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This article reviews the Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) score for the characterization of indeterminate ovarian masses. We aim to provide sufficient information to enable readers to apply the score efficiently in clinical practice. To this end, we review the indications of the O-RADS MRI score and the specific MRI protocol that must be applied. We review all the categories of the score, illustrating them through examples. Finally, we show the most common errors and pitfalls during the learning curve, providing the keys to avoiding them.

The European Society of Urogenital Radiology (ESUR) updated its guidelines for prophylaxis against postcontrast acute kidney injury (PC-AKI) in 2018 (ESUR 10.0). These guidelines drastically reduce the indications for prophylaxis against PC-AKI after iodine-based contrast administration, lowering the cutoff for administering prophylaxis to glomerular filtration rates30ml/min/1.73m

Resumen El colico renal es un motivo frecuente de consulta en los Servicios de Urgencias y la imagen diagnostica se ha convertido en una herramienta fundamental del diagnostico y manejo clinico. La ecografia y, fundamentalmente, la tomografia computarizada sin contraste permiten diagnosticarlo con un rendimiento elevado. El manejo radiologico va a depender de la disponibilidad del centro y de las caracteristicas de la poblacion. Es imprescindible usar tecnicas de baja dosis de radiacion en la tomografia computarizada y tecnicas alternativas como la ecografia en embarazadas y ninos. En este articulo hacemos una revision epidemiologica, clinica, radiologica y del manejo clinico de la litiasis ureteral.

a Servicio de Radiodiagnostico, Hospital U. Fundacion Alcorcon, Alcorcon, Madrid, Espana b Servicio de Radiodiagnostico, Hospital de Basurto, Bilbao, Vizcaya, Espana c Servicio de Radiodiagnostico, Hospital de Cabuenes, Gijon, Asturias, Espana d Servicio de Radiodiagnostico, Hospital Puerta de Hierro, Majadahonda, Madrid, Espana e Servicio de Radiodiagnostico, Hospital Donostia, Donostia/San Sebastian, Espana f Servicio de Radiodiagnostico, Hospital Clinic, Barcelona, Espana g Unidad Central de Radiodiagnostico (UCR), Hospital Infanta Leonor, Madrid, Espana h Servicio de Radiodiagnostico, Hospital Comarcal de Melilla, Melilla, Espana i Servicio de Radiodiagnostico, Hospital Virgen del Rocio, Sevilla, Espana j Miembro del Comite de Asuntos Profesionales de la SEUS

Resumen La creciente demanda de pruebas radiologicas y el envejecimiento progresivo de la poblacion ha llevado al aumento progresivo en la deteccion de lesiones suprarrenales indeterminadas. Una vez detectado el incidentaloma suprarrenal, disponemos actualmente de pruebas clinicas y hormonales y de una bateria de tecnicas de imagen (TC, RM, PET/TC…) que hacen posible el diagnostico etiologico de la mayoria de estos incidentalomas. En este articulo presentamos las ventajas y limitaciones de cada tecnica, las caracteristicas por imagen de las lesiones suprarrenales mas frecuentes y proponemos un algoritmo diagnostico que permita el diagnostico de las mismas.

Multidetector computed tomography (MDCT) and advances in CT urography techniques have enabled vast improvements in the depiction of the ureter. Studies of the ureter can find a wide variety of conditions including congenital defects and anatomic variants (anomalies in the origin, distribution, and distal insertion of the ureter) as well as all benign and malignant causes of focal and diffuse wall thickening (inflammatory and infectious processes, and neoplasms, as well as iatrogenic thickening and postsurgical changes). Other benign processes like ureteral kinking and stenosis due to extrinsic

Resumen Objetivos El objetivo de este estudio multicentrico ha sido evaluar si la ecografia con contraste permite aumentar el rendimiento diagnostico de la ecografia basal. Material y metodos En este estudio prospectivo multicentrico realizado en 42 hospitales se incluyeron 1.786 pacientes con estudios ecograficos considerados como no concluyentes. El 84,9% fueron ecografias abdominales (incluyendo estudios hepaticos, renales, esplenicos y de otras localizaciones), el 6,2% fueron estudios vasculares perifericos, el 4,3% fueron estudios mamarios y el 4,6% fueron estudios de otras localizaciones. Se evaluo el tipo de ecografia con contraste (Doppler color o metodo especifico de contraste), el tipo de contraste, la dosis y el numero de dosis y el tipo de administracion (en forma de bolo o infusion). Sobre los hallazgos obtenidos en la ecografia con contraste se valoro si conseguia aumentar el rendimiento diagnostico de la ecografia basal y si permitia un diagnostico concluyente. Resultados El 99,9% de los estudios se realizo con SonoVue, con una dosis de contraste (84,8%) y en forma de bolo (98,5%). En el 91,6% de los casos la ecografia con contraste aumento el rendimiento diagnostico de la ecografia basal, y en el 69,2% permitio un diagnostico de certeza. El mayor rendimiento diagnostico se obtuvo en los estudios de troncos supraaorticos con un diagnostico definitivo en el 95,4% de los casos, seguido por el area abdominal con resultado concluyente en el 72,6% de los casos. Conclusiones El uso de la ecografia con contraste aumento significativamente el rendimiento diagnostico de la ecografia basal, y se obtuvo un resultado concluyente en la mayoria de los casos.

Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

Renal colic is a common reason for presentation to emergency departments, and imaging has become fundamental for the diagnosis and clinical management of this condition. Ultrasonography and particularly noncontrast computed tomography have good diagnostic performance in diagnosing renal colic. Radiologic management will depend on the tools available at the center and on the characteristics of the patient. It is essential to use computed tomography techniques that minimize radiation and to use alternatives like ultrasonography in pregnant patients and children. In this article, we review the epidemiology, clinical and radiologic presentations, and clinical management of ureteral lithiasis.

A diaphragmatic hernia is defined as the protrusion of abdominal viscera into the thoracic cavity through a normal or pathological orifice. The herniated viscera compress the lungs, resulting in pulmonary hypoplasia and secondary pulmonary hypertension, which are the leading causes of neonatal death in patients with congenital diaphragmatic hernia. Congenital diaphragmatic hernia is diagnosed by sonography in routine prenatal screening. Although magnetic resonance imaging is fundamentally used to determine whether the liver is located within the abdomen or has herniated into the thorax, it also can provide useful information about other herniated structures and the degree of pulmonary hypoplasia. The aim of this article is to review the fetal magnetic resonance findings for congenital diaphragmatic hernia and the signs that enable us to establish the neonatal prognosis when evaluating pulmonary hypoplasia.

The growing demand for imaging tests and the progressive aging of the population have led to a progressive increase in the detection of indeterminate adrenal lesions. Once an adrenal incidentaloma is detected, clinical and hormone tests together with a battery of imaging techniques (CT, MRI, PET/CT…) make it possible to determine the cause in most cases. In this article, we discuss the advantages and limitations of each technique. We show the imaging characteristics of the most common adrenal lesions and propose a diagnostic algorithm to enable their diagnosis.

Multidetector computed tomography (MDCT) and advances in CT urography techniques have enabled vast improvements in the depiction of the ureter. Studies of the ureter can find a wide variety of conditions including congenital defects and anatomic variants (anomalies in the origin, distribution, and distal insertion of the ureter) as well as all benign and malignant causes of focal and diffuse wall thickening (inflammatory and infectious processes, and neoplasms, as well as iatrogenic thickening and postsurgical changes). Other benign processes like ureteral kinking and stenosis due to extrinsic compression of the iliac vessels are also well characterized by MDCT. The aim of this article is to show the spectrum of ureteral variants and disease apart from common entities related to stones.

We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US).We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached.The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases.The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases.