World journal of radiology最新文献

Background: Spinal cord injury can lead to long-term disability, but current imaging methods are limited in predicting outcomes. Rapid diffusion tensor imaging (DTI) has shown promise, yet its clinical utility remains underexplored.

Aim: To evaluate the potential applications of a short DTI sequence, incorporated into a cervical spine magnetic resonance imaging (MRI) protocol, for characterizing a range of symptomatic spinal cord pathologies. We propose that cervical spine tractography can provide essential diagnostic information beyond what is currently available from conventional MRI.

Methods: We utilized a quick DTI sequence to create tractography models of the cervical spinal cord in four patients with distinct pathologies of various etiologies: Cord contusion, metastasis, myelopathy, and multiple sclerosis. We used DSI Studio software for post-processing of tractography cases. Fiber tract findings for each pathology case were compared to five control cases from the same scanner by looking for individual differences in white matter tract integrity based on the fractional anisotropy (FA) and mean diffusivity (MD) of the regions of interest from controls. These correlated with clinical presentations and conventional MRI findings.

Results: Control cases showed consistent and intact tract patterns with stable FA and MD values. In pathological cases, abnormalities in fiber orientation and tract continuity correlated with clinical symptoms and lesion locations.

Conclusion: The tractography models can provide additional information on white matter disruption that was not discernible on standard MRI sequences. However, its clinical use remains limited due to the need for specialized imaging protocols and complex post-processing, restricting its use to mostly academic settings.

Background: Pre-eclampsia is a significant challenge in obstetric care and adversely affects the feto-maternal outcomes, causing significant perinatal morbidity and mortality. Early detection of women at higher risk of developing pre-eclampsia in the first trimester provides a vital opportunity to initiate timely prophylactic therapies. First-trimester uterine artery Doppler is gaining prominence as a promising tool in early risk stratification.

Aim: To assess the role of uterine artery Doppler in screening for pre-eclampsia at 11-14 weeks of gestation.

Methods: Pregnant women attending routine antenatal care between 11 weeks and 14 weeks of gestation and undergoing first-trimester nuchal translucency screening were offered enrolment in the study. After calculating gestational age from the last menstrual period or fetal biometry (crown-rump length), Doppler ultrasound of bilateral uterine arteries was performed, and relevant Doppler parameters were recorded. Patients were followed until delivery for development of preeclampsia.

Results: Out of a total of 342 participants, 42 women (12.28%) developed preeclampsia, while the remaining 300 women (87.71%) had a normal pregnancy without preeclampsia. The mean uterine artery pulsatility index was significantly elevated in the pre-eclampsia group (1.9455 ± 0.36) compared to the normal group (1.474 ± 0.52) (P < 0.001). Using a pulsatility index threshold of 1.622, the receiver operating characteristic curve analysis demonstrated a sensitivity of 75% (95% confidence internal: 0.66-0.82), specificity of 86% (95% confidence internal: 0.78-0.91), positive predictive value of 84.27%, and negative predictive value of 77.48% with a diagnostic accuracy of 80.5%. The area under the curve was 0.896, indicating good diagnostic performance. Uterine artery notching was observed in 88% of the pre-eclampsia group compared to 16% in the control group, a difference that was statistically significant (P < 0.001).

Conclusion: Uterine artery Doppler in the first trimester at 11-14 weeks of gestation showed a good diagnostic value for forecasting the development of pre-eclampsia and holds promise as a valuable tool for early risk stratification.

Background: Thermal ablation (TA) has been proved to be effective and safe as minimally invasive treatment method for thyroid nodules. However, patients' experience during the procedures and quality of life varies among operators.

Aim: To explore strategy to improve quality of life and subjective experiences during TA for papillary thyroid carcinoma (PTC) based on thermal field management (TFM).

Methods: This retrospective propensity-matched cohort study was conducted in a single center. A total of 490 patients with PTC treated with TA from September 2023 to August 2024 were studied and divided into two groups (TFM group and non-TFM group) according to treatment strategies. Propensity score matching (PSM) was used to control for confounding factors. Complications, side effect and complaints of patients were compared between the two groups.

Results: A total of 113 patients (41.7 ± 10.6; 31 men, 82 women) were assigned to the TFM group, and 377 patients (mean age, 41.1 ± 10.7 year; 116 men, 261 women) were assigned to the non-TFM group. After PSM, a total of 108 patients were included in the TFM group, and 216 patients were included in the non-TFM group. The median follow-up was 10 months (range from 4-15 months). The incidence of voice change in the TFM group was significantly lower than that in the non-TFM group (0.9% vs 6.5%; P = 0.049). Although there was no statistically significant difference in rate of pain between the two groups, the proportion of complaining of pain in the TFM group was numerically lower than that in the non-TFM group (3.7% vs 9.7%, P = 0.090).

Conclusion: TFM, as a novel procedural optimization technique, can effectively improve quality of life and subjective experiences of patients during TA for PTC.

Endoscopic retrograde cholangiopancreatography (ERCP) is a cornerstone procedure for the diagnosis and management of pancreatic and hepatobiliary diseases. Although its diagnostic role has been increasingly supplanted by noninvasive imaging modalities such as magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography, the therapeutic applications of ERCP have continued to expand. ERCP is widely used and has a generally favorable safety profile. However, it is important to recognize expected post-procedural imaging findings and serious complications that can arise. The increasing complexity of therapeutic interventions and the growing volume of procedures have led to a higher incidence of complications that often present with overlapping clinical and laboratory features, underscoring the critical role of imaging in differential diagnosis. This review focused on the typical normal ERCP findings and the imaging characteristics of common complications, including pancreatitis, bleeding, ERCP-related infections, perforations, and stent-related complications. Computed tomography (CT) is particularly valuable in timely recognition, management, and surgical decision-making for these complications. Furthermore, MRI offers a radiation-free alternative for managing complications in selected patients. Therefore, radiological modalities, particularly CT and MRI, are critical tools for the rapid diagnosis, management, and surgical decision-making processes for post-ERCP complications.

Background: Endometrial peristalsis (EmP) has been considered as a new indicator for evaluating endometrial receptivity and is associated with embryo implantation rate and successful pregnancy rate. However, EmP remains understudied, inconsistently measured, and poorly understood. New methods are needed urgently for better clinical practice.

Aim: To explore the value of EmP analysis (EmPA) technique in detecting and analyzing EmP features automatically and quantitatively.

Methods: One hundred and forty-five patients without abnormal findings on conventional transvaginal ultrasound were included in this study. A mid sagittal plane of uterus was recorded for 2 minutes in each patient and EmP features were analyzed using EmPA technique. EmP features in 50 patients were also analyzed by naked eyes analysis and the results of two methods were compared.

Results: EmPA was unsuccessful in 9 patients (9/145, 6.21%) due to the interference of respiratory or intestinal movement and was successful in 136 patients (136/145, 93.79%), of whom 21 patients showed no EmP and 115 patients underwent EmPA and obtained quantitative results. The results of EmPA technique and naked eyes analysis about EmP intensity and transfer time had no significant consistence. Menstrual cycle, uterine position and history of induced abortion affected the quantitative results of EmPA.

Conclusion: EmPA technique provides noninvasive, quantitative and accurate detection and analysis of EmP in normal population and can evaluate EmP changes associated with menstrual cycle, uterine position and history of induced abortion.

Male breast disorders, though less prevalent, present unique diagnostic challenges that differ significantly from their female counterparts. While benign entities such as gynecomastia are predominant, the risk of underlying malignancy, often diagnosed at an advanced stage, highlights the need for a systematic, image-guided assessment. Ultrasound and mammography are the first-line complementary tools, with magnetic resonance imaging reserved for problem-solving. This review outlines the anatomical, pathological, and radiological nuances of the male breast, describing crucial red flag signs, sonographic pitfalls, and mammographic mimics that aid in distinguishing benign entities from sinister pathologies such as invasive ductal carcinoma. Given the increasing visibility of transgender individuals, this review also addresses imaging considerations and screening recommendations tailored to this population. By integrating clinical insights with radiologic imaging, this review offers a comprehensive approach to both common and not-so-common male breast lesions, with an emphasis on an algorithmic stepwise diagnostic approach.

Thyroid nodules are common, with a prevalence of approximately 70% on thyroid ultrasonography; approximately 5% of these nodules are malignant. Distinguishing malignant and benign thyroid nodules is critical for clinical management. Clinicians can judiciously select patients for fine-needle aspiration, understand the cytology results and subsequent follow-up, and determine surveillance strategies for non-operated nodules. The challenge in selecting thyroid nodules for fine-needle aspiration is to avoid the diagnosis of small, clinically insignificant cancers without missing more severe diseases. The molecular characteristics of thyroid nodules are critical for their diagnosis and treatment. However, identifying these characteristics is costly and challenging because of unexpected technical difficulties. An imaging association model based on molecular features will bridge the essential link between molecular characteristics and the computed tomography radiomics, then improve diagnostic efficiency, reducing invasive examinations.

Background: Endometrial cancer (EC) is the most common gynecological malignancy in high-income countries, with incidence rates rising globally. Early and accurate diagnosis is essential for improving outcomes. Transvaginal ultrasound (TVUS) remains a cost-effective first-line tool, and emerging techniques such as three-dimensional (3D) ultrasound (US), contrast-enhanced US (CEUS), elastography, and artificial intelligence (AI)-enhanced imaging may further improve diagnostic performance.

Aim: To systematically review recent advances in US-based imaging techniques for the diagnosis and staging of EC, and to compare their performance with magnetic resonance imaging (MRI).

Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was performed to identify studies published between January 2010 and March 2025. Eligible studies evaluated TVUS, 3D-US, CEUS, elastography, or AI-enhanced US in EC diagnosis and staging. Methodological quality was assessed using the QUADAS-2 tool. Sensitivity, specificity, and area under the curve (AUC) were extracted where available, with narrative synthesis due to heterogeneity.

Results: Forty-one studies met the inclusion criteria. TVUS demonstrated high sensitivity (76%-96%) but moderate specificity (61%-86%), while MRI achieved higher specificity (84%-95%) and superior staging accuracy. 3D-US yielded accuracy comparable to MRI in selected early-stage cases. CEUS and elastography enhanced tissue characterization, and AI-enhanced US achieved pooled AUCs up to 0.91 for risk prediction and lesion segmentation. Variability in performance was noted across modalities due to patient demographics, equipment differences, and operator experience.

Conclusion: TVUS remains a highly sensitive initial screening tool, with MRI preferred for definitive staging. 3D-US, CEUS, elastography, and AI-enhanced techniques show promise as complementary or alternative approaches, particularly in low-resource settings. Standardization, multicenter validation, and integration of multi-modal imaging are needed to optimize diagnostic pathways for EC.

Cardiac arrest is associated with high rates of mortality and significant long-term neurological disability in survivors. Timely and accurate assessment following successful resuscitation is critical for optimizing outcomes. Imaging plays a central role in this evaluation process, providing crucial insights into the etiology of arrest, the extent of cerebral and cardiac injury, and guiding both acute management and long-term prognostication. A structured, multimodal imaging approach utilizing tools such as computed tomography, magnetic resonance imaging, echocardiography, and angiography is increasingly recognized as essential in the post-cardiac arrest setting. This review aims to consolidate current evidence related to the use of various imaging modalities across neurological, cardiac and systemic contexts. Particular emphasis is placed on the prognostic value and optimal timing of neuroimaging, the detection of potentially reversible causes of arrest, such as coronary occlusion or pulmonary embolism, and the emerging role of whole-body imaging in evaluating patients with non-traumatic out-of-hospital cardiac arrest.