Radiographics最新文献

It is essential to identify vascular anomalies of the thorax because of their potential association with congenital heart diseases and genetic abnormalities. Although some patients present with symptoms early in childhood, others remain asymptomatic until adulthood. However, certain anomalies can impact the prognosis significantly and necessitate tailored treatment strategies. Moreover, understanding the embryologic origins and anatomic variations of each vasculature is paramount because many of these anomalies arise from disruptions in the developmental process and can coexist simultaneously. The authors describe the embryology, anatomy, and specific imaging findings of each vascular anomaly in two primary systems: pulmonary circulation and systemic circulation. Within the pulmonary circulation, conditions explored are unilateral absence of the pulmonary artery, aberrant pulmonary artery (pulmonary sling), partial anomalous pulmonary venous return, total anomalous pulmonary venous return, and anomalous unilateral single pulmonary vein. For systemic circulation, the anomalies reviewed are double aortic arch, aberrant right subclavian artery, right aortic arch, aberrant left subclavian artery, Kommerell diverticulum, patent ductus arteriosus, persistent left superior vena cava, and azygos continuation of the inferior vena cava. By thoroughly examining these conditions alongside their imaging findings and embryologic backgrounds, radiologists and clinicians can gain the expertise required for precise diagnosis and effective management in patients with thoracic vascular anomalies. ^©RSNA, 2025 Supplemental material is available for this article.

Familial pulmonary fibrosis (FPF) represents a subset of patients with interstitial lung disease that can be a diagnostic dilemma for the clinician and radiologist. Diagnosis can be challenging, as the age at presentation and penetrance can vary even among family members. In fact, many of these diseases have been only recently discovered with improved gene sequencing. In addition, imaging patterns are often unclassifiable, and there can be a wide range of extrapulmonary symptoms such as bone marrow and liver failure, which can further obscure the diagnosis. Given that these patients have an overall worse prognosis than that of sporadic cohorts, accurate and early diagnosis is pivotal. The authors review the general concepts of FPF and highlight the known key mutations implicated in FPF, including those that cause abnormal surfactant function, premature shortening of telomeres, and other specific genetic syndromes such as dyskeratosis congenita, Hermansky-Pudlak syndrome, and coatomer-associated protein α syndrome. The clinical presentations and imaging findings are also highlighted. The authors raise awareness of FPF among radiologists who may encounter this entity when interpreting imaging or participating in multidisciplinary conferences. ^©RSNA, 2025 Supplemental material is available for this article.

Although lymphoscintigraphy is most commonly used for sentinel lymph node mapping, it can also be helpful for evaluating lymphedema, lymphatic malformations, lymphatic leaks, chylous ascites, and chylothorax. Assessment for lymphedema is important because this condition poses significant clinical challenges, and early diagnosis is essential for timely intervention and prevention of complications. Lymphoscintigraphy is a valuable radiologic tool for distinguishing lymphatic causes of edema from nonlymphatic ones, with findings of lymphedema including absent, asymmetric, or delayed drainage from the injection site; dermal backflow; and reduced activity in the inguinal or axillary lymph nodes at lower extremity and upper extremity lymphoscintigraphy. Other supporting evidence of lymphedema may include collateral lymphatic channels and visualization of the deep lymphatic nodes. Additional imaging modalities, such as fluorescence lymphangiography, US, and MR lymphangiography, can also aid in lymphedema assessment. The authors provide an overview of lymphatic physiology, image acquisition, and image interpretation. ^©RSNA, 2025.

Interventional radiologists are key members of the multidisciplinary team involved in the care of patients with primary or metastatic neoplastic disease in the thorax. Percutaneous ablation is a safe and efficacious treatment of lung tumors, especially for patients with medical comorbidities or oligometastatic disease. Endovascular approaches can benefit patients with thoracic oncologic disease by allowing for primary arterial treatment, preoperative embolization, or embolization for tumor-related hemoptysis. Drainage and shunt procedures can help alleviate symptoms in patients with malignant pleural effusions, chylothoraces, and pericardial effusions. The authors summarize several available minimally invasive interventions to the thorax for tumor treatment and symptom palliation. ^©RSNA, 2025.

Three-dimensional (3D) US is an invaluable, rapidly evolving tool in gynecologic imaging. This examination, comparable to CT and MRI, enables volumetric data to be obtained, reconstructed, and displayed in multiple planes. It also enables the sonologist to better understand the spatial and anatomic relationships of uterine and adnexal abnormalities, thereby improving diagnostic accuracy. Three-dimensional US can be performed routinely following a two-dimensional (2D) transabdominal and/or transvaginal US examination or as an adjunctive troubleshooting technique, since no additional patient preparation is necessary. Performing additional 3D imaging adds only a few minutes to the original examination time while yielding information that is useful for reaching a diagnosis. Multiplanar reconstruction of volumetric data in the midcoronal plane is the cornerstone for diagnosing congenital uterine anomalies, as it allows visualization of the external uterine contour and shape of the endometrial cavity. It also enables early detection of endomyometrial junction abnormalities such as adenomyosis and focal adenomyomas. Combined with 3D power Doppler imaging, 3D US may help differentiate endometrial polyps, submucosal fibroids, endometrial hyperplasia, and endometrial carcinoma, aiding in clinical decision making. This examination also facilitates accurate localization of fibroids relative to the endometrial cavity and serosal surface of the uterus. The authors review the technique for acquisition of 3D volume datasets, image reconstruction, and new software techniques for data postprocessing that are applicable to gynecologic imaging. In addition, scenarios in which the addition of 3D US provides an advantage over routine 2D US, including imaging of congenital uterine anomalies, fibroid localization, and differentiation of endometrial diseases, are highlighted. ^©RSNA, 2025 Supplemental material is available for this article.