No abstract

In paediatrics, the risks associated with ionising radiation should be a major concern, due to children's higher susceptibility to radiation effects. Measure entrance skin dose (ESD) in chest and pelvis X-ray projections and compare the results with the 'European guidelines on quality criteria for diagnostic radiographer images in paediatrics' in order to optimise radiological practice. ESD values were obtained using an ionisation chamber Diamentor M4 KDK (PTW) in 429 children, who underwent chest X-ray or pelvis X-ray in a Computed Radiography system. In the first phase of the study, data were collected according to protocols used in the department; in a second phase different tube voltage values were used according to patient weight. A third phase was carried out, only for chest X-ray, using the exposure parameters of phase 2, plus activating lateral ionisation chamber. Three paediatric radiologists blindly assessed image quality of chest X-ray, using a validated assessment available in the 'European guidelines on quality criteria for diagnostic radiographer images in paediatrics'. Considering all the patients submitted to chest X-ray, the average ESD was 0.22, 0.16 and 0.08 mGy, for phases 1, 2 and 3, respectively. For pelvis X-ray, the average ESD decreased from 1.18 mGy in phase 1 to 0.78 mGy in phase 2. Dose optimisation was achieved. ESD was reduced 63.6 and 33.9 % in chest and pelvis X-ray, respectively.

No abstract

Hepatocellular carcinoma (HCC) usually develops in the setting of chronic liver disease. In the adequate clinical context, both multiphasic contrast-enhanced CT and magnetic resonance imaging are non-invasive modalities that allow accurate diagnosis and staging of HCC, although the latter demonstrates greater sensitivity and specificity. Imaging criteria for HCC diagnosis rely on hemodynamic features such as hyperenhancement in the arterial phase and washout in the portal or equilibrium phase. However, imaging performance drops considerably for small (< 20 mm) nodules because their tendency to exhibit atypical enhancement patterns. In order to improve accuracy in the diagnosis and staging of HCC, particularly in cases of atypical nodules, ancillary features, i.e., imaging characteristics that modify the likelihood of HCC, have been described and incorporated into clinical reports, especially in Liver Imaging Reporting and Data System. In this paper, ancillary imaging features will be reviewed and illustrated.

Mulher de 59 anos, com antecedente conhecido de trombocitémia essencial, medicada com idroxiureia, re-correu ao serviço de urgência por desconforto no flanco esquerdo com cerca de 4 dias de evolução, com alívio em decúbito e sem outros sintomas acompanhantes, no-meadamente urinários. O exame objetivo e a avaliação laboratorial revelaram-se normais.