Miguel Trelles

Objective: To describe the results of transperineal prostate biopsy by fusion of cognitive magnetic resonance imaging and ultrasound in the detection of cancer. Materials and methods: A retrospective case series study conducted at the Delgado Clinic between July 2019 and October 2021. Patients with digital prostate examination and/or abnormal Prostatic Specific Antigen and prostate MRI images with category lesions were included. PI-RADS 4 or 5. Excluding patients with coagulation disorders, rectal injuries, impossibility for abduction, comorbidities for anesthesia. We recorded clinical and demographic characteristics, prostate-specific antigen data, prostate volume, PI-RADS lesions, cancer rates, and complications. Results: 18 patients were evaluated, with a mean age of 69.33 ± 7.67 years. The mean prostate specific antigen was 14.94 ± 12.42 ng/mL. The mean prostate volume was 57.72 ± 28.68 cc. At the digital examination of the prostate, 16/18 (88.88%) patients had suspected cancer. Biopsies in patients with PI-RADS lesions 4 in 6/18 (33.33%) and 5 in 12/18 (66.67%). Biopsy with 19 cores in 6/18 (33.33%) and 16 cores in 12/18 (66.67%) patients. Cancer patients 15/18 (83.33%), all acinar adenocarcinoma, with Gleason 6 in 2/18 (11.11%) and Gleason ≥ 7 in 13/18 (72.22%) patients. Mild complications such as hematuria 1/18 (5.6%), terminal dysuria 8/18 (44.4%) and perineal discomfort 7/18 (38.8%) and none infectious. Conclusions: transperineal prostate biopsy by fusion of cognitive magnetic resonance imaging and ultrasound is feasible, safe, with high positivity rates and without infections.

The early radiological features of viral pneumonia can be subtle. The high transmissibility rate of SARS-CoV-2 and the wide range of disease manifestations from asymptomatic to life-threatening COVID-19 have challenged health systems throughout the world. Early CT scanning of the lungs was found to be more sensitive than molecular detection of viral RNA with polymerase chain reaction (PCR) testing,¹ but is practically unrealistic in many healthcare systems due to a lack of CT scanners, whereas chest radiography is available.^2,3 The chest radiograph is an almost immediate test, and if it were sensitive and specific enough, it could act as an immediate screen for COVID-19, as for influenza,⁴ although with limited capacity to detect asymptomatic SARS-CoV-2 infection.⁵

BACKGROUND AND PURPOSE: Endoscopic third ventriculostomy is a well-accepted treatment choice for hydrocephalus and is used most frequently with a known impediment to CSF flow between the third ventricle and basal cisterns. However, there are scarce data on the imaging evolution of the defect in the floor of the third ventricle and how this affects patency rates and clinical outcomes. The purpose of this study was to assess whether, and how, the endoscopic third ventriculostomy defect changes in size with time. MATERIALS AND METHODS: All high-resolution endoscopic third ventriculostomy protocol MRIs performed between 2009 through 2014 were retrospectively identified. Two fellowship-trained neuroradiologists, blinded to clinical information, independently reviewed all retrospective cases. RESULTS: A total of 98 imaging studies were included from 34 patients. The average change in the area throughout the studied period was 0.02 mm²/day (7.5 mm²/year), with a higher increase in size noted in the first 3 postsurgical months, with a gradual decrease in the degree of defect-size change. Use of the NICO Myriad device was correlated with the area of the endoscopic third ventriculostomy defect on the last follow-up, demonstrating a larger final defect size in patients in whom the surgical technique included debridement of the endoscopic third ventriculostomy defect walls with the NICO Myriad device (28.21 versus 11.25 mm, P < .05). CONCLUSIONS: High-resolution MR imaging with sagittal CISS images is useful in the postoperative evaluation of endoscopic third ventriculostomies. Such findings may prove useful in determining the optimal duration of follow-up with MR imaging of patients who have undergone endoscopic third ventriculostomy.

This module was created to supplement the traditional learning methods that senior medical students, first-year radiology residents, and residents in other specialties employ to learn the fundamentals of radiologic image interpretation. It is part of an ongoing project entitled Diagnostic Imaging Fundamentals (DIF), with each module covering a unique topic. This module covers brain vascular anatomy, common imaging modalities, and imaging characteristics of brain vascular pathologies. This module has been designed for team-based learning and consists of advance-preparation reading material, in-class individual and group readiness assurance tests, and a group application exercise. Students are evaluated both individually and as groups. These DIF modules are designed primarily for group learning and are well suited for the academic setting. The feedback we received from first-year radiology residents was 100% positive, and the most frequent remark used by learners in their comments was "very helpful." Our limited feedback suggests that the level of material is appropriate for trainees at or above their final year of medical school. We are confident that this module will benefit students and residents who are eager to learn the fundamentals of brain vascular imaging and will serve as a useful adjunct to traditional methods of learning. We believe the module's application of team-based learning can act as a model for collaborative learning in a traditionally didactic learning environment. Future work will include expanding use of the module to larger groups of radiology residents, medical students, and residents in other specialties.

Previous publications from two countries in South America found one anatomical variation not previously reported in the rest of the world, which in turn give some clues with regard to a racial difference. The objective of the present study is to describe variations in the anatomical distribution of the branches of the aortic arch in a Peruvian population. To describe variations in the anatomical distribution of the branches of the aortic arch in a Peruvian population. A descriptive study of patients who underwent a tomography angiography of the aorta was performed. We analyzed the reports that showed the description of the variations of the branches of the aortic arch based on the eight types currently described in the literature. From 361 analyzed reports, 282 patients (78.12%) had a normal aortic arch configuration (type I; aortic arch gives rise to the brachiocephalic trunk, left common carotid and left subclavian arteries); followed by type II (left common carotid artery as a branch of the aorta) with 41 patients (11.36%); and type IX (common ostium for the brachiocephalic trunk and the left common carotid artery) with 25 patients (6.93%). The latter and two other types are new variations. Aortic Arch Type I, Type II and Type IX were the most frequent variations in this Peruvian study. Additionally, we also found two more new types that have not been previously described in the literature. Further investigation regarding these variations is needed in order to assess a racial factor in South America and possible relationships with clinical or surgical events.