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.
The integration of medical images is the process of registering and fusing them to obtain a greater amount of diagnostic information. In this work an analysis is performed for the integration of images obtained through computed axial tomography and magnetic resonance imaging, for which a tool was developed in the Matlab program, where the registration is implemented through equivalent features; in addition, the pairs of images are compared by several fusion rules, with a view to identify the best algorithm in which the resulting fused image contains the most information from the original representations.
Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.
Infrared thermal imaging technology is another new branch for medical imaging after traditional medical imaging technologies such as X-ray, ultrasound and magnetic resonance (MRI). It has the advantages of noninvasive, nondestructive, simple and fast. Its application can radiate multiple clinical departments. This paper mainly expounds the principle, influencing factors of medical infrared thermography and its application in radiation protection and other medical fields.
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.
Gout is an arthritis characterized by the deposition of sodium monoacid crystals in the synovial membrane, articular cartilage, and periarticular tissues that leads to an inflamatory process. In most cases, the diagnosis is established by clinical criteria and analysis of the synovial fluid for MSU crystals. However, gout may manifest in atypical ways and make diagnosis difficult. In these situations, imaging studies play a fundamental role in helping to confirm the diagnosis or even exclude other differential diagnoses. Conventional radiography is still the most commonly used method in the follow-up of these patients, but it is a very insensitive test, because it only detects late changes. In recent years, advances in imaging methods have emerged in relation to gout. Ultrasound has proven to be a highly accurate test in the diagnosis of gout, identifying MSU deposits in articular cartilage and periarticular tissues, and detecting and characterizing tophi, tendinopathies, and tophi enthesopathies. Computed tomography is an excellent exam for the detection of bone erosions and evaluation of spinal involvement. Dual-energy computed tomography, a new method that provides information on the chemical composition of tissues, allows identification of MSU deposits with high accuracy. MRI can be useful in the evaluation of deep tissues not accessible by ultrasound. In addition to diagnosis, with the emergence of drugs that aim to reduce the tophaceous burden, imaging examinations become a useful tool in the follow-up treatment of gout patients.
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