Clinical radiology最新文献_第7页

The magnetic resonance imaging (MRI) features of intracranial lesions in myelin oligodendrocyte glycoprotein-immunoglobulin G-associated disease (MOGAD). 髓鞘少突胶质细胞糖蛋白-免疫球蛋白g相关疾病（MOGAD）颅内病变的磁共振成像（MRI）特征

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-29 DOI: 10.1016/j.crad.2024.106764

J Wang, J Fang, J Wang, Y Xiong, W Zhu

Aim: This study aimed to summarise and analyse the magnetic resonance imaging (MRI) characteristics of patients with myelin oligodendrocyte glycoprotein-immunoglobulin G-associated disease (MOGAD), and to enhance the accuracy of disease diagnosis and advance scientific research.

Materials and methods: A retrospective collection of clinical data from 103 patients with MOGAD was conducted. The distribution and signal characteristics of intracranial lesions on MRI were analysed. Further subgroup statistical analysis based on age was performed to explore differences in lesion locations among different subgroups. Statistical comparisons were made using the χ² test or Fisher's exact test, with a significance level of P < 0.05 considered statistically significant.

Results: MRI revealed variable lesion morphologies in patients with MOGAD. Lesions were predominantly located in the cerebral deep white matter (47.6%), subcortical white matter (38.8%), and cortex (38.8%) of the supratentorial region, as well as in the brainstem (35.9%) of the infratentorial region. Notably, there was a significantly higher proportion of juvenile patients with thalamic involvement than adult patients (P = 0.013). Juvenile patients were more likely to have lesions involving both the thalamus and cerebral cortex (P = 0.040), thalamus and deep white matter (P = 0.026), or thalamus and brainstem (P = 0.014). Conversely, lesions involving both the corpus callosum and subcortical white matter were more frequently observed in adult patients, with statistically significant differences (P = 0.046). Contrast-enhanced MRI showed mild enhancement in some lesions, with a half of cases exhibiting leptomeningeal enhancement. One rare case presented extensive thickening and enhancement of the falx cerebri.

Conclusion: The distribution of intracranial lesions on MRI exhibits distinct characteristics. The differences in the spatial distribution of intracranial lesions between juvenile and adult patients suggest that MOGAD may represent a heterogeneous disease spectrum that varies with age.

目的：总结和分析髓鞘少突胶质细胞糖蛋白-免疫球蛋白g相关疾病（MOGAD）患者的磁共振成像（MRI）特征，提高疾病诊断的准确性，推进科学研究。材料和方法：回顾性收集103例MOGAD患者的临床资料。分析颅内病变在MRI上的分布及信号特征。进一步进行基于年龄的亚组统计分析，探讨不同亚组间病变部位的差异。采用χ2检验或Fisher精确检验进行统计学比较，P < 0.05为差异有统计学意义。结果：MRI显示MOGAD患者病变形态变化。病变主要位于脑深部白质（47.6%）、皮层下白质（38.8%）和幕上区皮层（38.8%），以及幕下区脑干（35.9%）。值得注意的是，青少年患者丘脑受累的比例明显高于成人患者（P = 0.013）。青少年患者更容易发生丘脑和大脑皮层（P = 0.040）、丘脑和深部白质（P = 0.026）或丘脑和脑干（P = 0.014）的病变。相反，同时累及胼胝体和皮层下白质的病变在成人患者中更为常见，差异有统计学意义（P = 0.046）。MRI增强显示部分病变轻度强化，半数病例表现为脑脊膜轻强化。一个罕见的病例表现为广泛的大脑镰增厚和增强。结论：颅内病变在MRI上的分布具有明显的特点。青少年和成年患者颅内病变空间分布的差异表明，MOGAD可能代表了一种随年龄变化的异质性疾病谱。

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引用次数: 0

A Radiology (with AI) christmas carol: Past, present and Yet to come. 放射学（人工智能）圣诞颂歌：过去，现在和未来。

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-26 DOI: 10.1016/j.crad.2024.106757

C Chew, A P Brady

引用次数: 0

Imaging of hypoglossal palsy: a pictorial synopsis. 舌下麻痹的影像：图像摘要。

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-23 DOI: 10.1016/j.crad.2024.106754

J Ragittaran, A Kamalasanan, R D White, T Sudarshan

Palsy of the hypoglossal nerve, the 12^th cranial nerve, is rare and presents with specific clinical features depending on the anatomical location of the underlying pathology. As such, knowledge of clinical presentation and detailed anatomy of the nerve is vital to aid in localisation and identification of the pathology. This pictorial review details the anatomy of the nerve, including innervation, segments, and branches, with particular reference to magnetic resonance imaging (MRI). The role of clinical examination and multimodality imaging in differentiating between types of hypoglossal palsy is highlighted. Key pathologies affecting the different nerve segments are described and illustrated on multimodality imaging.

舌下神经（第12脑神经）的麻痹是罕见的，并且根据潜在病理的解剖位置表现出特定的临床特征。因此，临床表现的知识和神经的详细解剖是至关重要的，以帮助定位和病理鉴定。这篇图片综述详细介绍了神经的解剖结构，包括神经支配、节段和分支，并特别提到了磁共振成像（MRI）。临床检查和多模态成像在区分舌下麻痹类型的作用被强调。影响不同神经节段的关键病理在多模态成像上被描述和说明。

引用次数: 0

Hydatid disease: imaging, treatment, and beyond 包虫病：影像学、治疗及其他

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-12 DOI: 10.1016/j.crad.2024.106748

A.H. Baykan , E. Aydin , M. Koc , H. Sahin , A. Karul , M.E. Baykan , T. Ikizceli , S.M. Erturk

Hydatidosis is an endemic parasitic disease that can occur in almost any part of the body. It presents in two different forms according to the type of tapeworm: Echinococcus granulosus (hydatid disease [HD]) and Echinococcus multilocularis (alveolar HD). Radiological imaging can reveal the type of cyst, disease activity and progression, and complications, with features depending on the HD stage, the organ involved, and complications. Radiological imaging is also used to plan treatment strategies and evaluate patients at follow-up. Here, we review the morphologies of different HD presentations and their radiological features, the diagnostic findings that suggest possible HD in rare sites, and the potential complications of HD. We also discuss the role of radiology in hydatidosis diagnosis and treatment.

包虫病是一种地方性寄生虫病，几乎可以发生在身体的任何部位。根据绦虫的类型，它有两种不同的形式：细粒棘球绦虫（包虫病[HD]）和多房棘球绦虫（肺泡型HD）。放射成像可以显示囊肿的类型、疾病的活动和进展以及并发症，其特征取决于HD的分期、受累的器官和并发症。放射成像也用于计划治疗策略和随访时评估患者。在这里，我们回顾了不同HD表现的形态学及其放射学特征，罕见部位可能HD的诊断结果，以及HD的潜在并发症。我们还讨论了放射学在包虫病诊断和治疗中的作用。

引用次数: 0

MRI-based radiomics virtual biopsy for BCL6 in primary central nervous system lymphoma 原发性中枢神经系统淋巴瘤BCL6的mri放射组学虚拟活检

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-08 DOI: 10.1016/j.crad.2024.106746

J. Liu , J. Tu , L. Yao , L. Peng , R. Fang , Y. Lu , F. He , J. Xiong , Y. Li

Aim

To establish a machine learning model based on a radiomic signature for predicting B-cell lymphoma 6 (BCL-6) rearrangement in primary central nervous system lymphoma (PCNSL).

Materials and Methods

Retrospective study on 102 PCNSL patients (31 with BCL-6 rearrangement positive, 71 with BCL-6 rearrangement negative) were randomly divided into the training and validation sets at a ratio of 7:3. Radiomics models based on contrast-enhanced T1-weighted imaging (CE-T1WI) and fluid-attenuated inversion recovery (FLAIR) in different regions, including VOI_{tumour core} and VOI_{peritumoural oedema.} Radiomics features were extracted and selected using LASSO regression, and radiomics score (rad-score) were calculated using the weighted coefficients. Four machine learning models (logistic regression, random forest, support vector machine, K-nearest neighbours) were developed and evaluated based on rad-score. The optimal radiomics model was integrated into the clinical or radiological factors to construct a predictive model through logistic regression analysis. A nomogram was constructed based on independent significant features for individualised prediction.

Results

All rad-scores based on CE-T1WI and FLAIR sequences were significantly associated with BCL6 rearrangement (p < 0.05) in univariate regression analysis. The logistic regression machine learning model performed best with AUCs of 0.935 (training) and 0.923 (validation). Rad-scores from CE-T1WI tumour core and peritumoural oedema were independent significant predictors.

Conclusion

Radiomics signatures based on CE-T1WI and FLAIR sequences have significant value in distinguishing BCL6 rearrangement. The CE-T1WI radiomics model based on VOI_{tumour core} and VOI_{peritumoural oedema} are robust markers for identifying BCL6 rearrangement.

目的建立基于放射学特征预测原发性中枢神经系统淋巴瘤（PCNSL） b细胞淋巴瘤6 （BCL-6）重排的机器学习模型。材料与方法回顾性研究102例PCNSL患者（BCL-6重排阳性31例，BCL-6重排阴性71例），按7:3的比例随机分为训练组和验证组。基于对比增强t1加权成像（CE-T1WI）和液体衰减反转恢复（FLAIR）的不同区域放射组学模型，包括voi肿瘤核心和voi肿瘤周围水肿。利用LASSO回归提取并选择放射组学特征，利用加权系数计算放射组学评分（rad-score）。开发了四种机器学习模型（逻辑回归、随机森林、支持向量机、k近邻），并基于rad-score进行了评估。将最佳放射组学模型与临床或放射学因素结合，通过logistic回归分析构建预测模型。基于独立显著特征构建了一种模态图，用于个性化预测。结果所有基于CE-T1WI和FLAIR序列的评分均与BCL6重排显著相关(p <；0.05)。逻辑回归机器学习模型的auc为0.935（训练）和0.923（验证）。CE-T1WI肿瘤核心和肿瘤周围水肿的rad评分是独立的显著预测因子。结论基于CE-T1WI和FLAIR序列的放射组学特征对鉴别BCL6重排具有重要价值。基于voi肿瘤核心和voi肿瘤周围水肿的CE-T1WI放射组学模型是识别BCL6重排的可靠标记。

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引用次数: 0

Introduction and accuracy assessment of Nicolab's StrokeViewer in a developing stroke thrombectomy UK service. a service development/improvement project Nicolab的StrokeViewer在英国发展中的中风血栓切除服务的介绍和准确性评估。服务开发/改进项目

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-08 DOI: 10.1016/j.crad.2024.106745

A. Karamitros , L.M.C. Flynn , A. Cox , C. Hawkes , A. Nania

AIM

The aim of this study was to evaluate the implementation of artificial intelligence (AI) software in a quaternary stroke centre as well as assess the accuracy and efficacy of StrokeViewer software in large vessel occlusion detection and its potential impact on radiological workflow.

MATERIALS AND METHODS

Data were collected during two separate three-month periods comparing the accuracy rate of StrokeViewer in detection of large vessel occlusion to that of a junior registrar. During the first three months, 37 cases were identified and during the second leg, 47. The second leg of the study was performed due to a high number of technical failures during the first one and in an attempt to improve those via communication with the manufacturer and co-operation between allied healthcare professionals. Statistical analysis was performed using SPSS software.

RESULTS

Technical failure rate was 25% in the first leg and reduced to 17% in the second leg, showing a trend to statistical significance. Specificity and sensitivity of StrokeViewer were similar in the two legs of the study, measuring 91% and 93% initially and 94% and 93% finally, respectively. Efficacy was comparable to that of the junior registrar with StrokeViewer, demonstrating 92% accuracy during the first leg vs 95% by the junior registrar and 93% in the second leg vs 98% by the junior registrar. These did not show statistical significance.

CONCLUSION

This is a real-life analysis of StrokeViewer efficacy and its potential failures, showing a reduction in failure rate, accuracy rate of a junior registrar, and sensitivity and specificity values close to the advertised ones.

本研究的目的是评估人工智能（AI）软件在四级脑卒中中心的实施情况，并评估StrokeViewer软件在大血管闭塞检测中的准确性和有效性及其对放射工作流程的潜在影响。材料和方法在两个独立的三个月期间收集数据，比较StrokeViewer在检测大血管闭塞方面的准确率与初级注册器的准确率。前三个月确诊37例，第二阶段确诊47例。由于在第一阶段中出现了大量的技术故障，因此进行了第二阶段的研究，并试图通过与制造商的沟通和联合医疗保健专业人员之间的合作来改进这些故障。采用SPSS软件进行统计分析。结果第一段技术故障率为25%，第二段技术故障率为17%，差异有统计学意义。StrokeViewer的特异性和敏感性在两组研究中相似，初始为91%和93%，最终为94%和93%。疗效与使用StrokeViewer的初级注册者相当，第一阶段的准确率为92%，初级注册者为95%，第二阶段为93%，初级注册者为98%。这些差异无统计学意义。结论：这是对StrokeViewer疗效及其潜在故障的现实分析，显示出故障率的降低，初级注册师的准确率，敏感性和特异性值接近广告值。

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引用次数: 0

The quandary of the indeterminate thyroid nodule: commentary on “comparison of British thyroid association and thyroid imaging reporting and data system (TIRADS) classifications and their impact on the radiological and surgical management of indeterminate thyroid nodules” 不确定甲状腺结节的困境：评“英国甲状腺协会与甲状腺影像报告和数据系统（TIRADS）分类的比较及其对不确定甲状腺结节放射学和外科治疗的影响”

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-07 DOI: 10.1016/j.crad.2024.106744

G. Madani

引用次数: 0

Quantitative plaque characteristics and pericoronary fat attenuation index enhance risk prediction of unstable angina in nonobstructive lesions 定量斑块特征和冠状动脉周围脂肪衰减指数增强了非阻塞性病变不稳定型心绞痛的风险预测

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-05 DOI: 10.1016/j.crad.2024.106742

D. Li , H. Li , Y. Wang , T. Zhu

AIM

The role of quantitative plaque characterization and pericoronary fat attenuation index (FAI) in nonobstructive lesions is uncertain. Hence, this study aimed to investigate artificial intelligence (AI)-based plaque characterization and pericoronary FAI in patients with nonobstructive lesions to enhance risk prediction of unstable angina.

MATERIALS AND METHODS

This study was conducted using the clinical data of 408 patients with cardiovascular disease diagnosed with angina pectoris. A coronary computed tomography angiography examination was performed, and quantitative plaque characteristics and pericoronary FAI were analyzed.

Results

Of the 408 patients with angina, 130 had nonobstructive lesions and 278 had obstructive ones. No significant difference in pericoronary FAI was observed between patients with nonobstructive and obstructive lesions. In patients with nonobstructive lesions, the plaque length and pericoronary FAI were significantly higher in patients with unstable angina than in those with stable angina. In patients with obstructive lesions, the plaque fibrolipid volume and percentage were significantly higher in patients with unstable angina than in those with stable angina, and the narrowest lumen area was significantly smaller. Left anterior descending peripheral (peri-LAD) FAI > -83 HU or total plaque length >20.17 mm were independent predictors of unstable angina in patients with nonobstructive lesions. In patients with obstructive lesions, peri-LAD FAI > -77 HU, total lipid volume >12.6 mm³, and narrowest lumen area ≤2.25 mm² were independent predictors of unstable angina.

CONCLUSION

Pericoronary FAI and total plaque length may be suitable imaging biomarkers for AI-based prediction of the occurrence of unstable angina in patients with nonobstructive lesions.

目的斑块定量表征和冠状动脉脂肪衰减指数（FAI）在非阻塞性病变中的作用尚不确定。因此，本研究旨在研究基于人工智能（AI）的斑块表征和非阻塞性病变患者冠状动脉周围FAI，以增强不稳定型心绞痛的风险预测。材料与方法本研究采用408例诊断为心绞痛的心血管疾病患者的临床资料。行冠状动脉ct血管造影检查，定量分析斑块特征和冠状动脉周围FAI。结果408例心绞痛患者中非梗阻性病变130例，梗阻性病变278例。非梗阻性病变和梗阻性病变患者的冠状动脉周围FAI无显著差异。在非阻塞性病变患者中，不稳定型心绞痛患者的斑块长度和冠状动脉周围FAI明显高于稳定型心绞痛患者。在有梗阻性病变的患者中，不稳定型心绞痛患者斑块纤维脂体积和百分比明显高于稳定型心绞痛患者，且最窄管腔面积明显小于稳定型心绞痛患者。左前降外周FAI >；-83 HU或总斑块长度20.17 mm是非阻塞性病变患者不稳定型心绞痛的独立预测因子。在梗阻性病变患者中，lad周围FAI >；结论冠状动脉周围FAI和总斑块长度可能是基于ai预测非阻塞性病变患者不稳定型心绞痛发生的合适成像生物标志物。

{"title":"Quantitative plaque characteristics and pericoronary fat attenuation index enhance risk prediction of unstable angina in nonobstructive lesions","authors":"D. Li , H. Li , Y. Wang , T. Zhu","doi":"10.1016/j.crad.2024.106742","DOIUrl":"10.1016/j.crad.2024.106742","url":null,"abstract":"<div><h3>AIM</h3><div>The role of quantitative plaque characterization and pericoronary fat attenuation index (FAI) in nonobstructive lesions is uncertain. Hence, this study aimed to investigate artificial intelligence (AI)-based plaque characterization and pericoronary FAI in patients with nonobstructive lesions to enhance risk prediction of unstable angina.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This study was conducted using the clinical data of 408 patients with cardiovascular disease diagnosed with angina pectoris. A coronary computed tomography angiography examination was performed, and quantitative plaque characteristics and pericoronary FAI were analyzed.</div></div><div><h3>Results</h3><div>Of the 408 patients with angina, 130 had nonobstructive lesions and 278 had obstructive ones. No significant difference in pericoronary FAI was observed between patients with nonobstructive and obstructive lesions. In patients with nonobstructive lesions, the plaque length and pericoronary FAI were significantly higher in patients with unstable angina than in those with stable angina. In patients with obstructive lesions, the plaque fibrolipid volume and percentage were significantly higher in patients with unstable angina than in those with stable angina, and the narrowest lumen area was significantly smaller. Left anterior descending peripheral (peri-LAD) FAI > -83 HU or total plaque length >20.17 mm were independent predictors of unstable angina in patients with nonobstructive lesions. In patients with obstructive lesions, peri-LAD FAI > -77 HU, total lipid volume >12.6 mm<sup>3</sup>, and narrowest lumen area ≤2.25 mm<sup>2</sup> were independent predictors of unstable angina.</div></div><div><h3>CONCLUSION</h3><div>Pericoronary FAI and total plaque length may be suitable imaging biomarkers for AI-based prediction of the occurrence of unstable angina in patients with nonobstructive lesions.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"80 ","pages":"Article 106742"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of British Thyroid Association and TIRADS classifications and their impact on the radiological and surgical management of indeterminate thyroid nodules 英国甲状腺协会和TIRADS分类的比较及其对不确定甲状腺结节放射学和外科治疗的影响

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-11-05 DOI: 10.1016/j.crad.2024.08.036

J. Cowen , R. Dave , J. Neale , M. Ward , C. Repanos , H. Nasef , G. Vigneswaran , P.A. Brennan , J. Bekker

Aim

The British Thyroid Association (BTA) Guidelines for the Management of Thyroid Cancer advocate for fine-needle aspiration cytology for all thyroid nodules graded indeterminate (U3) at ultrasound assessment. This approach raises concerns regarding potential over-diagnosis of low-risk lesions. Conversely, equivalent Thyroid Imaging Reporting and Data Systems (TIRADS) guidelines permit surveillance or discharge of indeterminate thyroid nodules of certain sizes. This service analysis analyses how guideline choice impacts the fine-needle aspiration cytology rate and subsequent surgical management of indeterminate thyroid nodules.

Materials and methods

All patients with an indeterminate (U3) thyroid nodule identified on ultrasound over a 12-month period were included. Indeterminate thyroid nodules were retrospectively rescored using three equivalent TIRADS classifications by three independent reviewers, blinded to the histopathology. Hypothetical differences in fine-needle aspiration cytology rates and surgical activity were then compared.

Results

Ninety-six nodules were identified. Retrospective application of TIRADS guidelines resulted in a hypothetical 44.8–55.2% reduction in fine-needle aspiration cytology performed for indeterminate thyroid nodules compared to BTA. A statistically significant increase in rates of surgical activity for indeterminate thyroid nodules was observed between BTA guidance and all retrospectively applied TIRADS guidelines (p < 0.001). Of four confirmed thyroid cancers, three would have been unanimously removed.

Conclusion

Under BTA guidance, increased fine-needle aspiration cytology rates for indeterminate thyroid nodules resulted in significantly increased surgical activity in our cohort compared to retrospectively applied TIRADS guidelines.

目的：英国甲状腺协会（BTA）甲状腺癌管理指南提倡对超声评估分级不确定（U3）的所有甲状腺结节进行细针穿刺细胞学检查。这种方法引起了对低风险病变的潜在过度诊断的关注。相反，甲状腺成像报告和数据系统（TIRADS）指南允许对某些大小的不确定甲状腺结节进行监测或出院。本服务分析分析指南选择如何影响不确定甲状腺结节的细针穿刺细胞学率和随后的手术处理。材料与方法所有12个月超声检查发现的不确定（U3）甲状腺结节患者均纳入本研究。不确定的甲状腺结节由三名独立的审稿人在不了解组织病理学的情况下，使用三个等效的TIRADS分类进行回顾性恢复。然后比较细针穿刺细胞学率和手术活动的假设差异。结果共检出96个结节。与BTA相比，TIRADS指南的回顾性应用导致对不确定甲状腺结节进行细针穿刺细胞学检查的假设减少44.8-55.2%。在BTA指南和所有回顾性应用的TIRADS指南之间，观察到不确定甲状腺结节的手术活动率在统计学上显著增加(p <；0.001)。在四例确诊的甲状腺癌中，有三例本应被一致切除。结论：在BTA指导下，与回顾性应用TIRADS指南相比，我们的队列中，不确定甲状腺结节的细针穿刺细胞学率增加导致手术活动显著增加。

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引用次数: 0

The ‘Tree trunk and root’ model: key imaging findings may anatomically differentiate axial psoriatic arthritis and DISH from axial spondyloarthropathy 树干和树根 "模型：主要成像结果可从解剖学上区分轴性银屑病关节炎和 DISH 与轴性脊柱关节病。

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2024-10-21 DOI: 10.1016/j.crad.2024.08.014

M. Hussein , C. Giraudo , D. McGonagle , W.J. Rennie

Variable axial skeleton inflammation and axial skeleton tissue remodelling with aberrant ligamentous soft-tissue ossification occurs across the axial spondyloarthritis (ax-SpA) axial psoriatic arthritis (ax-PsA) and the diffuse idiopathic skeletal hyperostosis (DISH) spectrum. In this article, we show how imaging has resulted in an enthesis-centric model for different disease pathology compartmentalisation or a ‘root and trunk’ model for pathological process development. Whilst ankylosing spondylitis is predominantly characterised by early entheseal bony anchorage-related osteitis (root inflammation) and DISH is characterised by ligamentous soft-tissue ossification, ax-PsA is more heterogenous. Whilst ax-PsA may share an identical osteitis pattern to ax-SpA, a substantial proportion of ax-PsA cases have a soft tissue or tree trunk pathology that manifests as back pain with lack of osteitis but prominent ligamentous trunk ossification at later stages. We illustrate this using different imaging modalities to create a base for imaging research to elucidate this pattern of pathology.

在轴性脊柱关节炎（ax-SpA）、轴性银屑病关节炎（ax-PsA）和弥漫性特发性骨骼增生症（DISH）谱系中，会出现不同的轴性骨骼炎症和轴性骨骼组织重塑，并伴有韧带软组织骨化异常。在这篇文章中，我们展示了影像学如何为不同疾病的病理分区建立了一个以骨内膜为中心的模型，或为病理过程的发展建立了一个 "根和干 "模型。强直性脊柱炎的主要特征是早期骨骺锚相关性骨炎（根部炎症），DISH 的特征是韧带软组织骨化，而 ax-PsA 则更具异质性。虽然 ax-PsA 可能与 ax-SpA 具有相同的骨炎模式，但相当一部分 ax-PsA 病例具有软组织或树干病理，表现为背部疼痛，缺乏骨炎，但在后期阶段有突出的韧带树干骨化。我们使用不同的成像模式来说明这一点，为成像研究阐明这种病理模式奠定基础。

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引用次数: 0