Acta radiologica最新文献

Background: Advanced methods are still lacking for the computed tomography (CT) evaluation of early degenerative changes of intervertebral disc in scoliosis.

Purpose: To investigate the feasibility of CT radiomics in evaluating early disc degeneration changes in scoliosis.

Material and methods: A total of 60 patients with severe scoliosis were assessed with the method of CT radiomics. CT radiomics features of the intervertebral disc were obtained by using the software of 3D Slicer and were then compared between vertex disc (VD) and normal disc (ND). The analysis of maximum correlation minimum redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) regression method was used to establish a model. The receiver operating characteristic (ROC) curve was used to determine the performance of the model.

Results: ND and VD differed in 23 radiomics features (P < 0.05). By using mRMR and LASSO methods, five features were finally selected to establish a model. The AUC of the model in the identification of VD were 0.93 and 0.90 for the training cohort and validation cohort, respectively. The sensitivity and specificity of the model were 90% and 85%, respectively.

Conclusion: CT radiomics of the intervertebral disc is feasible in identifying early degenerative changes caused by scoliosis.

Background: Uterine artery embolization (UAE) is a procedure commonly used to control uterine bleeding or pain. While the procedure is traditionally performed through the transfemoral approach (TFA), the transradial approach (TRA) is another method.

Purpose: To compare the effectiveness of the UAE using the TRA approach versus the TFA approach.

Material and methods: This non-blinded, randomized clinical trial was conducted at a tertiary hospital between 1 January 2019 and 30 June 2022. A total of 42 female patients with abnormal uterine bleeding and/or pelvic pain from uterine fibroids were randomly assigned to either the TRA group or the TFA group. Data collected included demographic information, procedural details, patient satisfaction, and radiation metrics.

Results: The TRA group had significantly lower numbers of microsphere vials used compared to the TFA group (P = 0.014). While there were no significant differences in procedure times (P = 0.058), fluoroscopic times (P = 0.117), or radiation doses (P = 0.466), the TRA approach was associated with a higher success rate in achieving bilateral UA catheterization and fewer instances of bilateral sheath insertion. Patient satisfaction scores were similar between the groups, with no statistically significant difference (P = 0.932). Minor adverse events such as local hematoma and color changes were more frequent in the TFA group, though these differences were not statistically significant.

Conclusion: Although both approaches were effective for the UAE, the TRA approach may be a viable alternative to the TFA due to its higher success rate in achieving bilateral catheterization, lower radiation doses, and shorter procedural times.

Background: Dedicated breast computed tomography (CT) is an emerging modality, but no study has compared breast lesions additionally detected on magnetic resonance imaging (MRI) with correlated CT lesions. Although there are differences between chest CT and dedicated breast CT, a preliminary evaluation would be valuable.

Purpose: To evaluate the usefulness of contrast-enhanced chest CT in evaluating additional suspicious lesions preoperatively detected on MRI in patients with breast cancer.

Material and methods: Between January 2020 and December 2021, 245 patients with breast cancer who underwent preoperative breast MRI and contrast-enhanced chest CT were included. Enhancing lesions detected on CT showing correlation with additional suspicious lesions detected on MRI were recorded as CT-correlated enhancements. The pathological findings were confirmed by subsequent percutaneous biopsy or lesion excision. The clinical and MRI features of additional suspicious lesions were compared according to the standard reference or the presence of CT-correlated enhancement.

Results: There were 96 (39.2%) additional suspicious lesions detected on preoperative breast MRI and a malignancy rate of 39.6%. Of 96 lesions, chest CT revealed correlated enhancement in 64 (66.7%) lesions, including 33 malignant lesions. Among the 32 lesions that showed no correlation enhancement on chest CT, 5 (15.6%) were malignant. Malignancy, diffusion-weighted image restriction, and fast/washout kinetics were more frequently observed in lesions with CT-correlated enhancement than in those without correlated enhancement (P < 0.001, P = 0.001, and P = 0.020, respectively).

Conclusion: When evaluating MRI-detected additional suspicious lesions in patients with breast cancer, lesions with CT-correlated enhancement were significantly more likely to be malignant than those without CT-correlated enhancement.

Background: Although non-vascular findings from computed tomography angiography (CTA) of the aorta are not the primary interpretation, the significant findings can affect the patient's treatment.

Purpose: To evaluate the disagreement between radiology residents and staff regarding non-vascular findings in CTA of the aorta.

Material and methods: We conducted a retrospective study of 419 CTA scans of the aorta between January 2014 and December 2016. The non-vascular findings from the final preliminary reports, which were interpreted by radiology residents, were recorded and compared with blind interpretations by an experienced member of the radiology staff. Disagreements were analyzed using the unweighted Kappa value.

Results: A total of 419 CTA aorta were interpreted by 38 radiology residents. The elective versus emergency CTA rate was 58% versus 42%. The emergency CTA rate related to traumatic conditions was 57.9% The thoracic system was the most common disagreement of significant non-vascular findings, with the highest disagreement rate being significant breast lesions (80.0%, Kappa = 0.33; 95% confidence interval [CI] = 0.15-0.81). Non-vascular findings detected by residents in significant and intermediated significant groups were 339/627 for elective CTAs and 241/457 for emergency CTAs. The disagreement rates for these findings were 45.9% (Kappa = 0.68; 95% CI = 0.54-0.97) in elective CTAs and 47.3% (Kappa = 0.60; 95% CI = 0.53-0.90) in emergency CTAs.

Conclusion: The most disagreement of non-vascular findings in significant and intermediated significant groups was the thoracic system. The disagreement rates of non-vascular findings between radiology residents and staff were higher in emergency CTA. These results can be used to improve radiology training.

Background: Preoperative transcatheter arterial embolization (P-TAE) is a procedure designed to reduce intraoperative blood loss (IBL) and support the performance of surgery for bone and soft tissue tumors (BSTT).

Purpose: To develop a new P-TAE technique using a triaxial microcatheter system (TMCS) that maintains normal tissue circulation while embolizing only the feeding artery of BSTT and to investigate the safety and efficacy of P-TAE with TMCS.

Material and methods: A total of 34 cases of BSTT in the whole body (25 men, nine women; mean age = 74.85 ± 11.32 years) were included between 1 April 2014 and 30 June 2024. We evaluated technical and clinical outcomes, P-TAE techniques, complications, and patient characteristics.

Results: Bone metastasis of renal cell carcinoma (n = 11) was the most frequent diagnosis. P-TAEs using TMCS were performed with technical success (97.05%) and clinical success (88.23%), demonstrating a high selectivity rate to the feeding artery of 97.14%. The mean IBL was 792.70 ± 1285.61 mL (median = 370 mL; range = 50-6935 mL). All surgeries were performed successfully after P-TAE.

Conclusion: P-TAE plays an important role in the presurgical operation of BSTT. The use of TMCS offers high selectivity, trackability, and crossability in the P-TAE procedure, enhancing the clinical efficacy of P-TAE.

Background: Intrahepatic cholangiocarcinoma (ICC) is an aggressive liver malignancy, and Ki67 is associated with prognosis in patients with ICC and is an attractive therapeutic target.

Purpose: To predict Ki67 expression based on multiparametric magnetic resonance imaging (MRI) radiomics multiscale tumor region in patients with ICC.

Material and methods: A total of 191 patients (training cohort, n = 133; validation cohort, n = 58) with pathologically confirmed ICC were enrolled in this retrospective study. All patients underwent baseline abdominal MR scans in our institution. Univariate logistic analysis was conducted of the correlation between clinical and MRI characteristics and Ki67 expression. Radiomics features were extracted from the image of six MRI sequences (T1-weighted imaging, fat-suppression T2-weighted imaging, diffusion-weighted imaging, and 3-phases contrast-enhanced T1-weighted imaging sequences). Using the least absolute shrinkage and selection operator (LASSO) to select Ki67-related radiomics features in four different tumor volumes (VOI^tumor, VOI^+8mm, VOI^+10mm, VOI^+12mm). The Rad-score was calculated with logistic regression, and models for prediction of Ki67 expression were constructed. The receiver operating curve was used to analyze the predictive performance of each model.

Results: Clinical and regular MRI characteristics were independent of Ki67 expression. Four Rad-scores all showed favorable prediction efficiency in both the training and validation cohorts (AUC = 0.849-0.912 vs. 0.789-0.838). DeLong's test showed that there was no significant difference between the AUC of the radiomics scores, while the Rad-score (VOI^+10mm) performed the most stable predictive efficiency with △_AUC 0.033.

Conclusion: Multiparametric MRI radiomics based on multiscale tumor regions can help predict the expression status of Ki67 in ICC patients.

Background: Primary insomnia (PI) is one of the most common sleep disorders. Diagnosis of insomnia is mainly based on subjective sleep difficulties, and it is still necessary to find objective neurobiological markers.

Purpose: To investigate the functional connectivity (FC) of frontal hub regions important for PI.

Material and methods: We enrolled 20 patients (5 men, 15 women) with PI and 20 controls (5 men, 15 women), matching age, sex. We used resting-state functional magnetic resonance imaging (fMRI) and voxel-mirrored homotopic connectivity (VMHC) to analyze the abnormal changes of FC in the frontal lobe of PI patients.

Results: Compared to controls, abnormal FC regions were mainly concentrated in the superior frontal gyrus (L/R), middle frontal gyrus (L/R), and inferior frontal gyrus (L) of the orbital region and the inferior frontal gyrus of the opercular region (L) (P < 0.05). The VMHC results showed abnormal FC in the middle frontal gyrus of the orbital region (GFR correction, voxel P < 0.01, cluster P < 0.025) in PI patients. The FC between the orbitofrontal gyrus and the inferior frontal gyrus of the opercular region with the frontal gyrus of the medial orbital region demonstrated a significant correlation with the clinical scale (p < 0.05).

Conclusion: Our study identified abnormal FC, which was mainly located in the orbitofrontal gyrus and the inferior frontal gyrus of the opercular region, in the frontal lobe of patients with insomnia using resting-state fMRI. This is helpful to understand the abnormal neural activity mechanism of insomnia in the frontal lobe and provide a relatively accurate brain region basis for future prevention, diagnosis, and treatment.

Background: Mechanical thrombectomy (MT) is the most effective treatment for large vessel occlusion (LVO) stroke. Despite this treatment, clinical outcomes are highly variable.

Purpose: To evaluate the role of collateral circulation in patients undergoing MT as a determinant of clinical outcome, especially in the long term.

Material and methods: The study included 80 patients who underwent MT for LVO of the anterior cerebral circulation. Patient data were collected on demographics, baseline neurological status, imaging studies (including ASPECTS and collateral circulation score), and clinical status of the patients as determined by NIHSS at discharge and by modified Rankin Scale (mRS) score at 3 and 12 months postoperatively.

Results: Patients with good collateral circulation were compared to the group with poor collateral circulation: they had significantly lower NIHSS at 24 h (median NIHSS 8 vs. 16; P < 0.001) and at the time of discharge (median NIHSS 3.5 vs. 13; P < 0.001). At 3 months, patients with good collateral circulation had a significantly higher chance of achieving a good functional outcome (mRS = 0-2) (62.75% vs. 10.34%; P < 0.001) and had a lower mortality (13.73% vs. 41.38%; P = 0.005). The benefits of good collateral circulation extended into the long term. At 12 months, patients with good collateral circulation were significantly more likely to have good functional outcome (mRS = 0-2) (60.78% vs. 10.34%; P < 0.001) and lower mortality (19.61% vs. 44.83%; P = 0.017).

Conclusion: Good collateral circulation increases the likelihood of favorable outcome in MT-treated stroke patients at discharge, 3 months, and 12 months.

Background: GRAPPATINI is capable of originating synthetic T2 images (T2_synth) and T2 maps in one magnetic resonance imaging (MRI) scan.

Purpose: To evaluate GRAPPATINI's performance in providing simultaneous morphological assessment of repaired rotator cuffs (RC) using T2_synth images and quantitative evaluation of the postoperative clinical outcomes on T2 maps.

Material and methods: A total of 45 individuals after repair surgery for at least 2 years were prospectively examined with GRAPPATINI MRI. Clinical scores were also collected. Image quality was measured using contrast-to-noise ratio (CNR) of the repaired tendons on the T2_synth and compared to conventional T2-weighted (T2W) images. Two blinded readers independently graded the repaired RCs based on the Sugaya classification on both T2_synth and T2W images to calculate intra- and inter-rater agreements. In addition, T2 values of repaired RCs from the T2 maps generated by GRAPPATINI were correlated with clinical scores.

Results: GRAPPATINI successfully provided both synthetic T2W and quantitative T2 map in a clinically feasible acquisition time of 2:18 min for the shoulder. There were no significant differences in mean CNR (P = 0.9) between conventional T2W and T2_synth images_. The inter-rater agreement for the Sugaya classification did not differ significantly between T2W and T2_synth images (P = 0.8). Furthermore, T2 values of the attached RC showed significant correlations with functional outcomes (r = 0.39-0.52; P < 0.05).

Conclusion: This study concludes that GRAPPATINI offers a comprehensive assessment of the shoulder by providing both morphological and quantitative evaluations in a single scan. It is an efficient tool for assessing repair status and predicting functional outcomes in patients after arthroscopic RC repair.