Radiology Research and Practice最新文献

Background: To characterize volume reduction in benign solid and predominantly solid thyroid nodules during long-term ultrasound surveillance, and to describe distinct absorption patterns over time.

Methods: This retrospective study included 34 solid or predominantly solid thyroid nodules from 32 patients (median age, 46 years; 78.1% female), who underwent longitudinal ultrasound surveillance for a median of 28 months (interquartile range, 47-120 months). Volumetric measurements were obtained at multiple time points. Generalized additive mixed models (GAMMs) were employed to model nonlinear trends in volume over time. Unsupervised clustering was applied to identify representative regression trajectories based on individual volume curves. Clinical and ultrasound features were compared between trajectory-defined groups.

Results: All nodules exhibited measurable volume decrease over time (median reduction: 85.6%). Two representative volume change patterns were identified: a rapid-absorption group with early shrinkage and a slow-absorption group with gradual decline. Nodules in the latter were more frequently located in the lower pole and lacked Doppler flow at baseline (p < 0.05). Some nodules developed hypoechoic or stiff appearances over time, leading to higher TIRADS categories despite continuous shrinkage and no clinical signs of malignancy.

Conclusion: Solid and predominantly solid thyroid nodules can undergo significant volume reduction during long-term surveillance, resembling the well-documented absorption phenomenon of cystic nodules. This phenomenon may be underrecognized in clinical practice. Describing the diversity of volume change patterns may improve the understanding and interpretation of nodule evolution during follow-up.

Purpose: To evaluate the safety and efficacy of percutaneous transhepatic retrieval of dysfunctional plastic biliary stent (PBS).

Materials and methods: In this retrospective, single-center study, clinical and procedural data of 36 patients who underwent percutaneous transhepatic retrieval of dysfunctional PBS between January 2015 and April 2021 were analyzed. The primary outcomes were technical success, clinical success, complications, procedure time, and radiation exposure. The secondary outcomes were biochemical indicators (total bilirubin [TB], direct bilirubin [DB], glutamic transaminase [ALT], and CA-19-9) measured before treatment and two weeks posttreatment.

Results: Technical and clinical success were both 100%. Minor complications occurred in 4 cases (11.2%), including 3 hemobilia (Grade 1) and 1 mild cholangitis (Grade 2). The mean procedure time was 39.22 ± 9.34 minutes, with no statistical significance between benign and malignant disease groups ([40.52 ± 9.0] min vs. [38.91 ± 9.5], p = 0.68). The mean radiation exposure was 326.13 ± 206.06 mGy, with no statistical significance between benign and malignant groups ([353.64 ± 258.93] mGy vs. [319.49 ± 196.15] mGy, p > 0.75). Liver functions parameter improved significantly after 2 weeks (TB: [168.31 ± 53.07] vs. [41.70 ± 7.29] μmol/L, DB: [133.51 ± 46.42] vs. [25.39 ± 7.26] μmol/L, ALT: [94.67 ± 38.06] vs. [47.41 ± 13.69] U/L, and CA-19-9: [479.11 ± 160.14] vs. [150.72 ± 105.72] U/mL) (all p = 0.01).

Conclusion: This study suggests that percutaneous transhepatic retrieval of dysfunctional PBS appears to be a safe and effective alternative when ERCP is not feasible. However, given the retrospective single-center design, limited sample size, and short follow-up, larger multicenter studies with longer observation are needed to validate these findings.

Introduction: Spontaneous resorption of a herniated lumbar disc and disappearance of clinical symptoms without repair is a well-known but not well-studied phenomenon. This prospective study uses magnetic resonance images to search for predictors as to the possibility of spontaneous herniation resorption without any intervention and patients' predisposition to benefit from conservative treatment.

Materials and methods: Of the 125 patients examined by magnetic resonance imaging, 22 had clinical symptoms that spontaneously (without any intervention) disappear. The spinal condition of each was classified using Fardon's, Modic's, and Pfirman's classifications, and physical dimensions of the affected disc and herniated disc were measured. Inter- and intrareproducibility of this measurement were determined. Predictors for spontaneous disappearance of clinical symptoms were selected using multivariable logistic regression and receiver operating characteristic (ROC) analysis.

Results: The measurement uncertainty was less than four pixels for most parameters. Fardon's classification and middle height of the affected disc were the only clinically relevant parameters statistically proven to be predictors of clinical symptoms resolution (p < 0.01). By combining these appropriately, we are able to identify a group of patients who have up to 22.5 times greater chance of spontaneous regression compared to others (odds ratio = 22.5, p < 0.001).

Conclusion: By a suitable combination of the two parameters, we can select patients who are suitable candidates for conservative treatment of lumbar disc herniation and unlikely to require surgery.

The 19^th-century discovery of radiographic imaging techniques revolutionized healthcare, allowing doctors to indirectly "see" inside their living patients. It was not until the mid-20^th century that mutagenic effects from radiation exposure became a topic of concern. Since then, healthcare providers, scientists, and regulatory agencies have battled the question, "Does radiation exposure from radiographic imaging increase the risk of developing cancers and heritable conditions?" With no established answer, physicians must rely on the available evidence when assessing the risk versus benefit of having their patients x-rayed. This review aims to gather and consolidate the available evidence so physicians can make informed decisions when ordering tests that use x-rays. Popular topics such as the linear-no-threshold (LNT) model, radiation hormesis, and the as-low-as-reasonably-achievable (ALARA) principle are covered. Epidemiology studies, x-ray physics, and related basic sciences are reviewed.

Objective: Accurate meniscal tear diagnosis is essential for proper knee injury management. While MRI is the gold standard, ultrasound (US) offers a cost-effective alternative. However, its accuracy compared to arthroscopy remains uncertain. This study evaluates the diagnostic performance of US versus MRI, using arthroscopic outcomes as the benchmark for meniscal tear detection.

Methods: A prospective cohort study was conducted on 208 patients aged 18-60 years with suspected meniscal injuries. Each patient underwent both US and MRI, with findings compared to arthroscopy, the gold standard for confirmation. Clinical, imaging and arthroscopic data were systematically recorded and analysed for sensitivity, specificity and diagnostic agreement. The McNemar test was used to assess differences in sensitivity and specificity between US and MRI, while the κ coefficient evaluated the agreement between US, MRI and arthroscopy.

Results: MRI demonstrated higher diagnostic accuracy (91.83%) compared to US (84.62%) in detecting meniscal tears, using arthroscopy as the gold standard. MRI showed superior sensitivity (96.19% vs. 86.67%), specificity (87.38% vs. 82.52%) and agreement (κ = 0.836 vs. 0.692), with a significant difference compared to arthroscopy (p=0.049).

Conclusion: Overall, MRI demonstrated superior diagnostic accuracy, sensitivity and specificity compared to US, suggesting that it is a more reliable imaging modality for detecting meniscal tears when arthroscopy is not feasible. In addition, US limitations in detecting complex tear patterns highlight the need for further refinement of US techniques.

The posterior fossa anomaly known as mega cisterna magna (MCM) is defined as an enlarged cisterna magna that is more than 10 mm in the anteroposterior dimension, without concomitant vermian or cerebellar malformations. Although this condition is usually discovered incidentally during prenatal or neuroimaging examinations, its clinical significance and long-term effects are still being studied and discussed. The prognosis and treatment of MCM depend on its differentiation from other posterior fossa malformations, including Blake's pouch cyst, Dandy-Walker variant, and arachnoid cysts. In addition to exploring debates surrounding MCM and potential clinical applications, this review attempts to summarize the state of knowledge currently available on the anatomical, embryological, clinical, and radiological aspects.

Background: Sternal foramina are congenital anomalies arising from incomplete fusion of sternal ossification centers. They are often clinically silent but can pose risks during sternal procedures because of their proximity to critical mediastinal structures. Large-scale postmortem computed tomography (CT) studies of their prevalence in Japanese populations are limited, and their developmental origins remain elusive. We aimed to investigate the development, prevalence, and anatomical characteristics of sternal foramina in a large Japanese cohort using postmortem CT.

Methods: We retrospectively reviewed postmortem CT scans from 1503 adults (1021 males, 482 females; age range: 20-96 years) and 92 pediatric cases (age range: 0-8 years). In adults, we assessed prevalence, sex distribution, location, diameter, and adjacent structures. In pediatrics, ossification patterns of the third and fourth sternebral segments were evaluated to explore developmental contributions to foramen formation.

Results: Sternal foramina were present in 3.7% of adults. They were more frequent in males (4.3%) than in females (2.5%), although the difference was insignificant. Most foramina were located at the level of the fifth costal notch and overlaid the pericardium or lung in 72% of evaluable cases. The median diameter was 4.5 mm. In pediatric cases, 11 (12%) exhibited lower-sternebral ossification-center patterns that could form sternal foramina, supporting a developmental origin. An estimated 31% of these patterns may persist into adulthood with unfused segments.

Conclusion: Sternal foramina occurred in 3.7% of adults and were often situated over vital structures, posing procedural risks. Among pediatrics, ossification patterns that may impede fusion-defined as horizontal two-center or ≥ 3 center configurations-were present in 12%, and approximately 31% of these patterns appear to persist into adulthood as sternal foramina. These findings support a developmental basis for sternal foramina and emphasize the importance of recognizing them during imaging and procedural planning.

Background: Currently, there is no standard normal tonsillar measurement using ultrasound (US) which can be used for comparison with an abnormal palatine tonsil in clinical practice. Objectives: In this study, we aim to estimate normal palatine tonsil size using US in children who have no tonsillar-related disease in TASH, Addis Ababa, Ethiopia. Methods: A prospective cross-sectional study was conducted at TASH. The study was conducted on patients under age of 18 years who visit the hospital for complaints unrelated to tonsillar diseases from May 26-September 30, 2023. A structured research tool was used to collect all the necessary data from participants selected by convenience sampling. Data were entered and analyzed using SPSS Version 27 software. Results: A total of 265 patients were enrolled in the study in the age range of 0-18 years. The mean palatine tonsillar volume ± SD for the right palatine tonsil was 0.97cm³ ± 0.55 and it was 0.97cm³ ± 0.56 for the left tonsil. We did not identify any significant correlation between PT values and sex as well as the side of palatine tonsil measured. We detected a significant positive correlation between PT values and height, weight, and body mass index (BMI), height having the strongest correlation and BMI the least. Relative contribution of anthropometric parameters to tonsil size varies with age: height is more influential in younger children and weight in early childhood, whereas evidence for BMI influence in older individuals is inconclusive. Conclusion: Normal tonsillar sizes on transcervical US can be used to aid diagnosis of tonsillar pathologies. Palatine tonsil size correlates with age, height, weight, and BMI; however, no correlation is present for sex and side. Age-specific anthropometric profiles and ethnic population differences also contribute to variability in palatine tonsil size measurements and should be carefully considered when interpreting normal tonsil dimensions.

Background: Idiopathic interstitial pneumonias (IIPs) are widespread interstitial lung diseases with no known cause. The diseases are characterized by a steady decline in lung function. Objective: To assess the patterns of IIPs and investigate the correlation between the extents of lung involvement on high-resolution computed tomography (HRCT) with spirometric findings in Tikur Anbessa Specialized Hospital (TASH) chest clinic, covering the period from February 2020 to February 2023. Methods: An institution-based retrospective, descriptive, and cross-sectional study design was used. This study included all cases diagnosed with IIPs that underwent HRCT and spirometry within a 3-month window. Finally, we used the Pearson correlation test with a 2-tailed significance of less than 0.05 as a cutoff. Then the information is presented using simple frequencies, summary measures, tables, and figures. Result: There were 54 patients diagnosed with IIP. The overall median age of the patients was 53.9 ± 15.4. Nonspecific interstitial pneumonia (NSIP) was the most common interstitial lung disease diagnosed. Ground-glass opacity (GGO) was the most dominant HRCT feature identified. Pearson correlation tests (p < 0.05) were used to examine the correlation between lung involvement and spirometry parameters, as well as pulse oximetry-measured oxygen saturation. All spirometry parameters, forced vital capacity (FVC), forced expiratory volume at 1 min (FEV1), peak expiratory flow (PEF), forced expiratory flow (FEF) 25%-75%, and oxygen saturation, demonstrated a significant negative correlation with lung involvement. The strongest correlations were observed with FVC (r = -0.827) and FEV1 (r = -0.789), both with p < 0.001. Oxygen saturation showed a moderate correlation (r = -0.49, p < 0.001), while PEF and FEF 25%-75% exhibited weak correlations (r = -0.39, p=0.003, and r = -0.38, p=0.005, respectively). Conclusion and Recommendations: There was a significant negative correlation between FVC and FEV1 and the extent of lung involvement identified by HRCT in IIPs suggesting a pivotal role of pulmonary function tests (PFTs), specifically FVC, in monitoring IIP progression, supported by HRCT for diagnostic clarity. To enhance IIP patient care, routine PFTs, particularly FVC, are recommended for monitoring.

Objective: This study aimed at assessing the value of a variety of ultrasound criteria for grading carpal tunnel syndrome (CTS) severity. Methods: Ultrasound evaluations were conducted on confirmed CTS patients by an experienced radiologist, blinded to NCS results. Cross-sectional area (CSA) at pronator quadratus muscle, carpal tunnel inlet and outlet, echogenicity, transverse motion during flexion, flattening ratio, and thickening of the flexor retinaculum were measured. Results: Decreased echogenicity of the median nerve was notably observed as a distinguishing feature between mild and moderate cases. Decreased nerve movement was significantly more prevalent in severe CTS cases. No significant differences were found in the median nerve flattening ratio or flexor retinaculum thickness. Bowing at the inlet showed significant differences. CSA at the inlet and outlet indicated severe CTS with significant differences. Conclusion: The findings highlight the importance of using multiple sonographic criteria for accurate diagnosis and treatment, although no significant differences were noted in the median nerve flattening ratio and flexor retinaculum thickness.