Journal of the Belgian Society of Radiology最新文献

Background: Varicocele is a common condition in men that can lead to several clinical problems. Treatment modalities include surgical and non‑surgical methods. There has been no randomized controlled trial proving the superiority of one treatment approach over another. Materials and methods: We conducted an 8‑year retrospective analysis of varicocele embolization procedures at our department of Interventional Radiology. Demographic data, procedure details, procedure success and complications were collected. Telephone interviews were also conducted at the time of the study. Results: A total of 182 interventions were performed. Median age of patients at presentation was 31 years (range, 12-71). Median follow‑up duration was 44.5 months (range, 3.4-106.9). Employed embolic agents were coils in 171/182 (91.94%) cases. Technical success rate was 88.15%. Ultrasonographic success was accomplished in 44.87% patients. Clinical success rate in patients referred for scrotal pain was 70.42%. Fluoroscopy time was 20.3 ± 14.9 min (mean ± SD), dose area product was 63.2 ± 50.5 Gy∙cm² (mean ± SD) and kinetic energy released per unit mass was 193.2 ± 173.6 (mean ± SD). Minor complications were encountered in 19/182 (10.45%) of the interventions. Conclusions: Varicocele embolization was found to be an efficient and safe procedure for patients referred for scrotal pain. Randomized controlled trials are warranted to elaborate treatment algorithms in varicocele patients.

Background: We assess the clinical outcomes and utility of cone‑beam computed tomography (CBCT) during transcatheter arterial embolization (TAE) in patients with malignant intractable hematuria, related to lower urinary tract malignancy. Methods: A total of 22 consecutive patients (20 males and 2 females; age 71.8 ± 9.6 years) underwent CBCT during TAE for malignant intractable hematuria from May 2023 to August 2024. CBCT was performed on both internal iliac arteries for selective imaging. Contrast‑enhanced three‑dimensional (3D) images were acquired during breath‑hold for embolization planning, with automated feeder detection aiding vessel visualization. Follow‑up CT was performed 2-3 months after TAE, and regular visits monitored hematuria recurrence and treatment effects. Results: In all, 27 TAE procedures were performed in 22 patients, including those with bladder and prostate cancers. Technical success was achieved with all procedures. Clinical improvement in hematuria was observed in 86.4% of patients within 2 days. Five patients required re‑intervention, and all improved. Significant changes were noted in hemoglobin, heart rate, transfusion, and tumor size, with 85.7% showing tumor reduction on follow‑up imaging. CBCT provided valuable information in 52.1% cases, leading to treatment plan adjustments, particularly in identifying additional feeders and enabling superselective embolization. No major complications were reported. Conclusion: TAE is a safe and effective treatment for malignant intractable hematuria, leading to significant clinical improvement. CBCT further enhances TAE by providing crucial imaging that optimizes the embolization process.

Teaching point: Although computed tomography (CT) is the diagnostic gold standard for acute subdural hematoma, the absence of clear trauma should prompt the use of computed tomography angiography (CTA) to identify potential underlying causes, such as ruptured aneurysms, which can significantly influence treatment decisions.

Teaching point: To highlight the potential complications associated with AQUAfilling injections, emphasizing the importance of early detection and proper management.

Teaching point: Spectral tomography offers valuable complementary diagnostic tools in the setting of cerebral fat macroembolism, a rare condition often presenting with nonspecific clinical symptoms.

Key message: Patients with polysplenia syndrome can develop pulmonary hypertension and heart failure due to underlying congenital heart disease, underscoring the need for early recognition and intervention to prevent further progression of the condition.

Objectives: This study aims to assess the performances of T1‑weighted (T1W) and T2‑weighted (T2W) Dixon sequences as replacements for the standard magnetic resonance imaging (MRI) protocol for diagnosing active and chronic sacroiliitis. Materials/Methods: This single‑centre, prospective study included 107 patients who underwent 3 Tesla MRIs. The patients with inflammatory low‑back pain (aged 18-50 years) were included. The exclusion criteria included pregnancy, pelvic infection/malignancy history, pelvic metal implants or foreign body artefacts. The imaging protocol comprised standard T1W and T2W fat‑saturated (T2W‑FS) sequences and T1W-T2W Dixon sequences. Active sacroiliitis signs were assessed by comparing T2W‑FS images with T2W Dixon water‑only (WO) images. Chronic sacroiliitis signs were evaluated by comparing the standard T1W sequence with T1W-T2W Dixon fat‑only (FO), in‑phase (IP) and out‑of‑phase (OP) images. The quantitative analysis involved calculating signal‑to‑noise ratios (SNRs) and contrast‑to‑noise ratios (CNRs) for bone marrow edema (BME) and periarticular fat deposition (PFD). Descriptive statistics, correlation, diagnostic performance tests and interobserver reliability tests were performed in the qualitative analysis. Results: There were no statistically significant differences in BME detection between the T2W‑FS and T2W Dixon‑WO images. T2W Dixon exhibited significantly greater SNRs-CNRs than did the standard protocol for BME and periarticular fat deposition assessments. T1W-T2W Dixon imaging demonstrated sufficiently high diagnostic performance for detecting erosions, periarticular fat deposition and ankylosis compared with the standard protocol. Conclusions: The T2W Dixon sequence has the potential to replace the standard protocol, which would reduce acquisition time. However, we do not recommend the use of the T1W Dixon sequence in routine practice, since standard T1W images provide similar or superior results to T1W Dixon images.

Rhabdomyosarcoma is the most common soft tissue sarcoma in children but is less frequent in adults, with the head and neck region as primary site. Magnetic resonance imaging (MRI) is the preferred diagnostic imaging tool, though its imaging characteristics are relatively non‑specific and overlap with other soft tissue sarcomas. The prognosis of rhabdomyosarcoma depends on the primary tumour site and size, with parameningeal head and neck localisations having a less favourable prognosis due to the higher risk of spread. Therefore, further imaging including brain and spinal MRI is recommended. Teaching point: The prognosis of rhabdomyosarcoma depends on the primary tumour site and size, with parameningeal head and neck localisations having a less favourable prognosis due to the higher risk of spread.

Teaching point: Accessory extraocular muscles are rare intraorbital congenital structures that can cause diplopia and restrictive strabismus.

Synovial haemangioma is a rare benign entity, most common in children and adolescents. These tumours can extensively infiltrate joint structures and periarticular soft tissues, making management challenging. Magnetic resonance imaging (MRI) has a key role in diagnosis and therapeutic planning. The authors report the case of a 17‑year‑old male with multiple synovial haemangiomas, highlighting the complexity of management and the essential role of MRI in assessment and treatment. Teaching point: Synovial haemangiomas may lead to bone remodelling, periarticular soft‑tissue infiltration and, ultimately, limb deformities and early‑onset osteoarthritis. Magnetic resonance imaging (MRI) is crucial for diagnosis as well as for guiding therapeutic planning.