted. In the latter case, this is where the chain ends, since it is on this screen that the image is formed and where the physician directly observes the region to be studied. It is also necessary to define that a foreign body is any element foreign to the body that enters it, either through the skin or through any natural orifice such as the eyes, nose, throat, preventing its normal functioning. It was possible to obtain as a result that the advantages of fluoroscopic navigation are the reduction of surgical time and the amount of irradiation, which goes from about 140 seconds without navigation to only 8 seconds, which is a substantial difference. Among the conclusions, it was possible to highlight that in the case of a radiopaque object, it is essential to have an image intensifier for localization of the foreign body during surgery; while in the case of a radiolucent foreign body, it is more advisable to locate it through the clinic, since these tend to form granulomas.
The suspicion of mediastinal alterations, always includes in its initial study, the chest radiography. The identification of mediastinal alterations in the X-ray is a priority. The knowledge of the mediastinal references and the identification of their alterations allows the suspicion of a pathology specific to each of the mediastinal spaces. When the semiology of mediastinal lesions, their location and the three most frequent pathologies are taken into account, the possibility of having an etiological diagnosis increases[1]. This is a review article based on a detailed literature search, in which radiological mediastinal references are studied, with emphasis on the epidemiological data of each one of them.
Introduction: Given the heterogeneous nature and inherent complexity of forensic medical expertise, the expert (medical professional or related areas) must make the best use of the technical and technological tools at his disposal. Imaging, referring to the set of techniques that allow obtaining images of the human body for clinical or scientific purposes, in any of its techniques, is a powerful support tool for establishing facts or technical evidence in the legal field. Objective: To analyze the use of magnetic resonance and computed tomography in postmortem diagnosis. Methodology: information was searched in the databases PubMed, Science Direct, Springer Journal and in the search engine Google Scholar, using the terms “X-Ray Computed Tomography”, “Magnetic Resonance Spectroscopy”, “Autopsy” and “Forensic Medicine” published in the period 2008–2015. Results: MRI is useful for the detailed study of soft tissues and organs, while computed tomography allows the identification of fractures, calcifications, implants and trauma. Conclusions: In the reports found in the literature search, regarding the use of nuclear magnetic resonance and computed tomography in postmortem cases, named by the genesis of the trauma, correlation was found between the use of imaging and the correct expert diagnosis at autopsy.
Introduction: Chest trauma has a high incidence and pneumothorax is the most frequent finding. The literature is scarce on what to do with asymptomatic patients with pneumothorax due to penetrating chest trauma. The aim of this study was to evaluate what are the findings of the control radiography of patients with penetrating chest trauma who are not initially taken to surgery, and their usefulness in determining the need for further treatment. Methods: A retrospective cohort study was performed, including patients older than 15 years who were admitted for penetrating chest trauma between January 2015 and December 2017 and who did not require initial surgical management. We analyzed the results of chest radiography, the time of its acquisition, and the behavior decided according to the findings in patients initially left under observation. Results: A total of 1,554 patients were included, whose average age was 30 years, 92.5% were male and 97% had a sharp weapon wound. Of these, 186 (51.5%) had no alterations in their initial X-ray, 142 had pneumothorax less than 30% and 33 had pneumothorax greater than 30 %, hemopneumothorax or hemothorax. Closed thoracostomy was required as the final procedure in 78 cases, sternotomy or thoracotomy in 2 cases and discharged in 281. Conclusion: In asymptomatic patients with small or moderate pneumothorax and no other significant lesions, longer observation times, radiographs and closed thoracostomy may be unnecessary.
Background: Through the development of robust techniques and their comprehensive validation, cardiac magnetic resonance imaging (CMR) has developed a wide range of indications in its almost 25 years of clinical use. The recording of cardiac volumes and systolic ventricular function as well as the characterization of focal myocardial scars are now part of standard CMR imaging. Recently, the introduction of accelerated image acquisition technologies, the new imaging methods of myocardial T1 and T2 mapping and 4-D flow measurements, and the new post-processing technique of myocardial feature tracking have gained relevance. Method: This overview is based on a comprehensive literature search in the PubMed database on new CMR techniques and their clinical application. Results and conclusion: This article provides an overview of the latest technical developments in the field of CMR and their possible applications based on the most important clinical questions.
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