array:24 [ "pii" => "S2387020621000991" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.06.034" "estado" => "S300" "fechaPublicacion" => "2021-04-09" "aid" => "5292" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2021;156:349-55" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775320304528" "issn" => "00257753" "doi" => "10.1016/j.medcli.2020.06.027" "estado" => "S300" "fechaPublicacion" => "2021-04-09" "aid" => "5292" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2021;156:349-55" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo especial</span>" "titulo" => "Hallazgos en las pruebas de imagen de la sarcoidosis" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "349" "paginaFinal" => "355" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Imaging findings of sarcoidosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figura 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1409 "Ancho" => 2667 "Tamanyo" => 286647 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A) Tomografía computarizada (TC) de abdomen axial. B) TC abdomen reconstrucción coronal. Hepatomegalia leve con numerosos granulomas (flechas) de pocos milímetros que se observan como nódulos hipodensos, se asocia a afectación esplénica con granulomas (flechas discontinuas) que se identifican también como nódulos hipodensos. C) Resonancia magnética, secuencia T1 tras administración de contraste. Engrosamiento de la duramadre en fosa temporal izquierda, con marcado realce (flechas sólidas). Engrosamiento nodular y difuso leptomeníngeo (flechas discontinuas) con marcado realce (meningitis sarcoidea).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Raquel Sánchez-Oro, María Ángeles Meseguer Ripollés, Elsa María Alonso-Muñoz, Salvador Pascual Alandete German" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Raquel" "apellidos" => "Sánchez-Oro" ] 1 => array:2 [ "nombre" => "María Ángeles" "apellidos" => "Meseguer Ripollés" ] 2 => array:2 [ "nombre" => "Elsa María" "apellidos" => "Alonso-Muñoz" ] 3 => array:2 [ "nombre" => "Salvador Pascual" "apellidos" => "Alandete German" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020621000991" "doi" => "10.1016/j.medcle.2020.06.034" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621000991?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320304528?idApp=UINPBA00004N" "url" => "/00257753/0000015600000007/v1_202103260933/S0025775320304528/v1_202103260933/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020621001169" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.12.006" "estado" => "S300" "fechaPublicacion" => "2021-04-09" "aid" => "5555" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2021;156:356-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Impact of the SARS-CoV-2 pandemic on the early diagnosis of melanoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "356" "paginaFinal" => "357" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Impacto de la pandemia SARS-CoV-2 en el diagnóstico precoz del melanoma" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2255 "Ancho" => 2925 "Tamanyo" => 159329 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">In 2019, 33 cases were melanomas <span class="elsevierStyleItalic">in-situ</span> and 4 melanomas over 2 mm in thickness, while in 2020, 5 cases were melanomas <span class="elsevierStyleItalic">in-situ</span> and 7 were melanomas over 2 mm in thickness.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Inés Fernández Canedo, Magdalena de Troya Martín, Francisco Rivas Ruíz" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María Inés" "apellidos" => "Fernández Canedo" ] 1 => array:2 [ "nombre" => "Magdalena" "apellidos" => "de Troya Martín" ] 2 => array:2 [ "nombre" => "Francisco" "apellidos" => "Rivas Ruíz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775321000191" "doi" => "10.1016/j.medcli.2020.12.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775321000191?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621001169?idApp=UINPBA00004N" "url" => "/23870206/0000015600000007/v1_202104020834/S2387020621001169/v1_202104020834/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020621001145" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.11.014" "estado" => "S300" "fechaPublicacion" => "2021-04-09" "aid" => "5539" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2021;156:344-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical report</span>" "titulo" => "Granulomatous lymphocytic interstitial lung disease: Description of a series of 9 cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "344" "paginaFinal" => "348" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad pulmonar intersticial linfocítica granulomatosa: descripción de una serie de 9 casos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 582 "Ancho" => 1750 "Tamanyo" => 143871 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracic computed tomography performed in the clinical presentation of granulomatous lymphocytic interstitial lung disease, showing septal and peripheral interlobular thickening, peripheral consolidations, and bilateral ground glass opacities (white arrow) and mediastinal and hilar lymphadenopathy (black arrow).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sandra Ruiz-Alcaraz, Ignacio Gayá García-Manso, Francisco Manuel Marco-De La Calle, María del Mar García-Mullor, Helena López-Brull, Raquel García-Sevila" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Sandra" "apellidos" => "Ruiz-Alcaraz" ] 1 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Gayá García-Manso" ] 2 => array:2 [ "nombre" => "Francisco Manuel" "apellidos" => "Marco-De La Calle" ] 3 => array:2 [ "nombre" => "María del Mar" "apellidos" => "García-Mullor" ] 4 => array:2 [ "nombre" => "Helena" "apellidos" => "López-Brull" ] 5 => array:2 [ "nombre" => "Raquel" "apellidos" => "García-Sevila" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775320308800" "doi" => "10.1016/j.medcli.2020.11.033" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320308800?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621001145?idApp=UINPBA00004N" "url" => "/23870206/0000015600000007/v1_202104020834/S2387020621001145/v1_202104020834/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "Imaging findings of sarcoidosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "349" "paginaFinal" => "355" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Raquel Sánchez-Oro, María Ángeles Meseguer Ripollés, Elsa María Alonso-Muñoz, Salvador Pascual Alandete German" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Raquel" "apellidos" => "Sánchez-Oro" "email" => array:1 [ 0 => "raquel_sanchez_oro@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María Ángeles" "apellidos" => "Meseguer Ripollés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Elsa María" "apellidos" => "Alonso-Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Salvador Pascual" "apellidos" => "Alandete German" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital General Obispo Polanco, Teruel, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Arnau de Vilanova, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hallazgos en las pruebas de imagen de la sarcoidosis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 793 "Ancho" => 1500 "Tamanyo" => 134519 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A) Axial abdominal computed tomography (CT). B) Abdominal CT coronal reconstruction. Mild hepatomegaly with numerous granulomas (arrows) of a few millimetres in size that are observed as hypodense nodules; it is associated with splenic involvement with granulomas (discontinuous arrows) that are also identified as hypodense nodules. C) Magnetic resonance imaging, T1-weighted image after contrast administration. Thickening of the dura mater in the left temporal fossa, with significant enhancement (solid arrows). Nodular and diffuse leptomeningeal thickening (dashed arrows) with significant enhancement (sarcoid meningitis).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Sarcoidosis is a multisystem disease that affects populations throughout the world, characterized by an exaggerated and persistent Th1 immune system response that leads to the formation of non-caseating granulomas. It was first described in 1877 by Hutchinson, who described them as purple skin lesions, and which were later termed "sarcoids" by Boeck, due to their histological similarity to sarcoma.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The aetiology of sarcoidosis is unknown. Its development requires genetic predisposition and interaction with environmental or infectious factors.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Some authors consider that sarcoidosis is a family of different diseases, which would include Löfgren's syndrome, its progression to pulmonary fibrosis, sarcoid uveitis or cardiac involvement.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> The clinical heterogeneity of sarcoidosis could be due to a hypothetical heterogeneity in its etiology.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In terms of epidemiology, it has a worldwide distribution, affecting both sexes and with a highly variable incidence among different populations. An incidence of 35.5/100,000 has been described in the African American population of the USA, compared to 10.9/100,000 in the population of the UK.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> Although there are not many epidemiological studies in Spain, the annual incidence rate described in the evaluation of a health area in León was 1.37/100,000 inhabitants, and the estimated cumulative annual incidence rate for the entire country was 1.36/100,000 inhabitants.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Sarcoidosis typically occurs in individuals between the ages of 20 and 60. Although most patients have clinical manifestations, a non-negligible percentage of patients are asymptomatic and may be diagnosed incidentally due to findings on a chest X-ray and/or computed tomography (CT) performed for another reason. The most common involvement is pulmonary, followed by cutaneous and ocular manifestations. 90% of patients show pulmonary abnormalities, and only 10–30% have skin, ocular or peripheral lymphadenopathy at the time of diagnosis. However, its initial manifestation is extrapulmonary in more than 30%. In patients with exclusively pulmonary involvement, a differential diagnosis with more common diseases such as asthma or chronic bronchitis may be clinically considered, but the findings on chest X-ray or CT can be of great help to guide the diagnosis. In these cases, a diagnosis can be made earlier than in sarcoidosis with extrapulmonary involvement, which can suffer a longer delay.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Typical clinical manifestations of sarcoidosis include: nonspecific respiratory symptoms such as dry cough, dyspnoea, and chest pain or discomfort (present in 9–50% of cases), asthenia, weight loss, fever or night sweats, muscle weakness or exercise intolerance. Lung auscultation is usually inconclusive, even when there is lung parenchymal involvement on imaging tests.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,7,8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Patients with suspected sarcoidosis should undergo a complete physical examination, including an ophthalmological examination, chest X-ray, conventional blood tests including calcium, total protein and angiotensin converting enzyme, tuberculin test or quantiferon determination, respiratory function, including spirometry, lung volumes and CO diffusion capacity and electrocardiogram.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">There is no definitive test for the diagnosis of sarcoidosis, which is based on a combination of different criteria: clinical presentation and compatible radiological findings, histopathological determination of non-caseating granulomas and other granulomatous diseases.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,8,9</span></a> This paper reviews the imaging tests of current utility in the diagnosis and management of sarcoidosis according to the different organ involvement of this disease.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Pulmonary sarcoidosis</span><p id="par0040" class="elsevierStylePara elsevierViewall">More than 90% of patients with chest involvement show abnormalities in the chest X-ray. The most common finding is lymphadenopathy, which appear in 60–70% of cases, and between 20-50% present ground-glass opacities in the upper and middle areas of the lungs. Pulmonary lesions may resolve or progress to fibrosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,10</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Hilar/mediastinal lymphadenopathy typically have a bilateral and symmetric distribution. This is the most common and characteristic finding of sarcoidosis, especially when it conforms to the so-called "1-2-3 sign" or Garland's triad, which corresponds to enlarged right paratracheal (1), right hilar (2) and left hilar (3) nodes. Lymphadenopathy may also occur in the aortopulmonary window ("1-2-3-4 sign") (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Hilar lymphadenopathies are typical of sarcoidosis and their absence should call the diagnosis into question. The differential diagnosis of hilar/mediastinal lymphadenopathy is made with lymphoma, tuberculosis, and metastatic lymphadenopathy, but their characteristic distribution and the absence of compression of the adjacent vessels can lead to sarcoidosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,10</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Based on chest X-ray findings, Scadding proposed a four-stage classification, which later expanded to five stages: without observable abnormalities (0), hilar/mediastinal lymphadenopathy (1), hilar/mediastinal lymphadenopathy and parenchymal involvement (2), parenchymal involvement without lymphadenopathy (3) and pulmonary fibrosis (4).<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> This system has lost its validity after the introduction of CT, a much more sensitive technique and with better correlation with abnormalities in functional tests.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,10</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Apart from confirming bilateral hilar/mediastinal lymphadenopathy in typical and in not so typical sites (subcarinal, prevascular), CT may show the following abnormalities in the lung parenchyma:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0060" class="elsevierStylePara elsevierViewall">Small pulmonary nodules between 1-5<span class="elsevierStyleHsp" style=""></span>mm in the upper and middle lobe distribution, with unclear margins and perilymphatic distribution, in the subpleural interlobular septa, which may show some degree of distortion in lung architecture (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). This is the most characteristic pattern, present in 80–100% of cases, which, together with a typically localised lymphadenopathy and the appropriate clinical manifestations, practically confirms the diagnosis.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0065" class="elsevierStylePara elsevierViewall">Large nodules, lung masses, or multifocal consolidations secondary to the coalescence of multiple granulomas, especially in the middle (parahilar) lung fields. The "galaxy sign" describes the presence of a larger nodule, formed by coalescence, surrounded by nearby satellite nodules (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). This sign can also appear in tuberculosis.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0070" class="elsevierStylePara elsevierViewall">Pulmonary fibrosis: it can develop in 20–25% of patients after years of development, and it is an irreversible alteration that also typically affects the middle and upper lobe distribution. It causes a distortion of lung architecture, loss of volume, linear reticulations from the hilum, bronchiectasis, and traction bronchiolectasis. Calcification of the lymphadenopathies, which can be mass-like, punctate, or eggshell-shaped, is also indicative of chronicity (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B).<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,10,12</span></a></p></li></ul></p><p id="par0075" class="elsevierStylePara elsevierViewall">Atypical findings of sarcoidosis on CT are asymmetric or unilateral hilar/mediastinal lymphadenopathies (less than 5% of cases) or in the paravertebral or retrocrural lymph node chains of the internal thoracic artery; perilymphatic pulmonary nodules with asymmetric distribution and signs of pulmonary hypertension. CT is also useful as a guide for a lymph node needle biopsy or to diagnose other possible causes.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,10</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The differential diagnosis of pulmonary parenchymal involvement should be made with bronchiolitis of different causes, lymphangitis carcinomatosa, hypersensitivity pneumonia, organizing pneumonia, and nonspecific interstitial pneumonia.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,10</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">[<span class="elsevierStyleSup">18</span>F]-2-fluoro-2-deoxy-<span class="elsevierStyleSmallCaps">d</span>-glucose positron emission tomography (<span class="elsevierStyleSup">18</span>F-FDG PET/CT) has shown to be a useful imaging technique for the management of sarcoidosis, its main indication is to assess the presence of active disease in patients with pulmonary sarcoidosis in the fibrotic phase in order to decide on the continuation or discontinuation of the treatment.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,13–16</span></a> Furthermore, the findings of the <span class="elsevierStyleSup">18</span>F-FDG PET/CT are related to lung function parameters and may indicate disease severity, although it is recommended to monitor pulmonary sarcoidosis using pulmonary function testing; PET is not indicated for this purpose.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Cardiac sarcoidosis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Cardiac sarcoidosis (CS) is a relevant cause of morbidity and mortality in patients with sarcoidosis. Although only 5% of patients with systemic sarcoidosis have cardiac involvement, some autopsy series studies have found a prevalence of subclinical CS of 25%, so cardiac involvement appears to be under-diagnosed.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is estimated that 16–35% of those under 60 years of age with atrioventricular block or ventricular tachycardia have underlying CS. Sarcoidosis can affect any part of the heart including the atria, ventricles, valves, papillary muscles, pericardium, conduction system, and coronary vessels. Patients with CS may be asymptomatic or present with potentially serious nonspecific symptoms such as dyspnoea, palpitations, chest pain, or sudden death. Conduction disorders, atrioventricular blocks, ventricular systolic dysfunctions, bundle-branch blocks, or supraventricular and ventricular arrhythmias may be found on the ECG and/or 24-h Holter monitoring.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18–21</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The definitive standard criterion for the diagnosis of CS is the histological confirmation of non-caseating granulomas through an endomyocardial biopsy of the right heart chambers. The procedure implies a significant bleeding risk and may not provide a representative sample, given the multifocal nature of CS, so its diagnostic rate is relatively low (20–50%).<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,19</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Echocardiography shows functional abnormalities such as reduced ejection fraction and abnormalities in left ventricular regional motility, or chronic changes such as thinning of the free wall or the base of the interventricular septum and ventricular aneurysms. Cardiomegaly, pericardial effusion, and ventricular aneurysms are observed on a CT.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,19</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">In recent years, cardiac magnetic resonance (CMR) imaging and <span class="elsevierStyleSup">18</span>F-FDG PET have gained importance. Both techniques have been included in the diagnostic criteria of the main cardiac sarcoidosis guidelines: <span class="elsevierStyleItalic">International Heart Rhythm Society Expert Consensus Recommendations on Criteria for Diagnosis of Cardiac Sarcoidosis</span> and the <span class="elsevierStyleItalic">Japanese Ministry of Health and Welfare Guidelines</span>.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,22</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">CMR can reveal both early and chronic manifestations of the disease, making it the best technique for the detection of asymptomatic CS.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In the inflammatory/early phase, when granuloma formation occurs in the myocardium, with inflammation and oedema, myocardial thickening and focal contractility abnormalities may be observed. The chronic/cicatricial phase results in fibrous tissue in the myocardium with focal wall thinning together with regional motility abnormalities. Hypointense scars are observed on T2-weighted images due to fibrosis. In the MRI sequences after contrast injection, sarcoidosis is associated with delayed, multifocal, and patchy enhancement in the basal segments of the septum and the lateral wall, which tends to involve the epicardium and myocardium while sparing the subendocardium<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Delayed contrast enhancement has been described as a marker of adverse events (ventricular arrhythmias and sudden death), compared to the absence of delayed contrast enhancement. These patients have a low incidence of cardiovascular mortality or ventricular arrhythmias, with a relative risk reduction of 68–100% compared to those who do show delayed enhancement.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19,21,24</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">In addition, novel T1 and T2 mapping techniques allow quantitative characterisation of myocardial tissue, directly determining the intensity and extent of inflammation through the changes in the magnetisation properties of each voxel.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> In addition, they are useful for assessing the response to anti-inflammatory treatment.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The differential diagnosis of CS must be made with other entities that also exhibit delayed enhancement such as myocardial infarction, myocarditis, and amyloidosis. Unlike sarcoidosis, myocardial infarcts involve the subendocardium and have a vascular distribution, myocarditis usually has predominantly subepicardial involvement and amyloidosis shows diffuse and heterogeneous left wall enhancement, and biventricular hypertrophy.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19,20,23</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET also plays an important role in the non-invasive diagnosis of CS. It is an especially useful technique to differentiate between old inactive lesions and lesions with active granulomatous inflammation that are characterized by having a patchy focal uptake with or without perfusion defects. Areas of fibrosis or scar show perfusion defect without FDG uptake. Likewise, PET is useful to assess treatment response in CS. Patients who are going to have a PET scan for CS study need to undergo a special preparation in order to suppress the consumption of FDG by myocytes and increase the consumption of free fatty acids. To this end, it is recommended to avoid strenuous exercise 24<span class="elsevierStyleHsp" style=""></span>h prior to the test, low-carbohydrate, and high-fat diets for at least two meals before, prolonged fasting for at least 12<span class="elsevierStyleHsp" style=""></span>h and the administration of intravenous unfractionated heparin.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,26</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Abdominal sarcoidosis</span><p id="par0135" class="elsevierStylePara elsevierViewall">Sarcoidosis can affect any abdominal organ, but the liver, kidneys, spleen, and stomach are the most common.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18</span></a></p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Hepatic sarcoidosis</span><p id="par0140" class="elsevierStylePara elsevierViewall">Hepatic involvement prevalence ranges between 1-40/100,000 inhabitants, generally in young individuals. This type of sarcoidosis is often underestimated because, although it appears in 24–80% of cases in autopsy series, most patients are asymptomatic and a very variable percentage, depending on the series (2–60%), will have laboratory abnormalities expressing liver dysfunction. When symptoms are present, these are nonspecific (jaundice, itching, abdominal pain, fever, and fatigue), although most of the time they coexist with lung disease.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,9,27</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Imaging findings include hepatomegaly, homogeneous or heterogeneous, usually associated with splenomegaly and parahilar hepatic or celiac lymphadenopathy. On ultrasound, a diffuse increase in the echogenicity of the parenchyma can be observed and granulomas are visible in only 5–15% of cases, as countless hypoechogenic nodules in relation to the rest of the parenchyma, varying in size from a few millimetres to several centimetres. CT scans show these granulomatous nodules to be hypodense (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>A-B), and liver MRI scans show them to be hyperintense in T2-weighted sequences in the acute phase and hypointense in the chronic phase due to their fibrotic component.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18,27</span></a></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">The differential diagnosis of hepatic sarcoidosis is made with metastases, liver involvement due to lymphoma, and fungal or mycobacterial microabscesses.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Splenic sarcoidosis</span><p id="par0155" class="elsevierStylePara elsevierViewall">Splenic involvement, similar to liver disease, has been variably described in 24–59% of biopsies and is often associated with thoracic sarcoidosis. Patients may be asymptomatic or present with fever, weight loss, and general malaise. Imaging tests may show splenomegaly (25–60%) and less often splenic granulomas (6–33%), which may be larger than 1<span class="elsevierStyleHsp" style=""></span>cm with a tendency to converge. They are observed as hypoechogenic nodules on ultrasound and hypodense after administration of intravenous contrast on CT (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>A-B). On MRI, nodular lesions show low signal in all sequences and may show delayed phase enhancement.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,9,27</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Gastrointestinal sarcoidosis</span><p id="par0160" class="elsevierStylePara elsevierViewall">The stomach (especially the antrum) is the site of the gastrointestinal tract that is most commonly involved. Barium intestinal studies show mucosal irregularities with small ulcers, abnormal thickening of the folds, polyps, or signs of linitis plastica in the gastric wall. Intestinal and colonic involvement may manifest as granular filling defects, circumferential masses, or stenosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,9,18</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">In the pancreas, sarcoidosis usually infiltrates the gland by extension from retroperitoneal lymphadenopathy rather than by a lesion of intrapancreatic origin. Imaging findings are not specific and cannot be distinguished from other causes such as pancreatitis or neoplasm.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,9,18</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Genitourinary sarcoidosis</span><p id="par0170" class="elsevierStylePara elsevierViewall">Renal involvement in autopsy series is described in 7–22% of patients with sarcoidosis. Renal function is usually preserved. Interstitial nephritis lesions have an infiltrative pattern that preserves the shape of the kidney but may also include expansive lesions. Radiological findings are remarkably diverse, as both nephromegaly and renal atrophy can be observed, sometimes with patchy areas of hypovascularisation on CT, and bilateral multifocal hypovascular nodules. The differential diagnosis includes: lymphoma, metastasis, hypovascular renal cell carcinoma, and pyelonephritis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Sarcoidosis can also affect the testis and epididymis. Unilateral or bilateral hypoechogenic nodules appear on ultrasound. Differential diagnosis is made once again with lymphoma, leukaemia, metastasis or other granulomatous diseases.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Lymphatic and peritoneal sarcoidosis</span><p id="par0180" class="elsevierStylePara elsevierViewall">Abdominopelvic lymphadenopathies occur in 30% of patients with sarcoidosis, often associated with thoracic involvement. Sarcoidosis-related lymphadenopathies are usually smaller than those associated with lymphomas, and retrocrural clusters are less common. Peritoneal sarcoid involvement is rare. It presents with ascites, fat trabeculation and peritoneal nodules, raising the differential diagnosis with peritoneal carcinomatosis, tuberculosis and fungal infections.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,9,27</span></a></p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Neurosarcoidosis</span><p id="par0185" class="elsevierStylePara elsevierViewall">The most common manifestations of neurosarcoidosis are cranial nerve involvement, especially peripheral facial palsy, sometimes bilateral, and optic nerve involvement. Other manifestations are headache, aseptic meningitis (cerebrospinal fluid [CSF] with lymphocyte cellularity, elevated spinal fluid protein count and presence of oligoclonal bands in both CSF and serum), seizures, motor, or sensory signs due to space-occupying lesions, intracranial hypertension, hypothalamic-pituitary involvement with diabetes insipidus or panhypopituitarism, diffuse encephalopathy with cognitive disorders and, rarely, psychiatric, and spinal cord abnormalities. Due to the difficulties in obtaining a central nervous system biopsy, a diagnosis of neurosarcoidosis is accepted when compatible clinical and imaging features are found in the presence of systemic sarcoidosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,28</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Imaging findings also vary depending on the structures affected. The involvement of the dura mater is observed on MRI as nodular thickenings or masses with enhancement after contrast administration (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>C). Leptomeningeal involvement, also known as "sarcoid meningitis," which occurs in one-third of patients with neurosarcoidosis, can be complicated by hydrocephalus, seizures, or cognitive impairment. The image shows leptomeningeal thickening, which can be nodular or diffuse and is enhanced after contrast administration (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>C). As a consequence of the disruption of the blood-brain barrier, the cerebral cortex, the perivascular spaces, and the cisterns are affected. Multiple granulomas can coalesce to form intra-axial masses surrounded by oedema. These findings are nonspecific since they can appear in other pathological conditions such as tuberculosis, lymphoma or metastasis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,28</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">Neurosarcoidosis can affect any cranial nerve. The most common is the <span class="elsevierStyleSmallCaps">VII</span> pair, which is associated with febrile uveoparotitis in Heerfordt syndrome. Approximately 5% of patients with neurosarcoidosis will develop bilateral facial paralysis. These neuropathies will be detected on MRI as thickening and increased enhancement of the affected nerve.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,28</span></a></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Sarcoidosis in the head and neck</span><p id="par0200" class="elsevierStylePara elsevierViewall">Between 10-15% of patients with sarcoidosis show involvement of head and neck structures such as the orbits, salivary glands, paranasal sinuses, hypopharynx, thyroid, cervical ganglia and larynx.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,28</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">Between 25-50% of patients with sarcoidosis will develop ophthalmological abnormalities, which will be their first clinical manifestation in 20%, even prior to the onset of pulmonary abnormalities. The most common is uveitis, although any part of the eye, adnexa or orbit can develop bilateral granulomas. They are more common in the anterior segment, but the involvement of the posterior segment can be more serious due to loss of visual acuity associated with damage to the optic nerve.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28,29</span></a> The MRI shows a thickening of the optic nerve with hyperintensity in T2 and contrast enhancement, non-specific sarcoidosis findings that can also occur in carcinomatosis, lymphoma and optic neuritis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,28</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">The involvement of the paranasal sinuses results in their invasion by soft tissue. Nodular thickening with enhancement of the nasal septum and turbinates can be seen on CT or MRI, but sarcoidosis can also cause aggressive lesions with bone destruction or intracranial extension.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Cervical lymphadenopathies are common, occurring in up to 40% of patients with cervical-cephalic sarcoidosis. 6% of sarcoidosis patients also have enlargement of both parotid glands. On CT, this enlargement is observed in a heterogeneous pattern, and on MRI, with increased signal intensity on T2-weighted images, diffuse or with intraparotid nodular lesions.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,28</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Musculoskeletal sarcoidosis</span><p id="par0220" class="elsevierStylePara elsevierViewall">Sarcoidosis can affect any bone, joint, or muscle. Bone involvement has been described in 1–13% of patients, with a certain preference for small bones, especially middle and distal phalanges of the 2nd and 3rd finger. Small bone involvement (hands and feet) is characterized by osteolysis with thickening of the preserved bone trabeculae and cortical thinning, without periosteal reaction. Bone collapse or pathological fracture may occur. The involvement of long bones and the axial skeleton causes lytic foci, with or without peripheral sclerotic ring. Since the introduction of MRI and PET, a much higher frequency of bone involvement has been observed, especially in the vertebrae, pelvis, calvaria, ribs and other locations, which in most cases are asymptomatic or hardly symptomatic. These findings on PET and/or MRI, even in the context of systemic sarcoidosis, require a differential diagnosis with bone metastases by CT-guided biopsy. MRI or PET should not be performed indiscriminately in order to screen for bone involvement. On MRI they may behave as well-defined focal lesions, hypointense on T1 and hyperintense on T2 which show enhancement, or as ill-defined infiltrative intramedullary lesions.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,30</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">Joint disease, in the sense of conventional arthritis, is relatively rare, it occurs in young women under 40 years of age, in the form of acute, chronic, or recurrent arthritis, causing pain, oedema, erythema, and reduced range of movement in the affected joint. Acute arthritis usually occurs in the early course of the disease (first six months after diagnosis), often self-limiting and can be associated with Löfgren's syndrome (erythema nodosum and/or ankle periarthritis with bilateral hilar lymphadenopathy on chest X-ray). Periarticular swelling of the ankles and arthralgias with mild arthritis in the small joints of the hands and arthralgias in other joints such as knees, wrists and elbows are frequently observed. Oligoarthritis or polyarthritis is more common than monoarthritis with joint effusion. When sarcoid arthritis persists for more than six months, it is considered chronic, although this is rare.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,30</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Muscle involvement is usually asymptomatic and can occur in 25–80% of cases. Symptomatic involvement is rare, producing symptoms of acute myositis, nodular sarcoidosis, or chronic myopathy. Nodular sarcoid myopathy may manifest as soft tissue masses. On T2-weighted MRI sequences it is observed as star-shaped areas with low signal intensity in the center and high signal intensity in the periphery ("black star sign"). When the respiratory muscles are affected, dyspnoea might occur.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,18,30</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Current significance of PET in sarcoidosis</span><p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT has proven to be a useful imaging technique in certain situations for the study and management of sarcoidosis. However, it is currently being used indiscriminately for the study and follow-up of cases of sarcoidosis that are not particularly complex. We consider PET to be especially useful in the following four situations. Firstly, for the study of complex clinical cases in which the diagnostic possibility of sarcoidosis is raised; although the most characteristic pattern is still the presence of bilateral hilar lymphadenopathy, PET is very sensitive in detecting the presence of foci of occult extrapulmonary granulomatous activity that can be biopsied. Second, for the assessment of the presence of active disease in patients with fibrotic phase pulmonary sarcoidosis in order to decide whether to continue or discontinue treatment. Third, in the assessment of the response to treatment in cases with extensive systemic involvement. Finally, in the diagnostic study and follow-up of cardiac sarcoidosis combined with CMR.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conclusions</span><p id="par0240" class="elsevierStylePara elsevierViewall">Sarcoidosis is a multisystemic, non-caseating granulomatous disease with a worldwide distribution that affects men and women of all ages. Its cause is unknown but is attributed to the effect of environmental or infectious triggers on a genetically susceptible host in whom a disproportionate granulomatous response will develop. This paper provides a review of the different organ involvement in sarcoidosis from an imaging point of view, highlighting its most common forms of presentation, as well as recommended indications.</p><p id="par0245" class="elsevierStylePara elsevierViewall">Considered separately, its extrapulmonary radiological manifestations are often non-specific, so there are no signs that allow us to differentiate it exclusively by imaging from other entities. In these cases, the clinical and laboratory context and the common concomitance of typical pulmonary sarcoid involvement, or a combination of different characteristic sites, are essential to guide the diagnosis early.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Funding</span><p id="par0250" class="elsevierStylePara elsevierViewall">This article has not received any type of funding.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflict of interests</span><p id="par0255" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Pulmonary sarcoidosis" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Cardiac sarcoidosis" ] 3 => array:3 [ "identificador" => "sec0020" "titulo" => "Abdominal sarcoidosis" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Hepatic sarcoidosis" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Splenic sarcoidosis" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Gastrointestinal sarcoidosis" ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Genitourinary sarcoidosis" ] 4 => array:2 [ "identificador" => "sec0045" "titulo" => "Lymphatic and peritoneal sarcoidosis" ] ] ] 4 => array:2 [ "identificador" => "sec0050" "titulo" => "Neurosarcoidosis" ] 5 => array:2 [ "identificador" => "sec0055" "titulo" => "Sarcoidosis in the head and neck" ] 6 => array:2 [ "identificador" => "sec0060" "titulo" => "Musculoskeletal sarcoidosis" ] 7 => array:2 [ "identificador" => "sec0065" "titulo" => "Current significance of PET in sarcoidosis" ] 8 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0075" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflict of interests" ] 11 => array:2 [ "identificador" => "xack522217" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-05-01" "fechaAceptado" => "2020-06-08" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez-Oro R, Meseguer Ripollés MÁ, Alonso-Muñoz EM, Alandete German SP. Hallazgos en las pruebas de imagen de la sarcoidosis. Med Clin (Barc). 2021;156:349–355.</p>" ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1277 "Ancho" => 1500 "Tamanyo" => 136100 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patient with sarcoidosis and pulmonary lymphadenopathy «1-2-3 sign». A) Posteroanterior chest X-ray. B) Lateral chest X-ray. C) Coronal reconstruction of chest computed tomography (CT). D) Axial CT. 1-2-3 sign: 1) right paratracheal lymphadenopathy (solid arrows in A and C); 2) right hilar lymphadenopathy (dashed arrows in A, B, C and D); 3) left hilar lymphadenopathy (hollow arrows in A, B, C and D).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 633 "Ancho" => 1500 "Tamanyo" => 114119 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Axial chest computed tomography (CT). B) Coronal CT reconstruction. Bilateral pulmonary nodules (arrows) with diffuse margins and lymphangitic distribution in upper lobe distribution. Note in B the sparing of the lung bases, in contrast to the prevalence of the basal localisation in the pulmonary nodules of metastatic origin.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 623 "Ancho" => 1500 "Tamanyo" => 146231 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography. Pulmonary masses (solid arrows) in the middle area formed by the coalescence of pulmonary granulomas. A) Sarcoid galaxy sign (black box): large pulmonary nodule surrounded by satellite nodules. B) Right paratracheal lymphadenopathy, right and left hilar lymphadenopathy and in aortopulmonary window (1-2-3-4 sign) with dense, punctate, and eggshell calcifications (chronicity) (discontinuous arrows).</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1279 "Ancho" => 1500 "Tamanyo" => 169886 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance images after gadolinium administration showing delayed, multifocal, patchy, subepicardial and mesocardial enhancement (arrows).</p>" ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 793 "Ancho" => 1500 "Tamanyo" => 134519 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A) Axial abdominal computed tomography (CT). B) Abdominal CT coronal reconstruction. Mild hepatomegaly with numerous granulomas (arrows) of a few millimetres in size that are observed as hypodense nodules; it is associated with splenic involvement with granulomas (discontinuous arrows) that are also identified as hypodense nodules. C) Magnetic resonance imaging, T1-weighted image after contrast administration. Thickening of the dura mater in the left temporal fossa, with significant enhancement (solid arrows). Nodular and diffuse leptomeningeal thickening (dashed arrows) with significant enhancement (sarcoid meningitis).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis from Head to Toe: What the Radiologist Needs to Know" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Ganeshan" 1 => "C. Menias" 2 => "M. Lubner" 3 => "P. Pickhardt" 4 => "K. Sandrasegaran" 5 => "S. Bhalla" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.2018170157" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "2018" "volumen" => "38" "paginaInicial" => "1180" "paginaFinal" => "1200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29995619" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiología de la sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Fernández Fabrellas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2007" "volumen" => "43" "paginaInicial" => "92" "paginaFinal" => "100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17288898" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Spagnolo" 1 => "G. Rossi" 2 => "R. Trisolini" 3 => "N. Sverzellati" 4 => "R. Baughman" 5 => "A. Wells" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet Resp Med" "fecha" => "2018" "volumen" => "6" "paginaInicial" => "389" "paginaFinal" => "402" "itemHostRev" => array:3 [ "pii" => "S0140673616324011" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Llanos" 1 => "N. Hamzeh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mcna.2018.12.011" "Revista" => array:6 [ "tituloSerie" => "Med Clin North Am" "fecha" => "2019" "volumen" => "103" "paginaInicial" => "527" "paginaFinal" => "534" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30955519" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aspectos actuales de la sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Mañá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2016" "volumen" => "147" "paginaInicial" => "67" "paginaFinal" => "69" "itemHostRev" => array:3 [ "pii" => "S0090429514010504" "estado" => "S300" "issn" => "00904295" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immunogenetics of disease-causing inflammation in sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Grunewald" 1 => "P. Spagnolo" 2 => "J. Wahlström" 3 => "A. Eklund" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clinic Rev Allerg Immunol" "fecha" => "2015" "volumen" => "29" "paginaInicial" => "19" "paginaFinal" => "35" "itemHostRev" => array:3 [ "pii" => "S0302283816304717" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Iannuzzi" 1 => "B. Rybicki" 2 => "A. Teirstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra071714" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2007" "volumen" => "357" "paginaInicial" => "2153" "paginaFinal" => "2165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18032765" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and detection of sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.D. Crouser" 1 => "L.A. Maier" 2 => "K.C. Wilson" 3 => "C.A. Bonham" 4 => "A.S. Morgenthau" 5 => "K.C. Patterson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.202002-0251ST" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2020" "volumen" => "201" "paginaInicial" => "e26" "paginaFinal" => "e51" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32293205" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and radiological features of extra-pulmonary sarcoidosis: a pictorial essay" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Palmucci" 1 => "S. Torrisi" 2 => "D. Caltabiano" 3 => "S. Puglisi" 4 => "V. Lentini" 5 => "E. Grassedonio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13244-016-0495-4" "Revista" => array:6 [ "tituloSerie" => "Insights Imaging" "fecha" => "2016" "volumen" => "7" "paginaInicial" => "571" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27222055" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis: a diagnosis of exclusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.M. Lee" 1 => "K. Pope" 2 => "L. Meek" 3 => "J.H. Chung" 4 => "S.B. Hobbs" 5 => "C.M. Walker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.19.21436" "Revista" => array:6 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2010" "volumen" => "214" "paginaInicial" => "50" "paginaFinal" => "58" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31670585" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognosis of intrathoracic sarcoidosis in England" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.G. Scadding" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.2.6145.1165-a" "Revista" => array:6 [ "tituloSerie" => "Br Med J" "fecha" => "1961" "volumen" => "2" "paginaInicial" => "1165" "paginaFinal" => "1172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/709289" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum of pulmonary sarcoidosis: variations of high-resolution CT findings and clues for specific diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Nishino" 1 => "K.S. Lee" 2 => "H. Itoh" 3 => "H. Hatabu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2008.09.038" "Revista" => array:7 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2010" "volumen" => "73" "paginaInicial" => "66" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19200680" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283812005209" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of positron emission tomography-computed tomography/magnetic resonance imaging in the management of sarcoidosis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Promteangtrong" 1 => "A. Salavati" 2 => "G. Cheng" 3 => "D.A. Torigian" 4 => "A. Alavi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hell J Nucl Med" "fecha" => "2014" "volumen" => "17" "paginaInicial" => "123" "paginaFinal" => "135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25097898" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of 18F-FDG-PET and PET/CT in patients with sarcoidosis: an updated evidence-based review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Treglia" 1 => "S. Annunziata" 2 => "D. Sobic-Saranovic" 3 => "F. Bertagna" 4 => "C. Caldarella" 5 => "L. Giovanella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acra.2014.01.008" "Revista" => array:6 [ "tituloSerie" => "Acad Radiol" "fecha" => "2014" "volumen" => "21" "paginaInicial" => "675" "paginaFinal" => "684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24703482" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammatory activity assessment by F18 FDG-PET/CT in persistent symptomatic sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.L. Mostard" 1 => "S. Vöö" 2 => "M.J. van Kroonenburgh" 3 => "J.A. Verschakelen" 4 => "P.A. Wijnen" 5 => "P.J. Nelemans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2011.08.012" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2011" "volumen" => "105" "paginaInicial" => "1917" "paginaFinal" => "1924" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21899998" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging features of sarcoidosis on MDCT, FDG PET, and PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.B. Prabhakar" 1 => "C.B. Rabinowitz" 2 => "F.K. Gibbons" 3 => "W.J. O’Donnell" 4 => "J.A.O. Shepard" 5 => "S.L. Aquino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.07.7001" "Revista" => array:7 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2008" "volumen" => "190" "paginaInicial" => "S1" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18287458" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090429516309530" "estado" => "S300" "issn" => "00904295" ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "18F-FDG PET as a predictor of pulmonary function in sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.G. Keijsers" 1 => "E.J. Verzijlbergen" 2 => "J.M. van den Bosch" 3 => "P. Zanen" 4 => "E.M. van de Garde" 5 => "W.J. Oyen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Sarcoidosis Vasc Diffuse Lung Dis" "fecha" => "2011" "volumen" => "28" "paginaInicial" => "123" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22117503" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of sarcoidosis: a contemporary review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Guidry" 1 => "R.G. Fricke" 2 => "R. Ram" 3 => "T. Pandey" 4 => "K. Jambhekar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rcl.2015.12.009" "Revista" => array:6 [ "tituloSerie" => "Radiol Clin North Am" "fecha" => "2016" "volumen" => "54" "paginaInicial" => "519" "paginaFinal" => "534" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27153786" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac Sarcoidosis: The Challenge of Radiologic-Pathologic Correlation: From the Radiologic Pathology Archives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Jeudy" 1 => "A.P. Burke" 2 => "C.S. White" 3 => "G.B. Kramer" 4 => "A.A. Frazier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.2015140247" "Revista" => array:7 [ "tituloSerie" => "Radiographics" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "657" "paginaFinal" => "679" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25969930" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1473309915002704" "estado" => "S300" "issn" => "14733099" ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differential diagnosis of thickened myocardium: an illustrative MRI review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Méndez" 1 => "R. Soler" 2 => "E. Rodríguez" 3 => "R. Barriales" 4 => "J. Ochoa" 5 => "L. Monserrat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13244-018-0655-9" "Revista" => array:6 [ "tituloSerie" => "Insights Imaging" "fecha" => "2018" "volumen" => "9" "paginaInicial" => "695" "paginaFinal" => "707" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30302634" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and radiological features of extra-pulmonary sarcoidosis: a pictorial essay" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Palmucci" 1 => "S.E. Torrisi" 2 => "D.C. Caltabiano" 3 => "S. Puglisi" 4 => "V. Lentini" 5 => "E. Grassedonio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13244-016-0495-4" "Revista" => array:6 [ "tituloSerie" => "Insights Imaging" "fecha" => "2016" "volumen" => "7" "paginaInicial" => "571" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27222055" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HRS expert consensus statement on the diagnosis and management of arrhythmias assocciated with cardiac sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.H. Birnie" 1 => "W.H. Sauer" 2 => "F. Bogun" 3 => "J.M. Cooper" 4 => "D.A. Culver" 5 => "C.S. Duvernoy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hrthm.2014.03.043" "Revista" => array:6 [ "tituloSerie" => "Heart Rhythm" "fecha" => "2014" "volumen" => "11" "paginaInicial" => "1305" "paginaFinal" => "1323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24819193" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A Pattern-based Approach to Assessment of Delayed Enhancement in Nonischemic Cardiomyopathy at MR Imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Cummings" 1 => "S. Bhalla" 2 => "C. Javidan-Nejad" 3 => "A. Bierhals" 4 => "F. Gutierrez" 5 => "P. Woodard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.291085052" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "2009" "volumen" => "29" "paginaInicial" => "89" "paginaFinal" => "103" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19168838" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Presence of late gadolinium enhancement by cardiac magnetic resonance among patients with suspected cardiac sarcoidosis is associated with adverse cardiovascular prognosis: a systematic review and meta-Analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Hulten" 1 => "V. Agarwal" 2 => "M. Cahill" 3 => "G. Cole" 4 => "T. Vita" 5 => "S. Parrish" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Circ Cardiovasc Imaging" "fecha" => "2016" "volumen" => "9" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "T1 and T2 mapping in recognition of early cardiac involvement in systemic sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V.O. Puntmann" 1 => "A. Isted" 2 => "R. Hinojar" 3 => "L. Foote" 4 => "G. Carr-White" 5 => "E. Nagel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2017162732" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2017" "volumen" => "285" "paginaInicial" => "63" "paginaFinal" => "72" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28448233" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac Sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.L. Tan" 1 => "H.K. Fong" 2 => "E.Y. Birati" 3 => "Y. Han" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2018.10.021" "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2019" "volumen" => "123" "paginaInicial" => "513" "paginaFinal" => "522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30503798" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of hepatobiliary involvement in sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.D. Karaosmanoğlu" 1 => "M.R. Onur" 2 => "S. Saini" 3 => "A. Taberi" 4 => "M. Karcaaltincaba" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00261-015-0533-6" "Revista" => array:7 [ "tituloSerie" => "Abdom Imaging" "fecha" => "2015" "volumen" => "40" "paginaInicial" => "3330" "paginaFinal" => "3337" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26318751" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534711032733" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis in the head and neck: an illustrative review of clinical presentations and imaging findings" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.N. Chapman" 1 => "A. Fujita" 2 => "E.K. Sung" 3 => "C. Siegel" 4 => "R.N. Nadgir" 5 => "N. Saito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.16.16058" "Revista" => array:6 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2017" "volumen" => "208" "paginaInicial" => "66" "paginaFinal" => "75" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27657552" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Salah" 1 => "S. Abad" 2 => "A. Brézin" 3 => "D. Monnet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jfo.2018.06.015" "Revista" => array:6 [ "tituloSerie" => "J Fr Ophtalmol" "fecha" => "2019" "volumen" => "42" "paginaInicial" => "303" "paginaFinal" => "321" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30850198" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI of sarcoidosis patients with musculoskeletal symptoms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.L. Moore" 1 => "A. Teirstein" 2 => "C. Golimbu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/ajr.185.1.01850154" "Revista" => array:7 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2005" "volumen" => "185" "paginaInicial" => "154" "paginaFinal" => "159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15972416" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534718434052" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack522217" "titulo" => "Acknowledgements" "texto" => "<p id="par0260" class="elsevierStylePara elsevierViewall">The authors would like to thank the selfless collaboration of doctors J. Torres Nuez, G. Martínez Sanz, E. García Martínez and C. Soto Sarrión.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015600000007/v1_202104020834/S2387020621000991/v1_202104020834/en/main.assets" "Apartado" => array:4 [ "identificador" => "44145" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015600000007/v1_202104020834/S2387020621000991/v1_202104020834/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621000991?idApp=UINPBA00004N" ]
Journal Information
Vol. 156. Issue 7.
Pages 349-355 (April 2021)
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Vol. 156. Issue 7.
Pages 349-355 (April 2021)
Special article
Imaging findings of sarcoidosis
Hallazgos en las pruebas de imagen de la sarcoidosis
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