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Temporal Bone Trauma: Typical CT
and MRI Appearances and Important Points for Evaluation
Autores: Yoshiko Y. Kurihara, MD
Astuko Fujikawa, MD
Natsuki Tachizawa, MD
Mamiko Takaya, MD
Hirotaka Ikeda, MD
Jay Starkey, MD
Objetivo:
describir los hallazgos de imagen clave en los estudios de RM estructural de las demen- cias de origen neurodegenerativo más frecuentes: enfermedad de Alzheimer, demencia vascular, demencia de cuerpos de Lewy, variantes de la demencia frontotemporal, parálisis supranu- clear progresiva, variantes de la atrofia multisistémica, parkinson-demencia y degeneración corticobasal.
Conclusión:
El papel de la resonancia magnética hoy en día ya no está limitado a excluir causas subyacentes de deterioro cognitivo, sino que puede mostrar patrones de atrofia y otros datos con un alto valor predictivo para determinadas demencias que, aunque no son específicos ni únicos de cada patología, pueden ayudar a confirmar una sospecha diagnóstica o a identificar inicios tempranos de determinados procesos. Por ello es importante que los radiólogos conozcan los hallazgos típicos de las demencias más frecuentes.
Palabras clave: Resonancia magnética; Atrofia; Demencia; Enfermedad de Alzheimer; Parálisis supranuclear progresiva; Demencia vascular; Atrofia multisistémica; Enfermedad de Parkinson; Demencia frontotemporal
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Temporal bone trauma is frequently encountered in the emergency
department. Technologic advances have enabled timely acquisition
of thin-section images and multiplanar reconstructions such that
temporal bone anatomy can be evaluated in great detail, with excellent delineation of fractures. The temporal bone is composed of a
myriad of tiny structures, including many fissures and canals, that
must be distinguished from true fractures. In addition, injury to important structures may result in serious complications such as hearing loss, dizziness, imbalance, perilymphatic fistula, cerebrospinal
fluid leakage, facial nerve paralysis, and vascular injury. Structures
that should be examined include the tympanic cavity and tegmen,
the ossicular chain, the bony labyrinth, the facial canal, the internal
carotid artery, the jugular foramen and venous sinuses, and the intracranial contents. Radiologists should be familiar with the anatomy
of the temporal bone and be able to describe any pathologic findings and make suggestions to referring clinicians to guide management and determine the prognosis. The authors describe the typical
CT and MRI appearances of temporal bone trauma, entities that
mimic this injury and thus must be differentiated, and compulsory
points for evaluating clinically relevant associated complications.
Instruction is provided for acquiring the diagnostic skills necessary
to report suggested injury status, complications, and likely sequelae
to clinicians.
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