Acta radiologica最新文献

BackgroundMyxoid liposarcoma (MLS) is a subtype of liposarcoma characterized by its myxoid stroma and adipocyte differentiation. MLS is prone to recurrence and metastasis. Magnetic resonance imaging (MRI) plays a crucial role in evaluating tumor characteristics, enabling accurate diagnosis, and predicting patient prognosis.PurposeTo analyze the components of MLS by MRI features and assess their correlation with prognosis.Material and MethodsA total of 20 patients with MLS who underwent MRI were retrospectively included. Tumor components were analyzed by MRI features, and their prognostic correlation was assessed. Patients were divided into good and poor prognosis groups based on postoperative follow-up.ResultsThe proportions of non-fatty/non-myxoid components in the good and poor prognosis groups were 15.00% (range = 10.00%-20.00%) and 70.00% (range = 52.50%-77.50%), respectively (P < 0.001). The proportion of myxoid composition also differed significantly between the two groups (75.00%, [range = 65.00%-85.00%] vs. 25.00% [range = 17.50%-42.50%]; P < 0.001). The good prognosis group had a greater mean apparent diffusion coefficient (ADC) value (1.66 ± 0.23 × 10^-3 mm²/s) and a lower mean ADC low signal ratio (5.00% [range = 0%-10.00%]) in the non-fatty/non-myxoid areas than the poor group (1.21 ± 0.41 × 10^-3 mm²/s; 20.00% [range = 11.00%-39.00%]; P = 0.006 and P = 0.001). The differences in the percentages of patients with a component ratio <25% and >50% in both the non-fatty/non-myxoid and myxoid groups were significant (P < 0.001 and P = 0.005).ConclusionImaging features were closely associated with the histological components of MLS. The use of MRI features for assessing MLS components has important implications for prognostic prediction.

BackgroundDynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) protocol was included into the Ovarian-Adnexal Reporting & Data System (O-RADS) MRI scoring system. To avoid the administration of contrast medium, the non-contrast MRI scoring (NCMS) system was proposed.PurposeTo evaluate the contribution of detecting intra-tumoral hemorrhage in the solid tissue of adnexal masses to improve tumor characterization and enhance the risk stratification of adnexal lesions using the NCMS system.Material and MethodsMRI findings including susceptibility-weighted sequences (T2*-weighted MR angiography [SWAN]) were retrospectively analyzed in 126 surgically confirmed adnexal tumors with solid tissue components (20 benign, 106 malignant). Solid tissue was classified as malignant based on the NCMS criteria, defined by intermediate intensity on T2-weighted (T2W) imaging, and corresponding diffusion restriction. Hemorrhage was assessed based on high intensity on T1-weighted (T1W) imaging and susceptibility-related signal voids on SWAN.ResultsThe NCMS solid tissue criteria identified malignancy with a sensitivity of 94.3%, specificity of 60%, and accuracy of 88.9%. High intensity on T1W imaging and signal voids on SWAN were observed in 23.6% and 72.6% of malignant lesions, compared to 0% and 5% in benign lesions, respectively. Hemorrhage was frequently observed in high-grade malignant tumors, or hemorrhagic subtypes. The combination of NCMS criteria and/or presence of intra-tumoral hemorrhage was associated with malignancy, yielding a sensitivity of 98.1%, specificity of 60%, and accuracy of 92.1%.ConclusionThe inclusion of intra-tumoral hemorrhage enhances the diagnostic accuracy of the NCMS for characterizing adnexal lesions. SWAN may also aid in estimating tumor grade and identifying hemorrhagic subtypes.

BackgroundOsteosarcoma (OS) is the most common primary malignant bone tumor. Exploring quantitative parameters that reflect the outcome of neoadjuvant chemotherapy (NACT) in patients with OS can help advance the treatment of patients.PurposeTo explore the role of T2-weighted (T2W) magnetic resonance imaging (MRI) radiogenomic features in characterizing changes in patients with OS and on NACT.Material and MethodsA total of 21 patients with OS were examined retrospectively and divided into a poor-response group (n = 13) and a good-response group (n = 8). A total of 98 radiomic features and 31 gene expression profiles were analyzed for each patient. Age, sex, alkaline phosphatase, pathologic type, tumor size, and tumor location were also analyzed. Comparisons between the good- and poor-response groups were made using the t-test, Mann-Whitney U test, or Fisher's exact test. The relationships between radiomic features and gene expression profiles were conducted using Spearman's correlative analyses.ResultsStatistical differences in 19 radiomics features and glutathione-s-transferase 1 were found between the good- and poor-response groups (P < 0.05). The receiver operating characteristic curve showed that four NGTDM busyness features had the best performance in predicting the NACT of patients with OS, with an area under the curve of 0.788, sensitivity of 0.750, and specificity of 0.923. Correlation analysis showed that the HLA_I, CD274, GSTP1, and CCND3 were significantly correlated with one or more radiomics features (P < 0.05).ConclusionThe T2W MRI radiogenomic features can be used as biomarkers for the early response evaluation of NACT in OS. This is the first study to analyze the association of T2 radiogenomic features with NACT in patients with OS to assist in the assessment of NACT.

BackgroundMeniscal damage compromises its capacity to resist load transmission. However, little is known about the effects of different meniscal injuries on meniscal extrusion under femorotibial loading conditions.PurposeTo evaluate meniscal extrusion in the medial compartment using ultrasound (US), with and without axial loading, and correlate to individual factors (age, body mass index [BMI], osteoarthritis [OA], and type of meniscal tear with different degrees of extrusion).Material and MethodsThe study involved 104 volunteers (53 men, 51 women; mean age = 41.5 ± 1.8 years; age range = 18-70 years; mean BMI = 28.7 ± 5.8 kg/m²; range = 20-47 kg/m²). Meniscal extrusion was evaluated using US in the supine and standing positions, and tears were confirmed by magnetic resonance imaging (MRI).ResultsOur study shows significant variation in meniscus extrusion between supine and standing positions (P = 0.0002). In the supine position, mean values of medial meniscal extrusion within the meniscal tear group (2.281 ± 2.03 mm) were higher than the group without tears (0.55 ± 0.68 mm) (P < 0.0001). From a total of 104 knees studied, 57 (54.8%) demonstrated meniscal injuries. All menisci with ≥3 mm of extrusion presented tears confirmed on MRI. Painful medial compartment showed higher extrusion values (P < 0.0001). OA and age had a greater impact on extrusion (P = 0.001).ConclusionThe presence of extrusion ≥3 mm predicts meniscal tear. In addition, OA and age have a greater impact on increasing extrusion. This research provides valuable insights into the effects of axial body load and associated factors on meniscal extrusion.

BackgroundCardiac magnetic resonance (CMR) is challenging in patients implanted with metallic devices, such as pacemakers or defibrillators, given metallic susceptibility artifacts. The technique of T1-mapping investigates interstitial fibrosis. The most used method for myocardial T1-mapping is the modified Look-Locker Inversion recovery sequence (MOLLI) using balanced steady-state free precession (SSFP). However, SSFP is susceptible to off-resonance artifacts, leading to errors. Gradient echo (GRE) sequences are less prone to these artifacts.PurposeTo investigate whether T1-mapping using GRE was comparable to SSFP in this population.Material and MethodsPre/post-contrast T1-mapping was performed on 16 devices utilizing MOLLI with SSFP and GRE strategies at 1.5 T, as well as 10 non-device controls. The difference in mean T1 time by SSFP versus GRE (both pre- and post-contrast for each slice) for device patients was analyzed.ResultsNative T1 for the device cohort was 1053 ± 94 ms for SSFP and 969 ± 83 ms for GRE. GRE T1 measurements were shorter than SSFP measurements (difference over all slices for SSFP vs. GRE pre-/post-contrast were 74 ms and 27 ms). Mean λ for GRE (devices) was 0.520 ± 0.194 (p = 0.30). λ for SSFP (devices) was 0.536 ± 0.124 (P = 0.08). There was no difference in λ between SSFP versus GRE in device patients (P = 0.91). The percentage of segments identified as artifact on T1 maps for device patients was 24% and 45% for GRE and SSFP, respectively.ConclusionCompared to SSFP, T1 values using GRE were consistently shorter, while λ values remained equivalent. There was less visual artifact on GRE images, suggesting advantageous utility over SSFP in patients with cardiac devices.

BackgroundThe multiparametric magnetic resonance imaging (mpMRI)-based Prostate Imaging for Recurrence Reporting (PI-RR) system has been proposed to evaluate local recurrence in patients with prostate cancer (PCa) who have been treated with radiation therapy (RT) or radical prostatectomy (RP).PurposeTo evaluate the diagnostic performance and interreader agreement of the PI-RR system in the diagnosis of locally recurrent PCa remains.Material and MethodsA total of 110 patients who have biochemically recurrent PCa after RT (n = 35) or RP (n = 75) were included in this retrospective study. All patients underwent mpMRI, PSMA-PET/CT, and biopsy. Four radiologists with varying levels of expertise independently assessed the local recurrence of PCa using PI-RR. The reference standard was the biopsy pathology. The receiver operating characteristic (ROC) curve was used to evaluate the performance of PI-RR and PSMA-PET/CT, and areas under the ROC curve (AUC) were calculated. Interreader agreement across four readers was evaluated using the intraclass correlation coefficient (ICC).ResultsAmong 110 patients with biochemically recurrent PCa, 28 had local recurrence and 82 had no local recurrence. Using a cutoff of 4, the AUCs of PI-RR in the diagnosis of local recurrence were in the range of 0.61-0.84 in patients treated with RT and 0.71-0.89 in patients treated with RP. The ICC was 0.86 (95% confidence interval = 0.81-0.91).ConclusionPI-RR using a cutoff of 4 has a favorable diagnostic performance and interreader agreement, which might be alternatively used for detecting local recurrence in patients with biochemically recurrent PCa treated with RT or RP.

BackgroundSAPHO syndrome can involve the spine, along with vertebral fractures (VFs), and demonstrates osteoporosis and sarcopenia. However, the relationship between musculoskeletal factors with VFs in SAPHO patients is unclear.PurposeTo quantify bone and muscle loss in SAPHO syndrome and identify the factors associated with VFs.Material and MethodsThe study included 35 patients and 70 age- and sex-matched controls. The bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), total hip (TH), the age- and sex-specific T- and Z-scores, and trabecular bone score (TBS) were evaluated using dual-energy X-ray absorptiometry (DXA). Cross-sectional muscle area (CSMA), skeletal muscle radio-attenuation (SMRA), skeletal muscle index (SMI), and skeletal muscle gauge (SMG) were assessed at the T8, T10, and T12 levels based on chest CT scans. The related factors of VFs were analyzed through univariable and multivariable analyses. The diagnostic accuracy of the related factors in VFs was based on receiver operator characteristic (ROC) curves.ResultsCompared to controls, LS-BMD, FN-BMD, TH-BMD, corresponding T- and Z-scores, and TBS were significantly reduced in women, whereas LS-BMD, T- and Z-scores were significantly increased in men. CSMA, SMI, and SMG at the T8, T10, and T12 levels were significantly reduced in women. LS-BMD and SMG-T12 were independently associated with VFs, and their combination showed the highest diagnostic efficacy for VFs.ConclusionFemale SAPHO patients exhibited notable bone and muscle loss, along with bone microstructure damage. LS-BMD and SMG-T12 hold the potential to offer valuable insights for the management of VFs risk in SAPHO patients.

BackgroundLacunar infarction accounts for almost 25% of ischemic strokes.PurposeTo evaluate the effectiveness of computed tomography perfusion (CTP) in identifying acute lacunar infarction (ALI) by comparing its performance with non-contrast CT (NCCT) and CT angiography (CTA), and to study the potential influence of various imaging characteristics on detection accuracy.Material and MethodsA total of 309 patients who underwent baseline CT and follow-up diffusion-weighted imaging due to lacunar symptoms were enrolled. The detection performance of NCCT, CTA, CTP, and various CTP-derived parametric maps for identifying ALI was calculated and compared. In addition, the study examined and compared the performance of CTP across different subgroups, categorized based on infarction location, infarction size, and degree of white matter hyperintensity.ResultsALI was identified in 184 patients. CTP demonstrated significantly higher sensitivity (44.6%) in detecting ALI compared to NCCT (8.2%) and CTA (12.0%) (both P < 0.001). Among the four CTP-derived parametric maps, sensitivity ranged from 2.2% (cerebral blood volume [CBV]) to 41.8% (mean transit time [MTT]). In subgroup analyses, CTP showed higher sensitivity for detecting cortical lesions (60.0%) compared to posterior lesions (41.0%) (P = 0.061) and subcortical lesions (39.8%) (P = 0.035). CTP showed slightly higher sensitivity in detecting ALI with a larger infarct size (>10.6 mm) and in cases with mild-to-moderate WMH. However, these differences were not statistically significant (>10.6 mm vs. ≤10.6 mm, 45.2% vs. 44.0%, P = 0.870; mild-to-moderate vs. severe WMH: 45.3% vs. 41.2%, P = 0.660).ConclusionIn this retrospective study, we found that CTP outperformed NCCT and CTA in detecting ALI. CTP demonstrated higher sensitivity for detecting ALI compared to posterior and subcortical lesions.

BackgroundThe morphology of radial sigmoid notch varies widely among individuals. It remains unclear whether variations in sigmoid notch morphology influence cartilage degeneration in this region. T1rho and T2 mapping, which are useful magnetic resonance imaging (MRI) methods to assess early cartilage degeneration, may help us evaluate the relationship between the morphology and cartilage degeneration of sigmoid notch.PurposeTo investigate the relationship between cartilage degeneration of radial sigmoid notch and its morphology.Material and MethodsWe investigated the dominant wrists of 40 healthy volunteers (mean age = 34.1 years) using 3-T MRI. We measured the inclination, depth, and width of the sigmoid notch on an axial multi-echo gradient-echo, and the ulnar head diameter on coronal T2-weighted images. T1rho and T2 values of the volar, central, and dorsal cartilages of the sigmoid notch were measured on coronal T1rho and T2 mapping. We evaluated the relationships of T1rho or T2 values of the three regions with age and morphological measurements using Pearson's correlation analysis and multiple linear regression analysis.ResultsThe T2 value of the dorsal sigmoid notch positively correlated with age and width of the sigmoid notch. Multiple linear regression analysis showed that older age and wider sigmoid notch significantly increased the dorsal T2 value.ConclusionA wider sigmoid notch and aging may induce cartilage degeneration in the dorsal sigmoid notch. This association can help future studies about distal radioulnar joint diseases.

BackgroundTesticular torsion (TT) is a scrotal emergency that needs urgent detection for successful treatment.PurposeTo investigate the diagnostic value of acute ultrasound and the possibility of more effective detection.Material and MethodsThis retrospective study included patients assessed with ultrasound for suspicion of TT between 2019 and 2023. Registration of parameters included symptoms, durations, ultrasound conclusions, and surgical outcome. Ultrasound assessment included inspection of the spermatic cord and testicular color Doppler signal. Sensitivity and specificity were presented with 95% confidence intervals (CIs) and symptoms with odds ratios (ORs).ResultsA total of 387 patients were included. Surgical exploration (SE) was carried out in 40 patients. TT was surgically confirmed in 23 patients. No missed cases of TT were detected. Spermatic cord rotation ≥180° showed a sensitivity of 100% (95% CI=86-100), specificity of 65% (95% CI=41-83), positive predictive value (PPV) of 79%, and negative predictive value (NPV) of 100%. Absent or reduced testicular color Doppler signal showed a sensitivity of 57% (95% CI=37-74), specificity of 77% (95% CI=53-90), PPV of 76%, and NPV of 57%. Sudden onset of pain (OR=9.44, 95% CI=2.10-42.35), earlier similar episodes (OR=6.71, 95% CI=2.27-19.89), and abdominal pain (OR=14.70, 95% CI=3.25-66.51) showed significant association with TT.ConclusionUltrasound, with focus on the spermatic cord, is reliable as a tool for the detection of TT. SE might be justified when cord rotation is ≥180°. These results can be used to develop and validate ultrasound guidelines for fast detection.