Paulina González M

Detección y caracterización por ultrasonido de cuerpos extraños de partes blandas

Background: Soft tissue foreign bodies are a frequent cause of consultation in emergency rooms. It is difficult to verify their existence since conventional radiology only detects radio opaque objects. Ultrasound can be a useful diagnostic procedure. Aim: To report our experience in the detection of soft tissue foreign bodies by ultrasound examination. Patients and methods: The ultrasonographic appearance of vegetables, glass and plastic, metal, bone and stones was studied in gelatin preparations. In a second stage, 52 patients (27 male, aged 3 to 88 years old) were studied, in whom the presence of a soft tissue foreign body was confirmed surgically. Results: The mean error of the procedure for the assessment of foreign body size was 0.2 mm in vitro and 0.5 mm in vivo. The deepness and involved planes were correctly diagnosed in 96%, the number of fragments were diagnosed correctly in 94% of cases. The type of foreign body was identified correctly in 77% of cases and complications were detected in 100% of cases. Conclusions: Ultrasound is a sensitive and accurate method for the detection of soft tissue foreign bodies. (Rev Med Chile 2000; 128: 419-424).

BIOPSIA ESTEREOTAXICA MAMARIA: 2 AÑOS DE EXPERIENCIA

Introduccion: La biopsia estereotaxica digital mamaria (BED), representa un excelente metodo para obtener diagnostico histologico, siendo alternativa de eleccion frente a la cirugia en muchos casos. Objetivo: Presentar nuestra experiencia en la aplicacion de la BED en el Hospital Clinico de Universidad de Chile. Material y metodo: Estudio descriptivo, retrospectivo de BED realizadas en el Hospital Clinico de la Universidad de Chile (marzo 2005-noviembre 2007). Se registro morfologia de las lesiones, clasificacion BI-RADS, informes de anatomia patologica, complicaciones y datos epidemiologicos. Resultados: Se incluyo a 79 pacientes con 95 lesiones. Edad promedio 55 anos. De las 95 biopsias, 95,7% correspondieron a microcalcificaciones. La sensibilidad fue 92,8% y la especificidad 100%. El valor predictivo positivo fue 100%o y negativo 98,7%. La subestimacion fue de 8% y la tasa de complicaciones 3,1%. Conclusiones: Nuestros resultados confirman las ventajas del procedimiento en nuestro Centro, demostrando la BED como altamente confiable, con buena correlacion histologica y minimas complicaciones.

ESTUDIO POR IMÁGENES EN PACIENTES CON ALTO RIESGO DE CÁNCER MAMARIO

Existen mujeres que, por diferentes razones, poseen una significativa mayor probabilidad de presentar cancer de mamas en su vida (pacientes de alto riesgo), en las cuales es de vital importancia la vigilancia clinica a fin de detectar precozmente la enfermedad. En el presente articulo se realiza una revision del tema, con especial enfasis en los examenes de imagenes y estrategias de seguimiento para ellas, que puedan ayudar a efectuar un diagnostico precoz y tratamiento efectivo.

RESONANCIA MAGNETICA MAMARIA: INDICACIONES POCO HABITUALES

The indications of breast MRI are now clearly established and internationally accepted. They are also applied in Chile as was agreed in the last the National Consensus on the management of breast cancer. In our study the indications not mentioned in the consensus were classified as infrequent. We determined that a 9.2% of breast MRI performed in our study centers were due to infrequent indications, leading to a change in medical management in 71,4% of these patients, although this change sometimes had no scientific evidence availing it. These results suggest that MRI could be useful in specific situation and reveal a need for multicentric high quality studies in order to gather enough evidence to justify its use in indications other than the ones already established. In other situations MRI would not be recommended. In exceptional cases, where it seems useful to perform this type of exam it is suggested to make the advisable to make the decision after discussion in a interdisciplinary committee.