European Journal of Radiology最新文献_第9页

Letter to the Editor regarding “Allergological evaluation of hypersensitivity reactions after administration of contrast agents: What the radiologist needs to know” – The role of polyethylene glycol in contrast-induced hypersensitivity 致编辑的关于“造影剂使用后超敏反应的过敏学评估：放射科医生需要知道的”的信-聚乙二醇在造影剂引起的超敏反应中的作用

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1016/j.ejrad.2025.112650

Igor Rubinić , Dominik Strikić , Marija Kurtov , Viktorija Erdeljić Turk

引用次数: 0

VIPs outperforms established models for predicting post-TIPS prognosis in viral hepatitis-dominant cirrhosis VIPs在预测病毒性肝炎主导型肝硬化tips后预后方面优于现有模型

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1016/j.ejrad.2026.112672

Zhongsong Gao , Kun Zhang , Bo Li , Zhaogang Zhang , Hengtao Zhang , Xin Zhang , Bo Feng , Ruihang Wang , Wen Shen , Kefeng Jia

Background

Transjugular intrahepatic portosystemic shunt (TIPS) manages portal hypertension complications in cirrhosis, but predicting post-TIPS outcomes remains challenging, especially in viral hepatitis-dominated populations.

Purpose

To systematically evaluate the predictive performance of the novel Viral-Associated Index of Post-TIPS Score (VIPs) for post-TIPS prognosis. We also comprehensively compare it with six established clinical prognostic models and one imaging-based model (the spleen volume-based model, SvBM).

Materials and methods

We retrospectively analyzed 247 cirrhotic patients undergoing TIPS (56.7 % viral hepatitis). Baseline data calculated prognostic scores (VIPs, MELD, MELD-Na, FIPS, Child-Pugh, ALBI, MOTS, and SvBM). The primary endpoint was transplant-free survival (TFS). Discrimination was assessed by the area under the receiver operating characteristic curve (AUROC) at 6, 12, 36, and 60 months post-TIPS. Calibration (Brier score), explanatory power (R²), and decision curve analysis (DCA) were also evaluated.

Results

VIPs demonstrated good-to-moderate discrimination for TFS, with AUROCs (95 % CI) of 0.794 (0.689–0.899), 0.753 (0.649–0.858), 0.721 (0.645–0.797), and 0.692 (0.617–0.767) at 6, 12, 36, and 60 months, respectively. This advantage was most pronounced in the viral hepatitis subgroup, with AUROCs ranging from 0.699 (0.603–0.796) to 0.822 (0.715–0.930) across follow-up. VIPs significantly outperformed Child-Pugh, ALBI, FIPS, MOTS and SvBM at all timepoints (all p < 0.05), and surpassed MELD and MELD-Na for long-term predictions (36/60 months, both p < 0.05). It also exhibited the best calibration (lowest Brier scores: 0.076–0.217) and the highest explanatory power (R² = 0.121–0.142). Subgroup analyses further confirmed robust performance in females and patients with variceal bleeding.

Conclusions

VIPs demonstrates superior predictive accuracy for post-TIPS survival in a viral hepatitis-dominated cohort and may serve as a preferred prognostic tool to guide individualized decision-making.

背景：经颈静脉肝内门静脉系统分流术（TIPS）可治疗肝硬化门静脉高压并发症，但预测TIPS后的预后仍然具有挑战性，特别是在病毒性肝炎为主的人群中。目的系统评价新型tips后病毒相关指数评分（VIPs）对tips后预后的预测效果。我们还将其与六种已建立的临床预后模型和一种基于影像学的模型（脾体积模型，SvBM）进行了综合比较。材料和方法回顾性分析247例接受TIPS治疗的肝硬化患者（56.7%为病毒性肝炎）。基线数据计算预后评分（vip、MELD、MELD- na、FIPS、Child-Pugh、ALBI、MOTS和SvBM）。主要终点是无移植生存期（TFS）。在tips后6、12、36和60个月，通过受试者工作特征曲线下面积（AUROC）来评估辨别力。校正（Brier评分）、解释能力（R2）和决策曲线分析（DCA）也进行了评估。结果vip对TFS表现出良好到中度的区分，在6、12、36和60个月时，auroc （95% CI）分别为0.794（0.689-0.899）、0.753（0.649-0.858）、0.721（0.645-0.797）和0.692（0.617-0.767）。这一优势在病毒性肝炎亚组中最为明显，随访期间auroc范围为0.699（0.603-0.796）至0.822（0.715-0.930）。VIPs在所有时间点上的表现都明显优于Child-Pugh、ALBI、FIPS、MOTS和SvBM（均p <； 0.05），并且在长期预测方面超过MELD和MELD- na（36/60个月，均p <； 0.05）。其校正效果最佳（最低Brier评分为0.076 ~ 0.217），解释能力最高（R2 = 0.121 ~ 0.142）。亚组分析进一步证实了在女性和静脉曲张出血患者中的良好表现。结论：在病毒性肝炎为主的队列中，vip对tips后患者的生存具有优越的预测准确性，可作为指导个体化决策的首选预后工具。

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引用次数: 0

Cortical vein opacification measurement using hounsfield unit values is a predictor for outcome in anterior circulation acute ischemic stroke 皮质静脉混浊测量使用霍斯菲尔德单位值是预测预后的前循环急性缺血性卒中。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1016/j.ejrad.2026.112671

Erling Wang , Yueyan Bian , Xiaoxu Yang , Huihui Xie , Xiuqin Jia , Qi Yang

Objectives

In acute ischemic stroke (AIS) patients, the cortical vein opacification on computed tomographic angiography (CTA) imaging is usually asymmetric. We aimed to explore the correlation between CT perfusion parameters and cortical vein opacification evaluated by Hounsfield unit (HU) values, which is more accurately, and compare the predictive ability between them for outcome in AIS.

Methods

Patients with AIS obtained within 24 h after onset from June 2023 to January 2024 were reviewed. Opacification of the cortical vein of Labbé, sphenoparietal sinus, and the Trolard vein was measured on CTA imaging using HU. Then HU ratio (rHU) was calculated by dividing the affected side by the controlateral side (rHU = HU-affected/HU-control). The sum of rHU of three cortical veins opacification (CVOR, CVOR = rHU_Labbé+ rHU_{sphenoparietal sinus} + rHU _{Trolard vein}) was calculated. The correlations between CVOR and CT perfusion parameters, hypoperfusion and ischemic core volume, were explored. Outcome was assessed at 90 days using the modified Rankin Scale (mRS), a standardized measure of disability ranging from 0 (no symptoms) to 6 (death). An mRS score of 2 or less is considered as functional outcome.

Results

A total of 143 patients (mean age, 67.3 ± 12.5 years; 106 men) were included. We found that CVOR had a strong negative correlation with hypoperfusion volume (r = -0.759, P < 0.001) and had a moderate negative correlation with ischemic core volume (r = -0.517, P < 0.001). Receiver operating characteristic curve analysis revealed CVOR performed better than hypoperfusion volume (area under the curve [AUC], 0.784 vs 0.711; P = 0.008) and ischemic core volume (AUC, 0.784 vs 0.693; P = 0.02) in predicting the favorable 90-day mRS. Multivariable analysis showed CVOR was an independent predictor for poor outcome after adjusting for confounding factors [odds ratio 0.06 (0.02–0.32), p < 0.001].

Conclusion

Cortical vein opacification evaluated by HU values, had a strong negative correlation with hypoperfusion volume, and was also a novel independent predictor for clinical outcome.

目的：在急性缺血性脑卒中（AIS）患者中，计算机断层血管成像（CTA）上的皮质静脉混浊通常是不对称的。我们旨在探讨CT灌注参数与更准确的Hounsfield unit （HU）值评价的皮质静脉混浊的相关性，并比较两者对AIS预后的预测能力。方法：回顾性分析2023年6月至2024年1月发病后24 h内的AIS患者。采用HU在CTA成像上测量labb皮质静脉、蝶顶窦和特罗德静脉的混浊情况。然后用患病侧除以对照组（rHU =患病侧/对照组）计算HU比（rHU）。计算3条皮质静脉混浊（CVOR, CVOR = rhulabb + rhusphenopartal sinus + rHU Trolard静脉）的rHU之和。探讨CVOR与CT灌注参数、灌注不足及缺血核体积的相关性。在90天时，使用改进的Rankin量表（mRS）评估结果，这是一种标准化的残疾衡量标准，范围从0（无症状）到6（死亡）。mRS评分为2分或更低被认为是功能性预后。结果：共纳入143例患者，平均年龄67.3±12.5岁，男性106例。我们发现CVOR与低灌注量有很强的负相关（r = -0.759， P）。结论：用HU值评价皮质静脉混浊与低灌注量有很强的负相关，也是临床预后的一个新的独立预测指标。

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引用次数: 0

Characterising liver lesions from free-text computer tomography reports – A real-world multicentre analysis 从自由文本计算机断层扫描报告中表征肝脏病变-真实世界的多中心分析

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-17 DOI: 10.1016/j.ejrad.2026.112689

Jianliang Lu , Keith Wan-Hang Chiu , Chelsea Chan , Ho-Ming Cheng , Jian Zhou , Justin Christopher NG , Fanny Fong Yi Tang , Wai Kuen Kan , Philip Leung Ho Yu , Wai-Kay Seto

Background

This study evaluates the performance of a general-purpose (GPT-4) and a medically fine-tuned (Med-LM) large language model (LLM) in classifying liver lesions from unstructured Computed Tomography (CT) reports.

Methods

Consecutive CT reports (2014–2020) from five institutions were input into GPT-4 and Med-LM with simple (sp) and optimised (op) prompts. Lesion- and patient-level performance were benchmarked against LI-RADS scores assigned by two radiologists, and report quality was analysed using a 5-point Likert scale.

Results

A total of 296 CT reports (mean age, 64.6 years ± 11.3 [SD]; 193 men; 654 lesions) were included. Lesion- and patient-level accuracies for LI-RADS scoring ranged from 40.8% (Med-LMsp) to 61.3% (Med-LMop) and from 27.7% (Med-LMsp) to 52.4% (Med-LMop), respectively. When dichotomized into malignant and benign lesions, lesion- and patient-level accuracies rose to 56.1% (GPT-4sp) − 82.3% (Med-LMop) and 71.3% (Med-LMsp) – 86.5% (Med-LMop). Med-LMop demonstrated the highest performance in all analyses and was statistically superior to other models (all p < 0.001). Non-classification rates ranged between 12.7% (Med-LMop) and 40.5% (GPT-4sp), particularly for benign lesions. Kappa values were weak to moderate between the two reviewers in different aspects of report quality (0.471–0.766), and Likert scores for lesion information differed significantly between correctly and incorrectly classified lesions (all p ≤ 0.04). Repeatability varied widely from 12.7% (Med-LMop) to 39.0% (GPT-4sp).

Conclusions

Med-LM outperforms GPT-4 in classifying liver lesions from unstructured CT reports with both models better at detecting malignancy than full LI-RADS classification. However, high misclassification rates and inconsistent repeatability hinder their clinical use.

本研究评估了通用（GPT-4）和医学微调（Med-LM）大语言模型（LLM）从非结构化计算机断层扫描（CT）报告中对肝脏病变进行分类的性能。方法采用简单（sp）和优化（op）提示，将5家机构2014-2020年连续CT报告录入GPT-4和Med-LM。病变和患者水平的表现以两名放射科医生分配的LI-RADS评分为基准，并使用5分李克特量表分析报告质量。结果共纳入296例CT报告，平均年龄64.6岁±11.3 [SD]，男性193例，病变654例。LI-RADS评分在病变和患者水平上的准确率分别为40.8% （Med-LMsp）至61.3% （Med-LMop）和27.7% （Med-LMsp）至52.4% （Med-LMop）。当被分为恶性和良性病变时，病变水平和患者水平的准确率分别为56.1% (GPT-4sp) - 82.3% （Med-LMop）和71.3% (Med-LMsp) - 86.5% （Med-LMop）。Med-LMop在所有分析中表现出最高的性能，在统计上优于其他模型（均p <； 0.001）。未分级率介于12.7% （Med-LMop）和40.5% （GPT-4sp）之间，尤其是良性病变。两名评论者在报告质量的不同方面Kappa值介于弱到中等之间（0.471-0.766），病变信息的Likert评分在正确和错误分类的病变之间差异显著（均p≤0.04）。重复性从12.7% （Med-LMop）到39.0% （GPT-4sp）变化很大。结论med - lm在从非结构化CT报告中对肝脏病变进行分类方面优于GPT-4，两种模型在检测恶性肿瘤方面都优于完全LI-RADS分类。然而，高误分率和不一致的可重复性阻碍了其临床应用。

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引用次数: 0

Image quality comparison between low-dose thin-slice deep-learning reconstruction and standard-dose thick-slice hybrid iterative reconstruction in pediatric abdominal CT 儿童腹部CT低剂量薄层深度学习重建与标准剂量厚层混合迭代重建图像质量比较。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.ejrad.2026.112703

Ryota Harai, Yasunori Nagayama, Soichiro Ishiuchi, Ryuya Yoshida, Taihei Inoue, Takumi Osaki, Kaori Shiraishi, Masafumi Kidoh, Seitaro Oda, Takeshi Nakaura, Toshinori Hirai

Objectives

To compare image quality between low-dose thin-slice deep-learning reconstruction (DLR) and standard-dose thick-slice hybrid iterative reconstruction (HIR) in pediatric abdominal CT.

Methods

82 children (≤6 years) who underwent contrast-enhanced abdominal CT with standard-dose (STD, n = 41) or low-dose (LD, n = 41) protocol matched by age and weight were retrospectively identified. STD and LD images were reconstructed at 3.0-mm using HIR (STD-HIR/3.0 and LD-HIR/3.0, respectively). LD images were also reconstructed at 0.5-mm using HIR (LD-HIR/0.5) and DLR (LD-DLR/0.5). Size-specific dose estimate (SSDE) was compared between groups. Image noise and contrast-to-noise ratio (CNR) were quantified. Noise power spectrum (NPS) and edge-rise slope (ERS) were employed for noise texture and edge sharpness measures, respectively. For subjective evaluation, noise magnitude, noise texture, edge sharpness, delineation of small structures, and diagnostic confidence were rated on a 5-point scale (1 = undiagnostic, 5 = best).

Results

SSDE was on average 59.5% lower in LD than in STD group (1.7 ± 0.4 vs. 4.2 ± 0.8 mGy, p < 0.001). Image noise was lower in LD-DLR/0.5 compared to STD-HIR/3.0, LD-HIR/3.0, and LD-HIR/0.5 (8.7 ± 1.5, 9.6 ± 1.1, 11.7 ± 1.9, and 17.9 ± 2.3 HU, respectively, all p ≤ 0.017). LD-DLR/0.5 showed equivalent CNR (e.g., liver CNR: 7.1 ± 2.1 vs. 7.0 ± 2.8, p = 0.827) and higher ERS (64.3 ± 23.9 vs. 53.3 ± 10.6 HU/mm, p = 0.011) with similar average NPS frequency (0.281 ± 0.042 vs. 0.291 ± 0.027 mm⁻¹, p = 0.177) compared to STD-HIR/3.0. Subjective scores for all criteria were higher in LD-DLR/0.5 than in STD-HIR/3.0 (e.g., diagnostic confidence score: 4.5 ± 0.5 vs. 3.4 ± 0.4, p < 0.001).

Conclusion

Low-dose thin-slice DLR improved edge sharpness, small structure visualization, and diagnostic confidence in pediatric abdominal CT without increasing noise compared to standard-dose thick-slice HIR.

目的：比较儿童腹部CT低剂量薄层深度学习重建（DLR）与标准剂量厚层混合迭代重建（HIR）的图像质量。方法：回顾性分析82例（≤6岁）接受标准剂量（STD, n = 41）或低剂量（LD, n = 41）腹部CT增强检查的儿童（年龄和体重相匹配）。利用HIR （STD-HIR/3.0和LD-HIR/3.0）在3.0 mm处重建STD和LD图像。利用HIR （LD-HIR/0.5）和DLR （LD-DLR/0.5）在0.5 mm处重建LD图像。比较各组间大小特异性剂量估计值（SSDE）。对图像噪声和噪比（CNR）进行量化。噪声功率谱（NPS）和边缘上升斜率（ERS）分别用于噪声纹理和边缘锐度度量。对于主观评价，噪声大小、噪声纹理、边缘清晰度、小结构的描绘和诊断置信度按5分制进行评分（1 =不可诊断，5 =最佳）。结果：LD组SSDE比STD组低59.5%(1.7±0.4 vs. 4.2±0.8 mGy, p -1, p = 0.177)；LD-DLR/0.5的主观评分高于STD-HIR/3.0的主观评分（例如，诊断置信度评分：4.5±0.5 vs. 3.4±0.4,p）。结论：与标准剂量厚层HIR相比，低剂量薄层DLR改善了儿童腹部CT的边缘清晰度、小结构可视性和诊断置信度，且不增加噪声。

{"title":"Image quality comparison between low-dose thin-slice deep-learning reconstruction and standard-dose thick-slice hybrid iterative reconstruction in pediatric abdominal CT","authors":"Ryota Harai, Yasunori Nagayama, Soichiro Ishiuchi, Ryuya Yoshida, Taihei Inoue, Takumi Osaki, Kaori Shiraishi, Masafumi Kidoh, Seitaro Oda, Takeshi Nakaura, Toshinori Hirai","doi":"10.1016/j.ejrad.2026.112703","DOIUrl":"10.1016/j.ejrad.2026.112703","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare image quality between low-dose thin-slice deep-learning reconstruction (DLR) and standard-dose thick-slice hybrid iterative reconstruction (HIR) in pediatric abdominal CT.</div></div><div><h3>Methods</h3><div>82 children (≤6 years) who underwent contrast-enhanced abdominal CT with standard-dose (STD, n = 41) or low-dose (LD, n = 41) protocol matched by age and weight were retrospectively identified. STD and LD images were reconstructed at 3.0-mm using HIR (STD-HIR/3.0 and LD-HIR/3.0, respectively). LD images were also reconstructed at 0.5-mm using HIR (LD-HIR/0.5) and DLR (LD-DLR/0.5). Size-specific dose estimate (SSDE) was compared between groups. Image noise and contrast-to-noise ratio (CNR) were quantified. Noise power spectrum (NPS) and edge-rise slope (ERS) were employed for noise texture and edge sharpness measures, respectively. For subjective evaluation, noise magnitude, noise texture, edge sharpness, delineation of small structures, and diagnostic confidence were rated on a 5-point scale (1 = undiagnostic, 5 = best).</div></div><div><h3>Results</h3><div>SSDE was on average 59.5% lower in LD than in STD group (1.7 ± 0.4 vs. 4.2 ± 0.8 mGy, p < 0.001). Image noise was lower in LD-DLR/0.5 compared to STD-HIR/3.0, LD-HIR/3.0, and LD-HIR/0.5 (8.7 ± 1.5, 9.6 ± 1.1, 11.7 ± 1.9, and 17.9 ± 2.3 HU, respectively, all p ≤ 0.017). LD-DLR/0.5 showed equivalent CNR (e.g., liver CNR: 7.1 ± 2.1 vs. 7.0 ± 2.8, p = 0.827) and higher ERS (64.3 ± 23.9 vs. 53.3 ± 10.6 HU/mm, p = 0.011) with similar average NPS frequency (0.281 ± 0.042 vs. 0.291 ± 0.027 mm<sup>−1</sup>, p = 0.177) compared to STD-HIR/3.0. Subjective scores for all criteria were higher in LD-DLR/0.5 than in STD-HIR/3.0 (e.g., diagnostic confidence score: 4.5 ± 0.5 vs. 3.4 ± 0.4, p < 0.001).</div></div><div><h3>Conclusion</h3><div>Low-dose thin-slice DLR improved edge sharpness, small structure visualization, and diagnostic confidence in pediatric abdominal CT without increasing noise compared to standard-dose thick-slice HIR.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112703"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118417","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 CT-based radiomics model for classification of chronic pancreatitis: new biomarkers for diagnosis and severity staging 基于ct的慢性胰腺炎放射组学分类模型：诊断和严重程度分期的新生物标志物。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.ejrad.2026.112711

Surenth Nalliah , Søren Nicolai Frederiksen Hostrup , Esben Bolvig Mark , Marjolein Henrieke Liedenbaum , Erlend Hodneland , Ingfrid Helene Salvesen Haldorsen , Trond Engjom , Asbjørn Mohr Drewes , Søren Schou Olesen , Jens Brøndum Frøkjær

Objectives

To develop and validate CT-based radiomics models for the identification of chronic pancreatitis (CP) and selected CP-related complications, and to explore associations between radiomics-derived features and clinical measures.

Material & methods

This retrospective, multicenter study included a training cohort of 349 subjects (201 CP; 148 healthy controls) from Aalborg University Hospital. Test cohort comprised 109 subjects, including 41 pancreas-healthy controls from Aalborg and an external cohort of 68 CP patients from Bergen. Portal venous phase CT scans were automatically segmented, and radiomics features were extracted using PyRadiomics. AI models were trained to classify CP and identify CP-related complications, including exocrine pancreatic insufficiency (EPI), diabetes, and pain. Model performance was assessed using area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CI).

Results

The CP classification model demonstrated high discriminative performance with an AUC of 0.97 (95% CI: 0.94–0.99). The EPI model showed moderate discriminative performance (AUC 0.80, 95% CI: 0.66–0.88). In contrast, the diabetes and pain models demonstrated lower discriminative performance, with AUCs of 0.63 (95% CI: 0.47–0.77) and 0.59 (95% CI: 0.37–0.67), respectively. Radiomics-derived probability scores correlated significantly with fecal elastase levels (p < 0.001) and increased with greater functional disease severity (p = 0.004).

Conclusion

CT-based radiomics can accurately classify CP and reflect exocrine functional impairment. However, performance for diabetes and pain was limited, and clinical utility beyond established clinical assessments remains to be demonstrated.

目的：开发和验证基于ct的放射组学模型，用于识别慢性胰腺炎（CP）和部分CP相关并发症，并探讨放射组学衍生特征与临床措施之间的关系。材料与方法：这项回顾性、多中心研究纳入了来自奥尔堡大学医院的349名受试者（201名CP， 148名健康对照）的训练队列。试验队列包括109名受试者，包括41名来自奥尔堡的胰腺健康对照组和来自卑尔根的68名CP患者的外部队列。门静脉期CT扫描自动分割，并使用PyRadiomics提取放射组学特征。训练人工智能模型对CP进行分类并识别CP相关并发症，包括外分泌胰功能不全（EPI）、糖尿病和疼痛。采用95%置信区间（CI）的受试者工作特征曲线下面积（AUC）评估模型性能。结果：CP分类模型具有良好的判别性能，AUC为0.97 （95% CI: 0.94 ~ 0.99）。EPI模型表现出中等的判别性能（AUC 0.80, 95% CI: 0.66-0.88）。相比之下，糖尿病和疼痛模型表现出较低的判别性能，auc分别为0.63 （95% CI: 0.47-0.77）和0.59 （95% CI: 0.37-0.67）。放射组学衍生的概率评分与粪便弹性蛋白酶水平显著相关(p)结论：基于ct的放射组学可以准确分类CP并反映外分泌功能障碍。然而，对糖尿病和疼痛的治疗效果有限，超出既定临床评估的临床应用仍有待证实。

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引用次数: 0

Ultrashort echo time MRI radiomics as a predictor of clinical outcomes in patellar tendinopathy: Insights from a large prospective clinical trial 超短回波时间MRI放射组学作为髌腱病临床结果的预测因子：来自一项大型前瞻性临床试验的见解。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-14 DOI: 10.1016/j.ejrad.2026.112675

Yijie Fang , Jie Deng , Stephan J. Breda , Robert-Jan de Vos , Edwin H.G. Oei , Jukka Hirvasniemi

Purpose

To evaluate the predictive utility of radiomic features extracted from ultrashort echo time (UTE) MRI in comparison to conventional proton density (PD) sequences for short-term (24-week) and long-term (5-year) clinical outcomes in patients with patellar tendinopathy (PT) receiving exercise therapy.

Materials and methods

This prospective study of 76 PT patients undergoing 24-week exercise therapy underwent baseline 3D UTE and PD MRI at 3.0 T. The patellar tendon segmentation used nnU-Net, evaluated with Dice coefficient. Six predictive models consisting of clinical covariates and radiomic features from UTE and PD were developed using Elastic Net with 10-fold cross-validation. Model performance in predicting responsiveness of the patient-reported Victorian Institute of Sports Assessment (VISA-P) score was evaluated using the area under the receiver operating characteristic curve (ROC AUC) and the precision-recall curve (PR AUC), with 95% confidence intervals.

Results

The mean Dice similarity coefficient for the automatic segmentation of the patellar tendon from 3D-PD was 0.92 (SD: 0.02) and from 3D-UTE-Cones 0.89 (SD: 0.03). The UTE-based radiomics model demonstrated the highest predictive performance at 24 weeks (ROC AUC: 0.714 [95% CI: 0.701–0.727]; PR AUC: 0.848 [0.837–0.858]), while the PD-based model showed the lowest (ROC AUC: 0.569 [0.553–0.584]; PR AUC: 0.710 [0.692–0.727]). At the 5-year follow-up, UTE radiomics maintained robust performance (ROC AUC: 0.692 [0.677–0.706]; PR AUC: 0.822 [0.810–0.834]), whereas PD radiomics remained limited (ROC AUC: 0.578 [0.561–0.594]; PR AUC: 0.694 [0.676–0.713]).

Conclusions

Radiomics features extracted from UTE MRI demonstrate the highest predictive performance for clinical outcomes.

目的：评估从超短回波时间（UTE） MRI中提取的放射学特征与传统质子密度（PD）序列相比，对接受运动治疗的髌骨肌腱病（PT）患者短期（24周）和长期（5年）临床结果的预测效用。材料和方法：本前瞻性研究对76例接受24周运动治疗的PT患者在3.0 t时进行基线3D UTE和PD MRI，使用nnU-Net进行髌骨肌腱分割，用Dice系数进行评估。使用Elastic Net建立了6个预测模型，包括临床协变量和来自UTE和PD的放射学特征，并进行了10倍交叉验证。模型在预测患者报告的维多利亚体育评估研究所（VISA-P）评分的反应性方面的表现采用受试者工作特征曲线（ROC AUC）和精确召回曲线（PR AUC）下的面积进行评估，置信区间为95%。结果：3D-PD自动分割髌骨肌腱的Dice相似系数均值为0.92 (SD: 0.02)， 3d - ute - cone自动分割髌骨肌腱的Dice相似系数均值为0.89 （SD: 0.03）。基于ute的放射组学模型在24周时表现出最高的预测性能（ROC AUC: 0.714 [95% CI: 0.701-0.727]; PR AUC: 0.848[0.837-0.858]），而基于pd的模型表现出最低的预测性能（ROC AUC: 0.569 [0.553-0.584]; PR AUC: 0.710[0.692-0.727]）。在5年随访中，UTE放射组学保持了良好的表现（ROC AUC: 0.692 [0.677-0.706]; PR AUC: 0.822[0.810-0.834]），而PD放射组学仍然有限（ROC AUC: 0.578 [0.561-0.594]; PR AUC: 0.694[0.676-0.713]）。结论：从UTE MRI中提取的放射组学特征对临床结果具有最高的预测性能。

{"title":"Ultrashort echo time MRI radiomics as a predictor of clinical outcomes in patellar tendinopathy: Insights from a large prospective clinical trial","authors":"Yijie Fang , Jie Deng , Stephan J. Breda , Robert-Jan de Vos , Edwin H.G. Oei , Jukka Hirvasniemi","doi":"10.1016/j.ejrad.2026.112675","DOIUrl":"10.1016/j.ejrad.2026.112675","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the predictive utility of radiomic features extracted from ultrashort echo time (UTE) MRI in comparison to conventional proton density (PD) sequences for short-term (24-week) and long-term (5-year) clinical outcomes in patients with patellar tendinopathy (PT) receiving exercise therapy.</div></div><div><h3>Materials and methods</h3><div>This prospective study of 76 PT patients undergoing 24-week exercise therapy underwent baseline 3D UTE and PD MRI at 3.0 T. The patellar tendon segmentation used nnU-Net, evaluated with Dice coefficient. Six predictive models consisting of clinical covariates and radiomic features from UTE and PD were developed using Elastic Net with 10-fold cross-validation. Model performance in predicting responsiveness of the patient-reported Victorian Institute of Sports Assessment (VISA-P) score was evaluated using the area under the receiver operating characteristic curve (ROC AUC) and the precision-recall curve (PR AUC), with 95% confidence intervals.</div></div><div><h3>Results</h3><div>The mean Dice similarity coefficient for the automatic segmentation of the patellar tendon from 3D-PD was 0.92 (SD: 0.02) and from 3D-UTE-Cones 0.89 (SD: 0.03). The UTE-based radiomics model demonstrated the highest predictive performance at 24 weeks (ROC AUC: 0.714 [95% CI: 0.701–0.727]; PR AUC: 0.848 [0.837–0.858]), while the PD-based model showed the lowest (ROC AUC: 0.569 [0.553–0.584]; PR AUC: 0.710 [0.692–0.727]). At the 5-year follow-up, UTE radiomics maintained robust performance (ROC AUC: 0.692 [0.677–0.706]; PR AUC: 0.822 [0.810–0.834]), whereas PD radiomics remained limited (ROC AUC: 0.578 [0.561–0.594]; PR AUC: 0.694 [0.676–0.713]).</div></div><div><h3>Conclusions</h3><div>Radiomics features extracted from UTE MRI demonstrate the highest predictive performance for clinical outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112675"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997644","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

Longitudinal predictive value of MOLLI T1 mapping imaging for minimal clinically important difference after surgery for cervical spondylotic myelopathy MOLLI T1成像对脊髓型颈椎病术后最小临床重要差异的纵向预测价值。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-07 DOI: 10.1016/j.ejrad.2026.112660

Ruo-Yu Wang , Xiao-Dan Mu , Yu-Jin Zhang , Yi-Fei Peng , Yue Liu , Zi-Bo Wang , Wei Yan , Li Zhang

Objective

To investigate the predictive value of MOLLI T₁ mapping imaging for the longitudinal changes in Minimal Clinical Important Difference (MCID) after surgery for patients with Cervical Spondylotic Myelopathy (CSM).

Methods

A prospective study enrolled 163 surgically treated CSM patients (October 2022–October 2023). All underwent preoperative conventional MRI and MOLLI T₁ mapping. The MCID was determined based on the difference in Modified Japanese Orthopedic Association (m JOA) scores before and at 3, 6, and 12 months after surgery. Patients with an MCID less than 2 were defined as the poor prognosis group, while those with an MCID of 2 or higher were defined as the good prognosis group. Patients were classified into the good prognosis and poor prognosis groups at 3, 6,12 months postoperatively. The differences in conventional MRI features and T₁ values between the two groups at these time points were compared. Univariate and multivariate logistic regression identified recovery predictors, with forest plots generated. Receiver operating characteristic (ROC) curve analysis assessed diagnostic performance.

Results

At 3 months, (27 good vs 136 poor). Only T₂WI hyperintensity differed between groups [Area under the receiver operating characteristic curve (AUC)=0.597, cut off = 0.1942; sensitivity = 40.74 %, specificity = 78.68 %]. At 6 months (60 good vs 103 poor), T₁ values showed significance (AUC = 0.690, cut off = 0.3091; sensitivity = 83.33 %, specificity = 47.57 %). At 12 months (100 good vs 63 poor), T₁ values demonstrated superior prediction (AUC = 0.875,cut off = 0.6389; sensitivity = 75.00 %, specificity = 88.89 %).

Conclusion

MOLLI T₁ mapping effectively predicts CSM recovery at 6,12 months postoperatively, with optimal diagnostic performance at 12 months.

Critical relevance statement

This study first employs MRI T₁ mapping to predict MCID outcomes in CSM patients, demonstrating its high predictive value for favorable postoperative prognosis and providing a reliable imaging parameter for outcome assessment.

目的：探讨MOLLI T1成像对脊髓型颈椎病（CSM）患者术后最小临床重要差异（MCID）纵向变化的预测价值。方法：一项前瞻性研究，纳入163例手术治疗的CSM患者（2022年10月至2023年10月）。所有患者术前均行常规MRI和MOLLI T1制图。MCID是根据手术前、术后3个月、6个月和12个月修正日本骨科协会（m JOA）评分的差异来确定的。MCID小于2定义为预后不良组，MCID大于等于2定义为预后良好组。术后3、6、12个月分为预后良好组和预后不良组。比较两组在这些时间点的常规MRI特征和T1值的差异。单变量和多变量逻辑回归确定了恢复预测因子，并生成了森林样地。受试者工作特征（ROC）曲线分析评估诊断效果。结果：3个月时，27例良好，136例不良。两组间仅有T2WI高信号差异[受试者工作特征曲线下面积（Area under receiver operating characteristic curve， AUC）=0.597, cut off = 0.1942；敏感性= 40.74%，特异性= 78.68%。6个月时，T1值具有显著性（AUC = 0.690, cut off = 0.3091；敏感性= 83.33%，特异性= 47.57%）。在12个月时，T1值显示出较好的预测（AUC = 0.875,cut off = 0.6389；敏感性= 75.00%，特异性= 88.89%）。结论：MOLLI T1映射能有效预测术后6、12个月的CSM恢复情况，12个月时诊断效果最佳。关键相关性声明：本研究首次采用MRI T1定位预测CSM患者的MCID结局，显示了其对术后良好预后的高预测价值，为结局评估提供了可靠的影像学参数。

{"title":"Longitudinal predictive value of MOLLI T1 mapping imaging for minimal clinically important difference after surgery for cervical spondylotic myelopathy","authors":"Ruo-Yu Wang , Xiao-Dan Mu , Yu-Jin Zhang , Yi-Fei Peng , Yue Liu , Zi-Bo Wang , Wei Yan , Li Zhang","doi":"10.1016/j.ejrad.2026.112660","DOIUrl":"10.1016/j.ejrad.2026.112660","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the predictive value of MOLLI T<sub>1</sub> mapping imaging for the longitudinal changes in Minimal Clinical Important Difference (MCID) after surgery for patients with Cervical Spondylotic Myelopathy (CSM).</div></div><div><h3>Methods</h3><div>A prospective study enrolled 163 surgically treated CSM patients (October 2022–October 2023). All underwent preoperative conventional MRI and MOLLI T<sub>1</sub> mapping. The MCID was determined based on the difference in Modified Japanese Orthopedic Association (m JOA) scores before and at 3, 6, and 12 months after surgery. Patients with an MCID less than 2 were defined as the poor prognosis group, while those with an MCID of 2 or higher were defined as the good prognosis group. Patients were classified into the good prognosis and poor prognosis groups at 3, 6,12 months postoperatively. The differences in conventional MRI features and T<sub>1</sub> values between the two groups at these time points were compared. Univariate and multivariate logistic regression identified recovery predictors, with forest plots generated. Receiver operating characteristic (ROC) curve analysis assessed diagnostic performance.</div></div><div><h3>Results</h3><div>At 3 months, (27 good vs 136 poor). Only T<sub>2</sub>WI hyperintensity differed between groups [Area under the receiver operating characteristic curve (AUC)=0.597, cut off = 0.1942; sensitivity = 40.74 %, specificity = 78.68 %]. At 6 months (60 good vs 103 poor), T<sub>1</sub> values showed significance (AUC = 0.690, cut off = 0.3091; sensitivity = 83.33 %, specificity = 47.57 %). At 12 months (100 good vs 63 poor), T<sub>1</sub> values demonstrated superior prediction (AUC = 0.875,cut off = 0.6389; sensitivity = 75.00 %, specificity = 88.89 %).</div></div><div><h3>Conclusion</h3><div>MOLLI T<sub>1</sub> mapping effectively predicts CSM recovery at 6,12 months postoperatively, with optimal diagnostic performance at 12 months.</div></div><div><h3>Critical relevance statement</h3><div>This study first employs MRI T<sub>1</sub> mapping to predict MCID outcomes in CSM patients, demonstrating its high predictive value for favorable postoperative prognosis and providing a reliable imaging parameter for outcome assessment.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112660"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951523","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

MRI sign of venous varicosity aids in diagnosis of quadrilateral space syndrome: A comparative study 静脉曲张MRI征象对四边形间隙综合征诊断的比较研究。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-02-07 DOI: 10.1016/j.ejrad.2026.112716

Li Ying , Dawei Han , Liwei Ying , Danxiu Wang , Zilong Wang , Tao-Hsin Tung , Xiaobo Zhou , Qingguo Zhang

Background

The diagnosis of quadrilateral space syndrome (QSS) is difficult due to its vague symptoms and lacking of simple imaging signs. This study aimed to assess the diagnostic value of venous varicosity as an indirect MRI marker for QSS.

Methods

Two blinded independent observers compared MRI findings of venous varicosity at quadrilateral space between QSS patients and controls. Consecutive QSS patients from July 2023 to July 2024 were included. Consecutive normal subjects from January 2020 to July 2024 and rotator cuff tear patients from June 2024 to July 2024 were included in control group. Venous tortuosity, engorgement, and maximum venous diameter, were evaluated on coronal and sagittal slices. Tortuous and engorged veins were recognized as varicosities.

Study design: retrospective comparative study; level of evidence, 3.

Results

A total of 31 QSS patients were compared to 119 control subjects. The intraclass correlation coefficient (ICC) of intra-rater reliability for the first observer was 0.90 (95% CI, 0.85–0.94; p < 0.001) for venous tortuosity and 0.96 (95% CI, 0.93–0.98; p < 0.001) for venous engorgement. The ICC of intra-rater reliability for the second observer was 0.85 (95% CI, 0.78–0.90; p < 0.001) for venous tortuosity and 0.92 (95% CI, 0.87–0.95; p < 0.001) for venous engorgement. The ICC of inter-rater reliability was 0.85 (95% CI, 0.77–0.90; p < 0.001) for venous tortuosity and 0.82 (95% CI, 0.72–0.88; p < 0.001) for venous engorgement. There was significant difference in maximum venous diameter between QSS group and control group (3.0 ± 0.7 mm vs. 2.2 ± 0.5 mm, p < 0.001).

Conclusion

Venous varicosity posterior to the quadrilateral space on MRI is a simple and specific sign aiding in diagnosis of QSS.

背景：四边形间隙综合征（quadrilateral space syndrome， QSS）症状模糊，缺乏简单的影像学征象，诊断困难。本研究旨在评估静脉曲张作为QSS的间接MRI标志物的诊断价值。方法：两名独立的盲法观察者比较QSS患者和对照组四边形静脉曲张的MRI表现。纳入2023年7月至2024年7月连续的QSS患者。对照组为2020年1月至2024年7月连续正常受试者和2024年6月至2024年7月肩袖撕裂患者。在冠状面和矢状面切片上评估静脉曲度、充血和最大静脉直径。弯曲和充盈的静脉被认为是静脉曲张。研究设计：回顾性比较研究；证据水平，3。结果：QSS患者31例，对照组119例。第一观察者的组内相关系数（ICC）的组内信度为0.90 （95% CI, 0.85-0.94; p）结论：MRI上四边形间隙后静脉曲张是一种简单而特异性的征象，有助于诊断QSS。

{"title":"MRI sign of venous varicosity aids in diagnosis of quadrilateral space syndrome: A comparative study","authors":"Li Ying , Dawei Han , Liwei Ying , Danxiu Wang , Zilong Wang , Tao-Hsin Tung , Xiaobo Zhou , Qingguo Zhang","doi":"10.1016/j.ejrad.2026.112716","DOIUrl":"10.1016/j.ejrad.2026.112716","url":null,"abstract":"<div><h3>Background</h3><div>The diagnosis of quadrilateral space syndrome (QSS) is difficult due to its vague symptoms and lacking of simple imaging signs. This study aimed to assess the diagnostic value of venous varicosity as an indirect MRI marker for QSS.</div></div><div><h3>Methods</h3><div>Two blinded independent observers compared MRI findings of venous varicosity at quadrilateral space between QSS patients and controls. Consecutive QSS patients from July 2023 to July 2024 were included. Consecutive normal subjects from January 2020 to July 2024 and rotator cuff tear patients from June 2024 to July 2024 were included in control group. Venous tortuosity, engorgement, and maximum venous diameter, were evaluated on coronal and sagittal slices. Tortuous and engorged veins were recognized as varicosities.</div><div><strong>Study design</strong>: retrospective comparative study; level of evidence, 3.</div></div><div><h3>Results</h3><div>A total of 31 QSS patients were compared to 119 control subjects. The intraclass correlation coefficient (ICC) of intra-rater reliability for the first observer was 0.90 (95% CI, 0.85–0.94; p < 0.001) for venous tortuosity and 0.96 (95% CI, 0.93–0.98; p < 0.001) for venous engorgement. The ICC of intra-rater reliability for the second observer was 0.85 (95% CI, 0.78–0.90; p < 0.001) for venous tortuosity and 0.92 (95% CI, 0.87–0.95; p < 0.001) for venous engorgement. The ICC of inter-rater reliability was 0.85 (95% CI, 0.77–0.90; p < 0.001) for venous tortuosity and 0.82 (95% CI, 0.72–0.88; p < 0.001) for venous engorgement. There was significant difference in maximum venous diameter between QSS group and control group (3.0 ± 0.7 mm vs. 2.2 ± 0.5 mm, p < 0.001).</div></div><div><h3>Conclusion</h3><div>Venous varicosity posterior to the quadrilateral space on MRI is a simple and specific sign aiding in diagnosis of QSS.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112716"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164596","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

MRI features of molecular glioblastoma: morphological and advanced imaging insights 分子胶质母细胞瘤的MRI特征：形态学和高级影像学见解

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.ejrad.2026.112692

Margaux Roques , Kevin Pimentel , Aurore Siegfried-Vergnon , Elizabeth Moyal , Caroline Zerbib , Amaury de Barros , Magali Raveneau , Delphine Dghayem , Fabrice Bonneville

Objective

IDH-wildtype diffuse gliomas with molecular features of glioblastoma (mGBM) were integrated into the GBM category in the 2021 WHO classification, yet their MRI characteristics remain poorly described. This study aimed to detail morphological and advanced MRI features of mGBM to improve diagnostic accuracy and management.

Methods

MRI scans (1.5 T or 3 T) of 72 patients with histomolecularly confirmed mGBM were retrospectively reviewed. Two neuroradiologists analyzed morphological features (necrosis, contrast enhancement, FLAIR pattern, multilobar involvement) and advanced imaging findings (diffusion, perfusion).

Results

Mean patient age was 63 years. mGBMs showed a broad spectrum of MRI appearances, from grade 2-like (39%) to grade 4-like (26%). Infiltrative FLAIR hyperintensity was nearly constant, frequently with multilobar involvement (65%). Contrast enhancement was absent in 39% or faint/limited when present, often mimicking lower-grade gliomas. Gyriform cortical infiltration sparing white matter was seen in 15% of cases, less than previously reported. Advanced imaging showed diffusion restriction in 64% and elevated rCBV (>1.75) in 88% of cases with perfusion data, leading to reclassification of 22% of morphologically grade 2-like lesions as grade 3-like.

Conclusion

mGBMs often mimic low-grade gliomas, exposing patients to underdiagnosis and treatment delays. However, infiltrative FLAIR abnormalities, multilobar involvement, diffusion restriction, or increased perfusion should raise suspicion, particularly in older patients. This cohort describing both morphological and advanced MRI features of mGBM provides practical imaging criteria to enhance early recognition in routine practice.

具有胶质母细胞瘤分子特征的idh -野生型弥漫性胶质瘤（mGBM）在2021年WHO分类中被纳入GBM类别，但其MRI特征仍然缺乏描述。本研究旨在详细介绍mGBM的形态学和高级MRI特征，以提高诊断准确性和管理。方法回顾性分析72例经组织分子学证实的mGBM患者的smri扫描（1.5 T或3t）。两名神经放射学家分析了形态学特征（坏死、对比增强、FLAIR模式、多叶受累）和高级影像学表现（扩散、灌注）。结果患者平均年龄63岁。mGBMs表现为广谱MRI表现，从2级样（39%）到4级样（26%）。浸润性FLAIR高强度几乎不变，经常累及多叶（65%）。39%的患者没有增强或有增强时微弱/受限，常表现为低级别胶质瘤。脑回状皮层浸润保留白质的病例占15%，比以前报道的少。高级影像学显示64%的患者弥散受限，88%有灌注数据的患者rCBV升高（>1.75），导致22%形态学上2级样病变重新分类为3级样。结论mgbms通常与低级别胶质瘤相似，使患者面临诊断不足和治疗延误的风险。然而，浸润性FLAIR异常、多叶受累、扩散受限或灌注增加应引起怀疑，特别是在老年患者中。该队列描述了mGBM的形态学和高级MRI特征，为日常实践中的早期识别提供了实用的成像标准。

{"title":"MRI features of molecular glioblastoma: morphological and advanced imaging insights","authors":"Margaux Roques , Kevin Pimentel , Aurore Siegfried-Vergnon , Elizabeth Moyal , Caroline Zerbib , Amaury de Barros , Magali Raveneau , Delphine Dghayem , Fabrice Bonneville","doi":"10.1016/j.ejrad.2026.112692","DOIUrl":"10.1016/j.ejrad.2026.112692","url":null,"abstract":"<div><h3>Objective</h3><div>IDH-wildtype diffuse gliomas with molecular features of glioblastoma (mGBM) were integrated into the GBM category in the 2021 WHO classification, yet their MRI characteristics remain poorly described. This study aimed to detail morphological and advanced MRI features of mGBM to improve diagnostic accuracy and management.</div></div><div><h3>Methods</h3><div>MRI scans (1.5 T or 3 T) of 72 patients with histomolecularly confirmed mGBM were retrospectively reviewed. Two neuroradiologists analyzed morphological features (necrosis, contrast enhancement, FLAIR pattern, multilobar involvement) and advanced imaging findings (diffusion, perfusion).</div></div><div><h3>Results</h3><div>Mean patient age was 63 years. mGBMs showed a broad spectrum of MRI appearances, from grade 2-like (39%) to grade 4-like (26%). Infiltrative FLAIR hyperintensity was nearly constant, frequently with multilobar involvement (65%). Contrast enhancement was absent in 39% or faint/limited when present, often mimicking lower-grade gliomas. Gyriform cortical infiltration sparing white matter was seen in 15% of cases, less than previously reported. Advanced imaging showed diffusion restriction in 64% and elevated rCBV (>1.75) in 88% of cases with perfusion data, leading to reclassification of 22% of morphologically grade 2-like lesions as grade 3-like.</div></div><div><h3>Conclusion</h3><div>mGBMs often mimic low-grade gliomas, exposing patients to underdiagnosis and treatment delays. However, infiltrative FLAIR abnormalities, multilobar involvement, diffusion restriction, or increased perfusion should raise suspicion, particularly in older patients. This cohort describing both morphological and advanced MRI features of mGBM provides practical imaging criteria to enhance early recognition in routine practice.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112692"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074616","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