Human fasciolasis is a zoonosis linked to the trematod Fasciola hepatica, which affects primarily bovine and ovine cattle, and by chance, humans. Difficulty in clinical diagnosis due to its various patterns of presentation, it may be necessary to obtain images that enable a diagnosis. Therefore, in endemic zones (such as Latin America, Asia, and northern Africa), should include this entity as differential diagnosis for focal liver lesion, especially in the presence of eosinophilia. Key words: Fasciolasis, Focal liver lesion.Resumen: La fasciolasis humana es una zoonosis causada por la Fasciola hepática, trematodo que en su vida adulta afecta principalmente el ganado ovino y bovino, siendo el hombre huésped accidental. La dificultad en el diagnóstico clínico, dada su variada sintomatología, muchas veces requerirá del apoyo imagenológico, por lo que el radiólogo debe estar preparado y conocer la epidemiología de este patógeno, especialmente en aquellas zonas endémicas (Latinoamérica, zonas de Asia y el Norte de África). Es importante considerarla dentro del diagnóstico diferencial de lesiones focales hepáticas, especialmente en el contexto clínico de eosinofilia.
Between January and July, 2003, a single blinded matched trial was done to assess focalized biliary ultrasound (US) and MR cholangiography (MRCP) compared with ERCP or surgery as reference standard in patients with suspected biliary obstruction. Focalized US was performed 24 hrs before/after MRCP. Patients were triage according symptoms, signs and laboratory in high, intermediate and low risk for obstruction. Radiologists sonographers were divided in low and highly experienced. None of the radiologist who reported either US or MRCP was aware to the other test results. Sensitivity, Specificity, PPV and NPV, (LR) Likelihood Ratios and pre and post-test odds for positive and negative test were estimated.We analized 64 out of 76 sampled patients, the prevalence of obstruction was 37 % (24 out of 64 patients). US found biliary tree dilated in 50% and MRCP in 48% of the patients. Main cause of obstruction was common bile duct stones in (16) 25%. and tumors were the second more common cause. US shown a Sensitivity (S) 58.3% when a non experienced radiologist perform the exam, and 70% when an experienced radiologist doest it. Specificity (Sp) 82,5%, PPV 66.7% and NPV 76.7%. RMCP Shown S 95.8%, Sp 87.5%, PPV 82.1%, NPV 97.2% For common bile duct stones US shown a PPV 53.3% and NPV 83.6% on the other hand MRCP a PPV 70% and NPV 95.4%. MRCP perform better than focalized US in overall patients with high risk of obstruction (37.5%), detecting the cause of obstruction but using aditional sequences rising the examination time and costs. With a positive ultrasound and LR(+) 3.3 pretest odds rise from 0.37/37% to a post-test odds of 0.55/55% and with negative test result and LR(-) 0.49 pre-test odds 0.37/37% will decrease to post-test odds of 0.2/20%. With MRCP a positive test with LR(+) 7.7 initial pre-test odds 0.37/37.5% to post-test odds of 0.8/ 80% and with a negative test result LR(-) 0.05 pretest odds 0.37/37% will decrease to post-test odds of 0.03%.Ultrasound performed by experienced sonographers has a Specificity and NPV over 80%, and perform similar to MRCP for detecting biliary tree dilatation the best predictor of obstruction. In patients with low pre-test odds (low risk) of obstruction, to use focalized US and then MRCP, when the cause of obstruction is not diagnosed could be the more cost/ efective initial alternative in this patients. This data must be confirmed with further studies with cost/effectivenes analysis.
RESUMENLas calcificaciones mamarias son hallazgos frecuentes en la mamografía. La mayoría de ellas son originadas por patología benigna, aunque algunos patrones agrupados específicos pueden ser causados por patología maligna, especialmente el carcinoma ductal in situ. El objetivo del presente artículo es realizar una revisión de los descriptores y categorías BI-RADS de las microcalcificaciones, señalando sus característi-cas más importantes y el riesgo de malignidad asociado a cada descriptor. PALABRAS CLAVE: Microcalcificaciones, BI-RADS, cáncer de mama SUMMARYBreast calcifications are frequent findings on mammography. Most of them are caused by benign pathologies, although some specific grouped patterns may be caused by malignancy, especially ductal carcinoma in situ. The aim of this article is to review the BI-RADS descriptors and categories of microcalcifications, marking its most important characteristics and the risk of malignancy associated with each descriptor. KEY WORDS: Microcalcifications, BI-RADS, breast cancer INTRODUCCIÓNLas calcificaciones mamarias corresponden a depósitos de calcio al interior del tejido mamario. Son hallazgos frecuentes en la mamografía, especialmente en mujeres postmenopáusicas. Si bien, la mayoría de las microcalcificaciones son originadas por patología benigna, algunos patrones agrupados específicos pueden ser causados por patología maligna (1). Aproximadamente el 55% de los cánceres de mama no palpables presentan microcalcificaciones visibles (2).El carcinoma ductal in situ (CDIS) corresponde al 25-30% de los cánceres de mama (3). Es un cán-cer intraductal, que no ha atravesado la membrana basal, sin tener aún la capacidad de generar metástasis. Presenta un mejor pronóstico que el carcinoma invasor. En la era previa a la incorporación de la mamografía de screening, el diagnóstico del CDIS era infrecuente y la mayoría de los cánceres se pesquisaba en etapas avanzadas. Hoy en día, con la incorporación de la mamografía, es posible pesquisar cada vez más microcalcificaciones sospechosas, que son su principal forma de manifestación. Las microcalcificaciones son responsables de la detección del 85-95% de los casos de CDIS en mamografía (3,4). REV CHIL OBSTET GINECOL 2013; 78(5): 383 -394
The purpose of this study was to determine the frequency, concordance and discordance of breast lesions during automated core biopsy . A USguided 14 -gauge automated core needle biopsy was performed on 188 lesions. Only in 1 of 120 bening diagnosed cases imaging-histologic discordance was present. This lesion underwent surgical excision and the case was diagnosed as having carcinoma in situ, as a definitive histological diagnosis. Assessment of correlation between imaging studies and histologic findings, as well as determination of concordance, are required to minimize diagnostic errors.Resumen: El propósito de nuestro estudio fue determinar la frecuencia, concordancias y discordancias de las lesiones mamarias. Se realizaron 188 biopsias core con aguja de 14G. Sólo 1 de las 120 lesiones benignas diagnosticadas fue discordante; se recomendó escisión quirúrgica cuyo resultado definitivo demostró carcinoma in situ. Para minimizar errores diagnósticos, se requiere evaluar la correlación entre las imágenes y el resultado histológico, además de establecer la concordancia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.