Radiologia Brasileira最新文献

Objective: To investigate the relationship between spinopelvic alignment and vertebral fracture in postmenopausal women with osteoporosis.

Materials and methods: This was a retrospective cross-sectional study including 93 women diagnosed with osteopenia or osteoporosis by densitometry between June 2017 and March 2018. Using the software Surgimap to analyze lateral X-rays of the spine and pelvis, we measured the following spinopelvic parameters: pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA), global tilt (GT), spinosacral angle (SSA), T1 pelvic angle (TPA), lumbar lordosis (LL), and thoracic kyphosis (TK). The spinopelvic parameters were assessed in relation to fracture occurrence by estimating prevalence ratios. Two groups (patients with and without fractures) were compared on the basis of their spinopelvic parameters. Vertebral fractures were graded by the Genant classification, and the spinal deformity index (SDI) was calculated as the sum of the grades. The SDI was found to correlate with spinopelvic parameters. Intraobserver and interobserver reliability for the measurement of the spinopelvic parameters was evaluated.

Results: The GT correlated significantly with the presence of fractures; the incidence of fracture was found to increase by 2.1% for every 1-degree increase in the GT. The presence of fractures was not found to correlate significantly with the SS, PT, PI, LL, TK, SVA, or SSA. The GT was significantly greater in the group with fractures than in the group without fractures. The SDI correlated significantly with global sagittal balance, as measured by the GT.

Conclusion: Fractures seem to be more prevalent among women with a higher GT. The SDI appears to correlate well with global sagittal balance, as assessed by the GT.

Objective: To comprehensively and impartially analyze the scientific evidence available for establishing diagnostic reference levels (DRLs) in interventional radiology.

Method: This was a systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search focused on studies related to interventional radiology and DRLs in PubMed/Medline and Embase. Studies involving computed tomography-guided procedures, studies with incomplete data, and systematic reviews were excluded. Two independent reviewers evaluated the studies, resolving discrepancies with a third reviewer. Articles were tabulated with information such as title, publication year, procedures, DRL values, and type of equipment used.

Results: A total of 475 articles were identified. After duplicates had been excluded and eligibility criteria had been applied, the final sample comprised 30 articles. Most DRL values (73%) were reported at the local level, as defined by International Commission on Radiological Protection criteria, representing typical dose values from a sample within one or a few institutions. A total of 113 procedures were identified, with endovascular aneurysm repair and nephrostomy being the most frequently reported. We identified DRLs at national and regional scales, predominantly within Europe. Influencing factors included technology, operator experience, specific protocols, and optimization strategies. The analysis also identified a lack of longitudinal studies assessing changes over time. The use of dose management software emerged as an effective tool for facilitating data collection and DRL establishment.

Conclusion: The lack of standardized procedural terminology hindered direct DRL comparisons. Our findings highlight a predominance of European studies and emphasize the need for broader international efforts to improve DRL implementation.

Objective: This study aimed to assess whether the evaluation of the central vein sign (CVS) and paramagnetic rim lesions (PRLs) using susceptibility-weighted magnetic resonance imaging (MRI) can distinguish multiple sclerosis (MS) from migraine.

Materials and methods: In this single-center observational study, we conducted a cross-sectional analysis of the CVS, determining the proportion of CVS-positive lesions per individual and absolute counts, using thresholds of 3 lesions (select3*) and 6 lesions (select6*), and of PRLs in participants with MS and in those with migraine, from 3.0-T MRI brain scans.

Results: The study included 20 participants with MS, 20 with migraine, and 20 included as healthy controls. The proportion of participants with CVS-positive lesions was higher in the MS group than in the migraine group (61.8% vs. 10.4%), and PRLs were observed exclusively in the MS group. The presence of at least one PRL and the select6* criterion demonstrated the highest diagnostic accuracy within the study sample.

Conclusion: The detection of the CVS and of a PRL on 3.0-T MRI scans may serve as a reliable biomarker to differentiate MS from migraine.

Objective: To evaluate the association between first-trimester screening for fetal growth restriction (FGR) and the effect of aspirin use as prophylaxis for this condition, as well as its effect on adverse maternal and perinatal outcomes. A secondary objective was to evaluate the association between a high risk of FGR and adverse perinatal outcomes.

Materials and methods: This was a retrospective cohort study of pregnant women who did or did not undergo first-trimester screening for FGR. Screening for FGR involved the evaluation of maternal characteristics, mean arterial pressure, and the results of uterine artery Doppler. Pregnancies with an estimated risk ≥ 1:155 were categorized as high risk, whereas those with an estimated risk < 1:155 were categorized as low risk.

Results: We evaluated 499 pregnant women who did not undergo first-trimester screening for FGR (unscreened group) and 615 who did (screened group). The risk of gestational hypertension was lower in the screened group, as evidenced by an adjusted odds ratio (aOR) of 0.24 (95% CI: 0.14-0.39; p < 0.001), as was the risk of spontaneous preterm birth at < 37 weeks of gestation (aOR: 0.22; 95% CI: 0.10-0.45; p < 0.001). The risk of delivery at < 32 weeks was higher in the screened group (aOR: 8.25; 95% CI: 1.05-65.71; p < 0.045) as was the risk of delivery at < 37 weeks (aOR: 5.91; 95% CI: 2.62-13.31; p < 0.001). Among all of the pregnancies at high risk of FGR (in both groups), there was an increased risk of delivery at < 32 weeks (3.1% vs. 0.2%; OR: 16.20; 95% CI: 2.20-190.90; p = 0.004), and at < 37 weeks (10.7% vs. 1.4%; OR: 8.41; 95% CI: 3.60-22.10; p < 0.0001). The use of aspirin was associated with a greater prevalence of gestational hypertension (8.0% vs. 2.1%; OR: 4.1; 95% CI: 1.77-10.10; p = 0.0014) and of a birth weight < 2,500 g (14.5% vs. 7.3%; OR: 2.14; 95% CI: 1.25-3.71; p = 0.009).

Conclusion: First-trimester screening for FGR seems to be associated with a higher risk of preterm birth (at < 32 and < 37 weeks). Pregnancies that are at high risk of FGR appear to also be at a higher risk of adverse perinatal outcomes. Aspirin use seems to be associated with a greater prevalence of developing gestational hypertension and of a birth weight < 2,500 g.

Systemic sclerosis (SSc) is a multifaceted autoimmune condition that leads to fibrosis in the skin and various internal organs, including the lungs. One of its most serious complications is interstitial lung disease (ILD), which has a profound impact on the prognosis and on patient quality of life. High-resolution computed tomography (HRCT) plays a critical role by offering detailed structural information, whereas positron-emission tomography/CT (PET/CT) provides a deeper understanding of disease activity by combining metabolic and anatomical data. Radiomics expands on those modalities, extracting subtle imaging features undetectable by visual analysis, thereby enabling superior diagnostic accuracy, staging, and prognostic accuracy. This review explores the current applications of radiomics in SSc-ILD, highlighting breakthroughs such as the integration of artificial intelligence for early ILD prediction and risk stratification. Studies have demonstrated that radiomics is efficacious in overcoming traditional diagnostic limitations, enhancing precision in identifying the patterns of usual interstitial pneumonia and monitoring disease progression. When applied to PET/CT, especially that using advanced tracers, radiomics can complement HRCT by identifying metabolic biomarkers of ILD activity, thus supporting personalized treatment strategies. Although radiomics holds significant transformative potential, its routine use in clinical practice still faces several obstacles, such as the need for standardization, validation, and consistency across institutions. Future efforts will be focused on combining radiomics with genetic and molecular data, developing artificial intelligence-driven longitudinal models, and adopting multimodal approaches to improve the management of SSc-ILD. These advances promise to drive a shift toward precision medicine, ultimately improving outcomes for patients with this complex disease.