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Magnetic resonance imaging of penile Prostheses: A pictorial review of normal appearances and complications 阴茎假体的磁共振成像:正常外观和并发症的图像回顾
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-30 DOI: 10.1016/j.ejrad.2025.112625
Francesco Verde , Vincenzo Iossa , Costanza Camillo , Dario Grimaldi , Roberto Ronza , Francesca Iacobellis , Francesco Muto , Marco Fasbender Jacobitti , Luigi Pucci , Enrico Scarano , Maurizio Carrino , Marco Di Serafino
Penile prostheses represent the definitive treatment option for erectile dysfunction refractory to conservative management, and recognition of their imaging appearances and potential complications is essential for radiologists. Magnetic resonance imaging (MRI) has emerged as the optimal imaging modality for post-implantation evaluation, offering superior soft tissue contrast and multiplanar capabilities compared to ultrasound and computed tomography. This review provides a comprehensive overview of penile prosthesis types, including semi-rigid and two- and three-piece inflatable devices, with emphasis on the imaging-relevant anatomical considerations of different surgical approaches. We present standardised MRI protocols for prosthesis evaluation, detailing recommended sequences, imaging planes, and technical parameters. The normal MRI appearances of each prosthesis component are described, including cylinders, pump, reservoir, and connecting tubing. The review illustrates the MRI findings of mechanical complications (fluid leakage, cylinder fracture, aneurysm formation), malpositioning abnormalities (erosion, cylinder crossover, buckling, floppy glans syndrome), and infectious complications, supported by a comprehensive pictorial collection. The complementary roles of computed tomography and ultrasound are also discussed. This pictorial review aims to familiarise radiologists with the expected post-surgical appearances and the spectrum of complications detectable on imaging, enabling accurate diagnosis and timely clinical management.
阴茎假体是难以保守治疗的勃起功能障碍的最终治疗选择,认识到其影像学表现和潜在的并发症对放射科医生至关重要。磁共振成像(MRI)已成为植入后评估的最佳成像方式,与超声和计算机断层扫描相比,它提供了优越的软组织对比和多平面成像能力。这篇综述提供了阴茎假体类型的全面概述,包括半刚性和两件和三件充气装置,重点是不同手术入路的成像相关解剖学考虑。我们提出了用于假体评估的标准化MRI方案,详细介绍了推荐的序列、成像平面和技术参数。描述了每个假体部件的正常MRI外观,包括圆柱体、泵、储层和连接管。这篇综述阐述了机械并发症(液体泄漏、椎体骨折、动脉瘤形成)、定位异常(侵蚀、椎体交叉、屈曲、龟头松弛综合征)和感染性并发症的MRI表现,并提供了全面的图片收集。计算机断层扫描和超声的互补作用也进行了讨论。这篇图片综述旨在使放射科医生熟悉预期的术后表现和成像可检测的并发症谱,从而实现准确的诊断和及时的临床管理。
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引用次数: 0
Quantitative airway evaluation using supine and upright computed tomography in patients with non-cystic fibrosis bronchiectasis and nontuberculous mycobacterial pulmonary disease 非囊性纤维化、支气管扩张和非结核性分枝杆菌肺病患者仰卧位和直立位计算机断层扫描定量气道评价
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-30 DOI: 10.1016/j.ejrad.2025.112626
Masanori Kaji , Takanori Asakura , Yoshitake Yamada , Hiromu Tanaka , Ho Namkoong , Shotaro Chubachi , Minoru Yamada , Takuya Ozawa , Yoichi Yokoyama , Shin Iizuka , Keiichi Narita , Genta Nagao , Ryoichi Kato , Naoki Fukunaga , Shunsuke Nakamura , Shuhei Azekawa , Sayaka Miyazaki , Kensuke Nakagawara , Hirofumi Kamata , Richard C. Boucher , Masahiro Jinzaki

Introduction

Bronchiectasis, closely associated with nontuberculous mycobacterial pulmonary disease (NTM-PD), exhibits unevenly distributed lesions, yet their spatial features remain unclear. We hypothesized that upright CT, which may better depict distal airways due to gravity-induced lung expansion, might more accurately reflect disease severity and its relationship with pulmonary function tests (PFTs).

Methods

In this prospective study, twenty patients underwent low-dose inspiratory and expiratory CT scans in standing and supine positions. Airways were segmented with Vincent® software and classified as bronchiectatic or non-bronchiectatic. Generation-specific quantitative CT (QCT) parameters, including inspiratory airway total area (ITA), inspiratory airway lumen area (ILA), wall thickness, and wall area percentage (WA%), were measured and correlated with PFTs.

Results

Bronchiectatic lesions were primarily identified in the 8th–10th generation airways (anatomically the 7th–9th generations), the transition from distal bronchi to proximal bronchioles. Standing CT detected more distal airways than supine CT. Mixed-effect models revealed significantly larger ITA and higher WA% in bronchiectatic airways (8th–10th generations) on standing CT. In non-bronchiectatic airways (trachea to 6th generation), ITA and ILA were significantly larger in the standing position, except for the main bronchus ITA. ITA, ILA, and WA% were moderate to strongly correlated with %FVC, %FEV1, and FEF25-75%, reflecting airway obstruction, with stronger correlations in the standing position. ITA in bronchiectatic airways was moderately negatively correlated with diffusing capacity of the lungs for carbon monoxide, indicating potential alveolar disease.

Conclusion

Upright CT offers useful structural biomarkers associated with airflow limitation and possible alveolar impairment in bronchiectasis with NTM-PD.

Registration

University Hospital Medical Information Network (UMIN 000026587).

URL

https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030456.
简介:支气管扩张与非结核性分枝杆菌肺病(NTM-PD)密切相关,病变分布不均匀,但其空间特征尚不清楚。我们假设直立CT可以更好地描绘由于重力引起的肺扩张导致的远端气道,可能更准确地反映疾病严重程度及其与肺功能测试(pft)的关系。方法:在这项前瞻性研究中,20例患者在站立和仰卧位下进行了低剂量吸气和呼气CT扫描。用Vincent®软件对气道进行分割,并将其分为支气管扩张型和非支气管扩张型。测量代特异性定量CT (QCT)参数,包括吸气气道总面积(ITA)、吸气气道管腔面积(ILA)、壁厚和壁面积百分比(WA%),并与PFTs相关。结果:支气管扩张病变主要见于第8 -10代气道(解剖学上为第7 -9代),由远端支气管向近端细支气管过渡。站立位CT比仰卧位CT检出更多远端气道。混合效应模型在站立CT上显示支气管扩张气道(8 ~ 10代)的ITA和WA%明显增大。在非支气管扩张气道(气管至第6代)中,除主支气管ITA外,站立位ITA和ILA均显著增大。ITA、ILA、WA%与%FVC、%FEV1、fef25 ~ 75%有中强相关性,反映气道阻塞,站立位相关性更强。支气管扩张气道的ITA与肺部一氧化碳弥散能力呈中度负相关,提示潜在的肺泡疾病。结论:直立CT提供了有用的结构生物标志物,与NTM-PD支气管扩张患者的气流限制和可能的肺泡损伤有关。注册:大学医院医疗信息网(UMIN 000026587)。URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030456。
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引用次数: 0
ChatGPT-generated informed consent forms in interventional radiology: A randomized controlled evaluation of comprehension, attitudinal responses, and readability 介入放射学中chatgpt生成的知情同意书:对理解、态度反应和可读性的随机对照评估
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-28 DOI: 10.1016/j.ejrad.2025.112624
Ural Koç , Yasin Celal Güneş , Mehmet Numan Çolakoğlu , Nazım Coşkun , Vural Dere , Mustafa Özdemir , Elif Özdemir

Objectives

To evaluate whether ChatGPT-generated informed consent forms improve comprehension, attitudinal responses, and readability compared with standard informed consent forms in two interventional radiology procedures.

Materials and methods

This prospective, single blind, randomized controlled study was conducted at a tertiary-care interventional radiology department between March and August 2025. A total of 122 participants with no prior exposure to the procedures were randomly assigned (1:1) to receive either a web-based Chat Generative Pre-trained Transformer (GPT)-4o-generated or a standard informed consent form for transarterial radioembolization (TARE) or percutaneous hydatid cyst treatment (PHCT). All participants completed a ten-item comprehension test and a four-item attitudinal survey. Readability was analyzed using multiple indices (Flesch–Kincaid, Gunning Fog, Coleman–Liau, SMOG, Automated Readability Index, and Ateşman) and the Patient Education Materials Assessment Tool (PEMAT).

Results

Participants who read ChatGPT-generated consent forms achieved higher comprehension scores than those who read standard forms (82.9 % vs. 77.3 %, p = 0.04). The benefit was consistent across procedures and education levels, with the greatest relative improvement among participants with lower educational attainment (p = 0.04). Readability analysis showed that ChatGPT-generated forms had shorter sentences and lower linguistic complexity (Flesch 39.2; Ateşman 53.9) than standard forms. Test–retest results indicated better knowledge retention for ChatGPT-generated forms, particularly in the TARE subgroup. No significant attitudinal differences were observed between groups.

Conclusion

ChatGPT-generated informed consent forms demonstrated superior comprehension and equivalent attitudinal responses compared with standard documents, supporting their potential as communication tools to enhance clarity and engagement in interventional radiology.
目的评估在两种介入放射治疗过程中,与标准知情同意书相比,chatgpt生成的知情同意书是否能提高患者的理解力、态度反应和可读性。材料和方法本前瞻性、单盲、随机对照研究于2025年3月至8月在一家三级保健介入放射科进行。共有122名之前没有接触过该程序的参与者被随机分配(1:1),接受基于网络的Chat -generated Pre-trained Transformer (GPT)- 40生成或标准的经动脉放射栓塞(TARE)或经皮包囊治疗(PHCT)的知情同意书。所有参与者都完成了一个包含10个项目的理解测试和一个包含4个项目的态度调查。采用多种指标(Flesch-Kincaid、Gunning Fog、Coleman-Liau、SMOG、Automated Readability Index和ate man)和患者教育材料评估工具(PEMAT)分析可读性。结果阅读chatgpt生成的知情同意书的参与者的理解得分高于阅读标准表格的参与者(82.9% vs. 77.3%, p = 0.04)。在不同的程序和教育水平中,获益是一致的,在受教育程度较低的参与者中,相对改善最大(p = 0.04)。可读性分析表明,chatgpt生成的表单比标准表单句子更短,语言复杂性更低(Flesch 39.2; ate man 53.9)。重测结果表明,chatgpt生成的表单的知识保留率更高,尤其是在TARE子组中。两组之间的态度差异不显著。结论:与标准文件相比,chatgpt生成的知情同意表表现出更好的理解能力和同等的态度反应,支持其作为沟通工具的潜力,以提高介入放射学的清晰度和参与度。
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引用次数: 0
Unveiling risk factors for transient osteoporosis of the hip in Middle-Aged Men: Insights from a Cross-Sectional study 揭示中年男性髋关节短暂性骨质疏松症的危险因素:来自横断面研究的见解。
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-23 DOI: 10.1016/j.ejrad.2025.112621
Yosi Eithan Sarusi , Mordechay Dulitzky , Omri Segal , Shlomi Toussia-Cohen , Iris Eshed

Objective

To identify clinical, environmental, and lifestyle-related risk factors for transient osteoporosis of the hip (TOH) in men, compared with a control group of men without TOH and peripartum women with TOH.

Method

This retrospective cross-sectional study included men aged ≥ 18 years who underwent pelvic/hip MRI for hip pain at a tertiary care center between 2010 and 2023. Among 231 men, 31 (13.4 %) were diagnosed with TOH. Prospective data were collected via telephone questionnaire. Controls included 190 men without TOH (questionnaires administered to an age-matched subgroup of 31) and a previously described cohort of 34 women with peripartum TOH. Data on demographics, medical history, physical activity, occupation, vitamin D/calcium supplement use, and corticosteroid exposure were analyzed.

Results

Men with TOH were significantly younger than controls (45.4 vs. 57.3 years; P = 0.006) with higher BMI (29.62 vs. 28.24p = 0.03) and more frequently reported vitamin D/calcium use (58.1 % vs. 10 %; P < 0.001). They tended to have more physically demanding occupations, higher activity levels, and more childhood dental issues (P > 0.05). Compared to women with peripartum TOH, men were older, had a similar BMI at symptom onset, a greater corticosteroid use, and a lower prevalence of family history of osteoporosis. Patients consulted an average of 3.7 physicians before diagnosis. Symptoms resolved within 3–6 months in most cases, and MRI findings normalized within 2–11 months.

Conclusions

TOH in men is underrecognized and may be associated with mechanical overload and altered bone turnover. Identifying potential risk factors may aid in earlier diagnosis and management.
目的:探讨男性短暂性髋关节骨质疏松症(TOH)的临床、环境和生活方式相关危险因素,并与无TOH的男性和围产期有TOH的女性对照组进行比较。方法:这项回顾性横断面研究纳入了年龄≥18岁的男性,他们在2010年至2023年期间在三级保健中心接受了骨盆/髋关节MRI检查。231名男性中,31名(13.4%)被诊断为TOH。前瞻性数据通过电话问卷收集。对照组包括190名无TOH的男性(年龄匹配的31个亚组进行问卷调查)和先前描述的34名围产期TOH的女性。分析了人口统计学、病史、身体活动、职业、维生素D/钙补充剂使用和皮质类固醇暴露的数据。结果:TOH患者明显比对照组年轻(45.4比57.3岁,P = 0.006), BMI较高(29.62比28.24,P = 0.03),维生素D/钙的使用频率更高(58.1%比10%,P = 0.05)。与围生期TOH的女性相比,男性年龄较大,症状发作时BMI相似,皮质类固醇使用较多,骨质疏松家族史患病率较低。患者在确诊前平均咨询了3.7名医生。大多数病例症状在3-6个月内消退,MRI表现在2-11个月内恢复正常。结论:男性TOH未被充分认识,可能与机械负荷和骨转换改变有关。识别潜在的危险因素可能有助于早期诊断和治疗。
{"title":"Unveiling risk factors for transient osteoporosis of the hip in Middle-Aged Men: Insights from a Cross-Sectional study","authors":"Yosi Eithan Sarusi ,&nbsp;Mordechay Dulitzky ,&nbsp;Omri Segal ,&nbsp;Shlomi Toussia-Cohen ,&nbsp;Iris Eshed","doi":"10.1016/j.ejrad.2025.112621","DOIUrl":"10.1016/j.ejrad.2025.112621","url":null,"abstract":"<div><h3>Objective</h3><div>To identify clinical, environmental, and lifestyle-related risk factors for transient osteoporosis of the hip (TOH) in men, compared with a control group of men without TOH and peripartum women with TOH.</div></div><div><h3>Method</h3><div>This retrospective cross-sectional study included men aged ≥ 18 years who underwent pelvic/hip MRI for hip pain at a tertiary care center between 2010 and 2023. Among 231 men, 31 (13.4 %) were diagnosed with TOH. Prospective data were collected via telephone questionnaire. Controls included 190 men without TOH (questionnaires administered to an age-matched subgroup of 31) and a previously described cohort of 34 women with peripartum TOH. Data on demographics, medical history, physical activity, occupation, vitamin D/calcium supplement use, and corticosteroid exposure were analyzed.</div></div><div><h3>Results</h3><div>Men with TOH were significantly younger than controls (45.4 vs. 57.3 years; P = 0.006) with higher BMI (29.62 vs. 28.24p = 0.03) and more frequently reported vitamin D/calcium use (58.1 % vs. 10 %; P &lt; 0.001). They tended to have more physically demanding occupations, higher activity levels, and more childhood dental issues (P &gt; 0.05). Compared to women with peripartum TOH, men were older, had a similar BMI at symptom onset, a greater corticosteroid use, and a lower prevalence of family history of osteoporosis. Patients consulted an average of 3.7 physicians before diagnosis. Symptoms resolved within 3–6 months in most cases, and MRI findings normalized within 2–11 months.</div></div><div><h3>Conclusions</h3><div>TOH in men is underrecognized and may be associated with mechanical overload and altered bone turnover. Identifying potential risk factors may aid in earlier diagnosis and management.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112621"},"PeriodicalIF":3.3,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855149","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
Role of magnetic resonance imaging in evaluation of urogenital sinus malformations 磁共振成像在评价泌尿生殖窦畸形中的作用。
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-22 DOI: 10.1016/j.ejrad.2025.112623
Walaa M. Saad , Omnia Ezz Eldin , Ashraf N. Ettaby , Khaled E. El Noauaem , Hebatallah H.M. Hassan , Ahmed Oshiba , Samar Eshiba

Background

Persistent urogenital sinus (UGS) is a rare but complex congenital anomaly that poses significant challenges in pediatric reconstructive surgery. Accurate preoperative visualization of the urogenital anatomy is essential for optimal surgical planning. This study aims to evaluate the diagnostic utility of magnetic resonance imaging (MRI) in assessing persistent UGS, specifically the site of confluence, common channel length, urethral length, and to correlate MRI findings with the preoperative cystoscopy and surgical outcomes.

Objectives

To evaluate role of MRI in evaluation of urogenital sinus and associated anomalies helping in pre operative planning for surgical decision making and post operative evaluation.

Materials and methods

This prospective study included 29 female pediatric patients with UGS anomalies who underwent pelvic MRI as part of their preoperative assessment. MRI findings were compared with intraoperative data. Parameters assessed included the length of the urethra, the common urogenital channel, and vaginal length, in addition to the identification of associated anomalies. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated.

Results

MRI identified UGS in 89.7 % of surgically confirmed cases, with radiological-surgical concordance observed in 25 out of 29 patients. Discordance was noted in 4 cases, including one misclassified “high” type UGS and three “very low” types not visualized on MRI. MRI showed a sensitivity of 89.7 % and an overall accuracy of 89.7 %. Significant correlations were found between UGS type and both common channel length (P = 0.005) and urethral length (P = 0.011). Associated anomalies were present in 68.9 % of patients, most commonly involving genital, spinal, and rectal systems.

Conclusion

MRI is a highly sensitive and accurate modality for the preoperative evaluation of UGS, offering detailed anatomical insights and enabling the detection of associated anomalies. Its integration into diagnostic workflows can improve surgical planning and patient outcomes.
背景:持续性泌尿生殖窦(UGS)是一种罕见但复杂的先天性异常,在儿科重建手术中提出了重大挑战。准确的术前可视化的泌尿生殖解剖是必不可少的最佳手术计划。本研究旨在评估磁共振成像(MRI)在评估持续性UGS的诊断价值,特别是合流部位、共通道长度、尿道长度,并将MRI结果与术前膀胱镜检查和手术结果联系起来。目的:探讨MRI对泌尿生殖窦及相关异常的评价,为术前规划手术决策及术后评价提供依据。材料和方法:本前瞻性研究纳入了29例患有UGS异常的女性儿科患者,这些患者接受盆腔MRI检查作为术前评估的一部分。将MRI结果与术中数据进行比较。评估的参数包括尿道长度、泌尿生殖道和阴道长度,以及相关异常的识别。计算诊断性能指标,包括敏感性、特异性和准确性。结果:MRI在89.7%的手术确诊病例中发现了UGS,在29例患者中有25例观察到放射-手术一致性。4例不一致,包括1例错误分类的“高”型UGS和3例未在MRI上显示的“极低”型UGS。MRI显示灵敏度为89.7%,总体准确率为89.7%。UGS类型与共尿道长度(P = 0.005)和尿道长度(P = 0.011)均有显著相关。68.9%的患者存在相关异常,最常见的包括生殖器、脊柱和直肠系统。结论:MRI是术前评估UGS的一种高度敏感和准确的方式,可以提供详细的解剖信息,并能够发现相关异常。将其集成到诊断工作流程中可以改善手术计划和患者预后。
{"title":"Role of magnetic resonance imaging in evaluation of urogenital sinus malformations","authors":"Walaa M. Saad ,&nbsp;Omnia Ezz Eldin ,&nbsp;Ashraf N. Ettaby ,&nbsp;Khaled E. El Noauaem ,&nbsp;Hebatallah H.M. Hassan ,&nbsp;Ahmed Oshiba ,&nbsp;Samar Eshiba","doi":"10.1016/j.ejrad.2025.112623","DOIUrl":"10.1016/j.ejrad.2025.112623","url":null,"abstract":"<div><h3>Background</h3><div>Persistent urogenital sinus (UGS) is a rare but complex congenital anomaly that poses significant challenges in pediatric reconstructive surgery. Accurate preoperative visualization of the urogenital anatomy is essential for optimal surgical planning. This study aims to evaluate the diagnostic utility of magnetic resonance imaging (MRI) in assessing persistent UGS, specifically the site of confluence, common channel length, urethral length, and to correlate MRI findings with the preoperative cystoscopy and surgical outcomes.</div></div><div><h3>Objectives</h3><div>To evaluate role of MRI in evaluation of urogenital sinus and associated anomalies helping in pre operative planning for surgical decision making and post operative evaluation<strong>.</strong></div></div><div><h3>Materials and methods</h3><div>This prospective study included 29 female pediatric patients with UGS anomalies who underwent pelvic MRI as part of their preoperative assessment. MRI findings were compared with intraoperative data. Parameters assessed included the length of the urethra, the common urogenital channel, and vaginal length, in addition to the identification of associated anomalies. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated.</div></div><div><h3>Results</h3><div>MRI identified UGS in 89.7 % of surgically confirmed cases, with radiological-surgical concordance observed in 25 out of 29 patients. Discordance was noted in 4 cases, including one misclassified “high” type UGS and three “very low” types not visualized on MRI. MRI showed a sensitivity of 89.7 % and an overall accuracy of 89.7 %. Significant correlations were found between UGS type and both common channel length (<em>P</em> = 0.005) and urethral length (<em>P</em> = 0.011). Associated anomalies were present in 68.9 % of patients, most commonly involving genital, spinal, and rectal systems.</div></div><div><h3>Conclusion</h3><div>MRI is a highly sensitive and accurate modality for the preoperative evaluation of UGS, offering detailed anatomical insights and enabling the detection of associated anomalies. Its integration into diagnostic workflows can improve surgical planning and patient outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112623"},"PeriodicalIF":3.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827263","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
A novel and general spatiotemporal diagnostic model: Intratumoral outflow and peritumoral inflow for the differentiation and stratification of breast tumor 一个新的和通用的时空诊断模型:肿瘤内流出和肿瘤周围流入用于乳腺肿瘤的分化和分层
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-20 DOI: 10.1016/j.ejrad.2025.112622
Zhanao Meng , Chenyi Zhou , Hui Xie , Ting Chen , Chunhua Wu , Wenxuan Li , Wenjie Tang , Yanling Wang

Objective

A novel Intratumoral Outflow and Peritumoral Inflow (IOPI) model based on spatiotemporal information was developed to quantify differences in blood perfusion and microcirculation. Its performance was compared with conventional indicators, and its clinical application for diagnosing benign and malignant breast tumors, as well as its potential for risk stratification, was validated in a two-center study.

Materials and methods

A retrospective analysis of 159 patients (80 malignant and 79 benign lesions) undergoing dynamic contrast-enhanced MRI was conducted. Training set was from Center 1, testing set was from Center 2. Conventional kinetic parameters (PE and SER) and interpreted MRI features (ADC and BI-RADS) were extracted. Hemodynamics models (IOPI, IIO, PIO and IPIO) and combined models (ADC + IOPI, BIRADS + IOPI) were constructed by logistic regression. Classification performance was assessed by AUC, sensitivity, specificity and accuracy.

Results

In the training cohort, the proposed IOPI model achieved an AUC of 0.911, with specificity of 95.1 %, sensitivity of 82.0 % and accuracy of 89.5 %. In external testing cohort, the AUC was 0.802, significantly outperformed conven tional indicators and others models (p < 0.05). The BIRADS combined IOPI model achieved the highest diagnostic performance in classifying malignancy of breast lesions, with the AUC values of 0.940 and sensitivity of 92.0 % in training cohort. In the testing cohort, the ADC combined IOPI model achieved the highest diagnostic performance with the AUC of 0.878, accuracy of 84.2 % and specificity of 88.9 %. The combined models also showed comparable performance in stratifying invasive grades and predicting Ki-67 expression (exceptional specificity of 90.9 % in ADC combined IOPI).

Conclusion

IOPI serves as a valuable tool that highlights the additional potential of spatiotemporal kinetic information for improving breast tumor diagnosis. The combined model which integrates time and spatial concepts, exhibited strong diagnostic performance for improved breast cancer diagnosis and risk stratification.
目的建立一种基于时空信息的肿瘤内流出和肿瘤周围流入(IOPI)模型,以量化血液灌注和微循环的差异。将其性能与常规指标进行比较,并通过双中心研究验证其在乳腺良恶性肿瘤诊断中的临床应用及风险分层潜力。材料与方法对159例(恶性80例,良性79例)行动态增强MRI检查的患者进行回顾性分析。训练集来自中心1,测试集来自中心2。提取常规动力学参数(PE和SER)和解释MRI特征(ADC和BI-RADS)。通过logistic回归建立血流动力学模型(IOPI、IIO、PIO和IPIO)和组合模型(ADC + IOPI、BIRADS + IOPI)。通过AUC、敏感性、特异性和准确性评价分类效果。结果在训练队列中,所提出的IOPI模型的AUC为0.911,特异性为95.1%,敏感性为82.0%,准确性为89.5%。在外部测试队列中,AUC为0.802,显著优于常规指标和其他模型(p < 0.05)。BIRADS联合IOPI模型对乳腺病变恶性分类的诊断效能最高,在训练队列中AUC值为0.940,灵敏度为92.0%。在检测队列中,ADC联合IOPI模型的诊断性能最高,AUC为0.878,准确率为84.2%,特异性为88.9%。联合模型在浸润分级和预测Ki-67表达方面也显示出相当的性能(ADC联合IOPI的异常特异性为90.9%)。结论iopi是一种有价值的工具,它突出了时空动力学信息在提高乳腺肿瘤诊断方面的附加潜力。该模型融合了时间和空间概念,在提高乳腺癌诊断和风险分层方面表现出较强的诊断性能。
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引用次数: 0
Elevated 18F-FDG uptake in non-metastatic lymph nodes of POLE-mutated endometrial cancer on PET/CT PET/CT显示pole突变子宫内膜癌非转移性淋巴结中18F-FDG摄取升高
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-18 DOI: 10.1016/j.ejrad.2025.112620
Maho Kurihara , Yu Iwabuchi , Yoshitake Yamada , Atsushi Shimizu , Takuma Yoshimura , Kensuke Sakai , Tatsuyuki Chiyoda , Kohei Nakamura , Hiroshi Nishihara , Wataru Yamagami , Masahiro Jinzaki

Purpose

DNA polymerase epsilon (POLE) exonuclease domain-mutated endometrial cancer (EC) is associated with a favorable prognosis and significant immune cell infiltration. Cancers with significant immune cell infiltration often exhibit higher maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT). This study aimed to evaluate the correlation between POLE status and FDG-PET/CT imaging in patients with EC.

Methods

This retrospective study enrolled 102 patients (mean age, 56.2 ± 11.8 years) with EC who underwent preoperative FDG-PET/CT between July 2018 and August 2023. Patients were categorized into molecular subtypes based on molecular profiling. SUVmax of the primary tumor and lymph nodes was measured, and correlations with molecular subtypes were examined.

Results

The SUVmax in the primary tumor of POLE-mutated ECs was higher than that in non-POLE-mutated ECs (mean ± SD, 13.21 ± 4.78 vs 9.82 ± 3.78; p = 0.001). Multiple regression analysis showed that POLE status was associated with SUVmax in primary tumors (B = 2.30, p = 0.031). The SUVmax in non-metastatic lymph nodes of POLE-mutated ECs was higher than that in non-POLE-mutated ECs (median SUVmax, 1.31 [IQR, 1.05–2.21] vs. 1.06 [IQR, 0.91–1.20]; p = 0.003). Multiple regression analysis revealed that POLE status was the only factor associated with SUVmax in non-metastatic lymph nodes (B = 0.339, p = 0.046), while age, BMI, blood glucose level, histological type, and primary tumor size showed no significant association.

Conclusion

Patients with POLE-mutated EC exhibit high SUVmax in primary tumors and also tend to show elevated uptake in non-metastatic lymph nodes.
目的:DNA聚合酶epsilon (POLE)外切酶结构域突变的子宫内膜癌(EC)与良好的预后和显著的免疫细胞浸润有关。具有显著免疫细胞浸润的癌症通常在18f -氟脱氧葡萄糖(FDG)-正电子发射断层扫描/计算机断层扫描(PET/CT)上表现出更高的最大标准化摄取值(SUVmax)。本研究旨在评估EC患者的POLE状态与FDG-PET/CT成像的相关性。方法:本回顾性研究纳入102例EC患者(平均年龄56.2±11.8岁),于2018年7月至2023年8月接受术前FDG-PET/CT检查。根据分子谱将患者分为分子亚型。测定原发肿瘤和淋巴结的SUVmax,并检测与分子亚型的相关性。结果:原发性肿瘤中pole突变ECs的SUVmax高于非pole突变ECs(平均±SD, 13.21±4.78 vs 9.82±3.78;p = 0.001)。多元回归分析显示,原发性肿瘤中POLE状态与SUVmax相关(B = 2.30, p = 0.031)。pol -突变ECs非转移性淋巴结的SUVmax高于非pole -突变ECs(中位SUVmax, 1.31 [IQR, 1.05-2.21]比1.06 [IQR, 0.91-1.20]; p = 0.003)。多元回归分析显示,POLE状态是与非转移性淋巴结SUVmax相关的唯一因素(B = 0.339, p = 0.046),而年龄、BMI、血糖水平、组织学类型和原发肿瘤大小无显著相关性。结论:pole突变的EC患者在原发肿瘤中表现出较高的SUVmax,并且在非转移性淋巴结中也倾向于表现出较高的摄取。
{"title":"Elevated 18F-FDG uptake in non-metastatic lymph nodes of POLE-mutated endometrial cancer on PET/CT","authors":"Maho Kurihara ,&nbsp;Yu Iwabuchi ,&nbsp;Yoshitake Yamada ,&nbsp;Atsushi Shimizu ,&nbsp;Takuma Yoshimura ,&nbsp;Kensuke Sakai ,&nbsp;Tatsuyuki Chiyoda ,&nbsp;Kohei Nakamura ,&nbsp;Hiroshi Nishihara ,&nbsp;Wataru Yamagami ,&nbsp;Masahiro Jinzaki","doi":"10.1016/j.ejrad.2025.112620","DOIUrl":"10.1016/j.ejrad.2025.112620","url":null,"abstract":"<div><h3>Purpose</h3><div>DNA polymerase epsilon (<em>POLE</em>) exonuclease domain-mutated endometrial cancer (EC) is associated with a favorable prognosis and significant immune cell infiltration. Cancers with significant immune cell infiltration often exhibit higher maximum standardized uptake value (SUVmax) on <sup>18</sup>F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT). This study aimed to evaluate the correlation between <em>POLE</em> status and FDG-PET/CT imaging in patients with EC.</div></div><div><h3>Methods</h3><div>This retrospective study enrolled 102 patients (mean age, 56.2 ± 11.8 years) with EC who underwent preoperative FDG-PET/CT between July 2018 and August 2023. Patients were categorized into molecular subtypes based on molecular profiling. SUVmax of the primary tumor and lymph nodes was measured, and correlations with molecular subtypes were examined.</div></div><div><h3>Results</h3><div>The SUVmax in the primary tumor of <em>POLE</em>-mutated ECs was higher than that in non-<em>POLE</em>-mutated ECs (mean ± SD, 13.21 ± 4.78 vs 9.82 ± 3.78; <em>p</em> = 0.001). Multiple regression analysis showed that <em>POLE</em> status was associated with SUVmax in primary tumors (B = 2.30, <em>p</em> = 0.031). The SUVmax in non-metastatic lymph nodes of <em>POLE</em>-mutated ECs was higher than that in non<em>-POLE-</em>mutated ECs (median SUVmax, 1.31 [IQR, 1.05–2.21] vs. 1.06 [IQR, 0.91–1.20]; <em>p</em> = 0.003). Multiple regression analysis revealed that <em>POLE</em> status was the only factor associated with SUVmax in non-metastatic lymph nodes (B = 0.339, p = 0.046), while age, BMI, blood glucose level, histological type, and primary tumor size showed no significant association.</div></div><div><h3>Conclusion</h3><div>Patients with <em>POLE</em>-mutated EC exhibit high SUVmax in primary tumors and also tend to show elevated uptake in non-metastatic lymph nodes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112620"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818168","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
Changes in the cerebral glymphatic system after rehabilitation of COVID-19 patients: A five-year follow-up study COVID-19患者康复后脑淋巴系统的变化:一项为期五年的随访研究
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-17 DOI: 10.1016/j.ejrad.2025.112615
Jiaqi Yao , Lijie Zhang , Sihong Huang , Shirui Cao , Xinjia Xu , Junjie Yang , Yule Zeng , Jun Liu

Background

COVID-19 patients often experience cognitive deficits and sleep disorders, potentially linked to cerebral glymphatic system (GS) dysfunction. Long-term progression remains unclear.

Methods

A prospective follow-up study was conducted on 17 COVID-19 patients at 1(V1), 2 (V2), and 5 years (V5) post-discharge. Multimodal MRI was used to assess the Analysis Along the Perivascular Space (ALPS) index, White Matter Free Water (WM-FW), Choroid Plexus Volume (CPV), and Global Blood-Oxygen-Level-Dependent–Cerebrospinal Fluid (gBOLD–CSF) Coupling, alongside comprehensive neuropsychological tests. Data were analyzed using Linear Mixed-Effects Models (LME), correlation, and regression analyses (P < 0.05), with Minimal Clinically Important Difference (MCID) and Receiver Operating Characteristic (ROC) analyses applied to evaluate clinical significance and discriminative performance.

Results

COVID-19 patients exhibited persistent declines in cognitive and sleep functions, as measured by the Logical Memory Test-B (V5: P < 0.001) and the Pittsburgh Sleep Quality (V1: P < 0.001, V5: P = 0.004). The ALPS index remained reduced (V1L:P = 0.026; V2L:P = 0.011; V5R: P = 0.025), while WM-FW fluctuated nonlinearly (V1:P = 0.028; V5:P = 0.045) and CPV was stable (L: χ2 = 0.36, P = 0.83; R: χ2 = 0.27, P = 0.87). gBOLD–CSF showed significant recovery (χ2 = 24.95, P < 0.001), exceeding the MCID and correlating with word fluency (β = –0.754, P < 0.001) and sleep quality; ROC analysis confirmed high discriminative power (AUC = 0.853).

Conclusion

Structural GS impairment may persist up to 5 years, while gBOLD–CSF shows reversible, clinically meaningful recovery. Integrating four imaging markers, this study outlines a “persistent damage–partial recovery–nonlinear fluctuation” trajectory, offering mechanistic insights into SARS-CoV-2 infection and a potential biomarker for long-term monitoring.
背景:COVID-19患者经常出现认知缺陷和睡眠障碍,这可能与脑淋巴系统(GS)功能障碍有关。长期进展尚不清楚。方法:对17例COVID-19患者在出院后1年(V1)、2年(V2)和5年(V5)进行前瞻性随访研究。采用多模态MRI评估沿血管周围间隙(ALPS)指数、白质游离水(WM-FW)、脉络膜丛体积(CPV)和全血氧水平依赖性脑脊液(gBOLD-CSF)耦合分析,并进行综合神经心理测试。采用线性混合效应模型(LME)、相关性和回归分析对数据进行分析(P结果:通过逻辑记忆测试b (V5: P L:P = 0.026; V2L:P = 0.011; V5R: P = 0.025)测量,COVID-19患者表现出持续的认知和睡眠功能下降,而WM-FW呈非线性波动(V1:P = 0.028; V5:P = 0.045), CPV稳定(L: χ2 = 0.36, P = 0.83; R: χ2 = 0.27, P = 0.87)。结论:结构性GS损伤可持续长达5年,而gBOLD-CSF的恢复是可逆的,具有临床意义。该研究整合了四种成像标志物,概述了“持续损伤-部分恢复-非线性波动”的轨迹,为SARS-CoV-2感染提供了机制见解,并为长期监测提供了潜在的生物标志物。
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引用次数: 0
Diagnostic value of ultrasound in different positions for detecting nutcracker syndrome during physical examination of flying cadets 飞行学员体检中不同体位超声检测胡桃夹综合征的诊断价值。
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-17 DOI: 10.1016/j.ejrad.2025.112616
Mengjie Li , Mengnan Yu , Wenli Hu , Lu Li , Xing Zhong , Jiahui Huang , Xi Liu , Xiaozhou Fan

Objective

To examine the ultrasonographic parameters and diagnostic efficacy of nutcracker syndrome (NCS) in two positions and thus to ensure accurate recruitment.

Materials and methods

According to the presence or absence of left varicocele, 184 teenagers from Air Force medical selection in 2024 were classified into the NCS-positive group or the control. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of ultrasound parameters in the seated anteversion and supine position. Independent predictors were determined via regression analysis. Individual and combined diagnostic prediction models were developed based on these independent predictors through nomogram and the calibration curve.

Results

ROC curve analysis showed the superior diagnostic efficacy for NCS in the seated anteversion position. Regression analysis identified two independent diagnostic predictors: the diameter ratio between the dilatation and stenosis of the left renal vein (D2/D1) and the peak velocity (V1) at the stenosis. And the combination of these two diagnostic parameters (the cutoff value of D2/D1: 2.38 and the cutoff value of V1: 69.5 cm/s) achieved an AUC of 0.821 with a sensitivity of 68.3 % and a specificity of 84.3 %. The calibration curve demonstrated good consistency between the predictions made by the nomogram and actual clinical observations.

Conclusions

This study established the diagnostic criteria at the seated anteversion position for NCS, indicating that D2/D1 and V1 of left renal vein serve as independent diagnostic parameters. In the future, these criteria can enhance accuracy in aviation recruitment medical examinations.
目的:探讨两体位胡桃钳综合征(NCS)的超声参数及诊断效果,为准确征管提供依据。材料与方法:将2024年空军医学选拔的184名青少年按有无左侧精索静脉曲张分为ncs阳性组和对照组。采用受试者工作特征(ROC)曲线分析评价超声参数对坐位前倾和仰卧位的诊断价值。通过回归分析确定独立预测因子。在这些独立预测因子的基础上,通过模态图和校准曲线建立了单独和联合诊断预测模型。结果:ROC曲线分析显示坐位前倾时NCS的诊断效果较好。回归分析确定了两个独立的诊断预测指标:左肾静脉扩张与狭窄之间的直径比(D2/D1)和狭窄处的峰值流速(V1)。2个诊断参数(D2/D1截断值为2.38,V1截断值为69.5 cm/s)联合AUC为0.821,敏感性为68.3%,特异性为84.3%。标定曲线显示nomogram预测结果与实际临床观察结果具有较好的一致性。结论:本研究建立了坐位前倾NCS的诊断标准,左肾静脉D2/D1和V1可作为独立的诊断参数。今后,这些标准可提高航空招聘体检的准确性。
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引用次数: 0
Visualisation of lenticulostriate arteries using photon counting detector CT angiography: A retrospective cohort study 利用光子计数检测器CT血管造影显示纹状体透镜状动脉:一项回顾性队列研究。
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-16 DOI: 10.1016/j.ejrad.2025.112618
Ilse Huijberts , Bart A.J.M. Wagemans , Florentina M.E. Pinckaers , M.M.Quirien Robbe , Wim H. van Zwam , Robert J. van Oostenbrugge , Alida A. Postma

Purpose

The visualisation of lenticulostriate arteries (LSA) using CT-techniques has not been extensively studied. Currently, digital subtraction angiography (DSA) is the preferred imaging modality for LSA visualisation. The new photon-counting detector CT (PCD-CT) may offer a non-invasive alternative. This study evaluates PCD-CT for LSA visualisation compared to DSA and energy-integrating detector CT-angiography (EID-CTA).

Methods

We assessed imaging data from subarachnoid haemorrhage (SAH) patients, as they are expected to have intact LSA and routinely undergo DSA. From 2021 to 2024, adult SAH-patients who underwent both DSA and either EID-CTA or PCD-CT were enrolled. PCD-CT was acquired in UHR mode. For LSA > 5 mm from the middle cerebral artery (MCA) origin, only the length of the largest branch was measured, whereas for LSA < 5 mm all individual branches were assessed. LSA presence, length and subjective image quality were assessed across PCD-CT, EID-CTA, and DSA by two radiologists. Cohen’s kappa and the Intraclass Correlation Coefficient were used to evaluate inter-rater agreement.

Results

159 patients were included. No differences were found between DSA and PCD-CT in LSA detection and length < 5 mm from the MCA origin. At > 5 mm from the MCA origin, the measured length of LSA was significantly longer on DSA. PCD-CT outperformed EID-CTA for LSA detection and length measurements. Observer 1 rated PCD-CT quality lower than DSA, while observer 2 found no difference. EID-CTA quality was rated significantly lower than both PCD-CT and DSA. Inter-rater agreement ranged from poor to moderate across modalities.

Conclusion

PCD-CT holds promise as a method for non-invasive LSA visualisation and requires further evaluation in prospective studies and clinical settings.
目的:使用ct技术显示透镜状纹状动脉(LSA)尚未得到广泛的研究。目前,数字减影血管造影(DSA)是对LSA进行可视化的首选成像方式。新的光子计数检测器CT (PCD-CT)可能提供一种非侵入性的替代方法。本研究评估了与DSA和能量积分检测器ct血管造影(EID-CTA)相比,PCD-CT对LSA的可视化效果。方法:我们评估了蛛网膜下腔出血(SAH)患者的影像学资料,因为他们预计有完整的LSA并常规接受DSA。从2021年到2024年,纳入了同时接受DSA和EID-CTA或PCD-CT的成年sah患者。在UHR模式下获取pc - ct。对于距离大脑中动脉(MCA)起源0.5 mm的LSA,仅测量了最大分支的长度,而对于LSA结果:包括159例患者。DSA和PCD-CT检测到的LSA长度与MCA原点距离5mm无差异,DSA上测量到的LSA长度明显更长。在LSA检测和长度测量方面,PCD-CT优于EID-CTA。观察者1认为PCD-CT质量低于DSA,而观察者2没有发现差异。EID-CTA的质量评分明显低于PCD-CT和DSA。评估者之间的一致性从差到中等不等。结论:PCD-CT有望作为一种无创的LSA可视化方法,但需要在前瞻性研究和临床环境中进一步评估。
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引用次数: 0
期刊
European Journal of Radiology
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