Tuberculosis is a disease whose incidence has increased principally as a consequence
of HIV infection and use of immunosuppressive drugs. The abdomen is the most common
site of extrapulmonary tuberculosis. It may be confused with several different
conditions such as inflammatory bowel disease, cancer and other infectious diseases.
Delay in the diagnosis may result in significantly increased morbidity, and therefore
an early recognition of the condition is essential for proper treatment. In the
present essay, cases with confirmed diagnosis of abdominal tuberculosis were assessed
by means of computed tomography and magnetic resonance imaging, demonstrating the
involvement of different organs and systems, and presentations which frequently lead
radiologists to a diagnostic dilemma. A brief literature review was focused on
imaging findings and their respective prevalence.
Most malignant liver tumors are represented by hepatocellular carcinoma and
cholangiocarcinoma; however a variety of other uncommon hepatic lesions might also be
found. Common lesions such as hemangioma, focal nodular hyperplasia and metastases
are well known and have already been extensively documented in the literature. The
diagnosis of typical hepatic lesions may be done with some reliability by means of
several imaging methods; on the other hand, uncommon lesions normally represent a
diagnostic challenge for the radiologist. In this first part of the study, the
authors will approach five uncommon liver tumors - angiosarcoma, angiomyolipoma,
cystadenoma/biliary carcinoma, epithelioid hemangioendothelioma, and fibrolamellar
hepatocellular carcinoma -, describing their main characteristics and image findings
with focus on computed tomography and magnetic resonance imaging.
Recent studies have demonstrated that the use of paramagnetic hepatobiliary contrast
agents in the acquisition of magnetic resonance images remarkably improves the
detection and differentiation of focal liver lesions, as compared with extracellular
contrast agents. Paramagnetic hepatobiliary contrast agents initially show the
perfusion of the lesions, as do extracellular agents, but delayed contrast-enhanced
images can demonstrate contrast uptake by functional hepatocytes, providing further
information for a better characterization of the lesions. Additionally, this
intrinsic characteristic increases the accuracy in the detection of hepatocellular
carcinomas and metastases, particularly the small-sized ones. Recently, a
hepatobiliary contrast agent called gadolinium ethoxybenzyl dimeglumine, that is
simply known as gadoxetic acid, was approved by the National Health Surveillance
Agency for use in humans. The authors present a literature review and a practical
approach of magnetic resonance imaging utilizing gadoxetic acid as contrast agent,
based on patients' images acquired during their initial experiment.
In cases where typical aspects are shown, the diagnosis of most frequent hepatic
lesions can be made with some safety by means of several imaging methods; on the
other hand, uncommon lesions generally represent a diagnostic challenge for the
radiologist. In the present second part of the study, the authors describe four rare
hepatic lesions, as follows: primary hepatic lymphoma, myofibroblastic tumor, primary
hepatic neuroendocrine tumor and desmoplastic small round cell tumor, approaching
their main characteristics and imaging findings with emphasis on computed tomography
and magnetic resonance imaging.
ObjectiveTo analyze the perception of the relevance of introducing bilingual
(Portuguese-English) musculoskeletal imaging education into radiology and
diagnostic imaging residency programs, describing the method used.Materials and MethodsTo evaluate the relevance of incorporating the bilingual study of
musculoskeletal imaging into medical residency programs, we administered a
questionnaire, consisting of several multiple-choice questions and one
subjective question, to 21 radiology residents at a private tertiary
hospital. The residents completed the questionnaire voluntarily and
anonymously.ResultsIntegrating English teaching into radiology training was considered important
by 95.2% of the residents. Approximately 90% of residents believe that the
method applied at their institution is suitable for learning.ConclusionThe introduction of the English language into the teaching of musculoskeletal
imaging in the radiology residency program was perceived positively by the
residents, and the preceptors effectively supported those activities.
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