European Journal of Radiology最新文献

Pelvic floor dysfunction encompasses a spectrum of disorders characterized by organ descent, muscular weakness, and impaired coordination across the anterior, middle, and posterior compartments. MRI defecography has become an established non-invasive technique for comprehensive assessment of both static anatomy and dynamic function of the pelvic floor. This review describes the MRI defecography technique, protocol components, and quantitative parameters that provide an objective evaluation of pelvic floor dysfunction. Standard MRI defecography protocol incorporates resting, contraction, straining, and evacuation phases, with single-shot fast spin-echo and real-time sequences enabling visualization of pelvic structures throughout motion. Quantitative parameters, including the anorectal angle, pubococcygeal line, H and M lines, minimal prolapse level, and levator plate angle, allow for objective evaluation of pelvic floor dysfunction. MRI defecography is particularly valuable in complex and postoperative scenarios, allowing detection of cystoceles, rectoceles, enteroceles, uterine or vaginal prolapse, intussusception, and post-surgical complications. In addition, MRI-defecography highlights the importance of stabilizing structures such as the urogenital diaphragm, endopelvic fascia, and levator ani complex. By integrating anatomic and functional findings, MRI defecography supports individualized therapeutic planning, guides surgical decision-making, and improves long-term outcomes. MRI defecography has thus emerged as a cornerstone in the multidisciplinary management of pelvic floor dysfunction.

Objective: Bone erosion is a hallmark of progressive joint damage and poor prognosis in psoriatic arthritis (PsA). Early identification of high-risk patients is critical for implementing aggressive interventions that can mitigate inflammation and prevent irreversible structural joint damage. This study aimed to identify clinical and ultrasonographic features associated with bone erosion in patients with early PsA.

Methods: A total of 82 patients with early PsA with articular and/or the entheseal involvement of less than 6-month duration were prospectively enrolled from the Rheumatology Department of the First Affiliated Hospital with Nanjing Medical University between March 2022 and January 2025 and followed for 24 months. Data about demographic and clinical characteristics, clinical enthesitis and dactylitis, and medication were collected. Musculoskeletal ultrasound was performed at baseline and the 2-year visit.Inflammatory and structural changes were scored with the modified MAdrid Sonographic Enthesitis Index (MASEI) and Novel and reliable DACTylitis glObal Sonographic (DACTOS) score. Erosions were defined by two radiology experts based on at least two imaging techniques. Logistic regression analysis was performed to identify variables associated with bone erosion occurring within 2 years of initial diagnosis. This trial has been registered on ClinicalTrials.gov under identifier NCT06730334.

Results: Early PsA patients with bone erosion had later onset of the disease (40.70 ± 13.35 vs 32.33 ± 13.98, p = 0.008), higher proportion with metabolic syndrome (p = 0.043), a greater number of swollen joints at baseline (p = 0.029), and higher DACTOS scores (p = 0.026). Over the 24-month follow-up, a higher proportion of patients without bone erosion received IL-17 inhibitor therapy (p = 0.034). Multivariate analysis identified older age at symptom onset (OR 1.049, p = 0.012) and higher DACTOS score (OR 1.082, p = 0.036) as independent predictors of bone erosion.

Conclusion: Our findings establish that an older age at symptom onset and a higher ultrasonographic dactylitis burden, quantified by the DACTOS score, are independent risk factors for bone erosion in early PsA. This supports the integration of ultrasound into early risk stratification to identify patients at greater risk for structural damage.

Introduction: High-grade soft tissue sarcomas (STShg) of the extremities are rare cancers with a poor prognosis. Accurate staging at initial evaluation is crucial for determining optimal treatment. Current guidelines recommend systematic chest computed tomography (CT) scans during initial assessment. Recent advances in artificial intelligence (AI)-based imaging software now enable automatic, rapid volumetric assessment of body composition from CT scans. Our study aims to evaluate the predictive role of body composition features, obtained using a dedicated AI program, on overall survival (OS) and disease-free survival (DFS), using staging chest CT scans from patients diagnosed with extremity STShg.

Materials and methods: We conducted a single-center retrospective study at the Jules Bordet Institute, including patients diagnosed with extremity STShg between January 2010 and January 2023 who underwent CT scans covering the thoracic region. Using dedicated software, we performed automated 3D quantitative analysis of various anatomical compartments, including intramuscular adipose tissue (IMAT), pericardial adipose tissue (PAT), epicardial adipose tissue (EAT), and visceral adipose tissue (VAT). We assessed the association between body composition metrics and OS, DFS, local recurrence-free survival, and metastatic recurrence-free survival.

Results: Higher volumes of IMAT and PAT were associated with shorter OS, DFS, and local recurrence-free survival. Increased EAT volume correlated with reduced OS, while higher VAT volume was linked to worse OS and DFS.

Conclusion: Our study suggests a potential predictive role of specific body composition features, particularly IMAT, PAT, EAT, and VAT volumes, in the prognosis of extremity STShg.

We comment on Ba-Ssalamah et al.'s study comparing MRI-derived and biopsy-confirmed liver iron concentration in chronic liver disease. The strong agreement between two R2*-based methods supports the robustness of relaxometry-based LIC estimation in the low-mild iron range. We discuss physics-related considerations, including R2* nonlinearity, spatial sampling, signal modeling, and calibration dependence, and outline future directions toward volumetric mapping and cross-platform harmonization for quantitative liver MRI.