Polish journal of radiology最新文献

Crohn's disease (CD) is an increasingly common disease in clinical practice. The progress of medicine, which has resulted in an extension of the survival time of patients, the introduction of new treatment methods, and the nature of the disease itself means that we are seeing more and more new, unusual complications of this disease. We have reviewed three cases of rare complications of CD, with a focus on possible atypical complications that may be seen on imaging studies. Complications of CD and its treatment can occur in various organs and systems, and manifest in very non-specific ways. If unnoticed, they can be even life-threatening; therefore, it is important in clinical practice to take into account the possibility of their presence when evaluating patients with CD. When assessing radiological examinations of these people, we should take into account the possibility of atypical signs and radiographic features, and consider whether they may be related to the underlying disease.

Purpose: Accurate quantification of coronary artery calcium (CAC) via computed tomography (CT) imaging is essential for effective cardiovascular risk assessment. This study investigates the impact of different iteration levels in the advanced model-based iterative reconstruction (ADMIRE) algorithm on artificial intelligence-driven CAC quantification and subsequent risk stratification, with filtered back projection (FBP) serving as the reference.

Material and methods: For 254 patients undergoing coronary CT angiography (120 kVp, automated tube current), raw data were reconstructed using FBP and ADMIRE levels 1-5 (kernel Sa36, 3.0 mm slice thickness, 1.5 mm spacing). AI-derived CAC parameters (volume, mass, Agatston score) and risk stratification were compared across reconstruction groups. Statistical analysis employed the Friedman test, one-way analysis of variance, and c² test.

Results: Compared to FBP, ADMIRE 1-5 reduced image noise by 9.70% to 49.76% (noise: 14.95 ± 2.26 HU vs. 7.55 ± 1.40 HU, F = 455.105, p < 0.001). Maximum CAC CT values progressively decreased with higher ADMIRE levels (FBP: 458.50 [306.00-645.00] HU vs. ADMIRE 5: 432.50 [281.75-620.75] HU; χ² = 455.105, p < 0.001). CAC volume, mass, and Agatston scores declined significantly (p < 0.001 for all): volume decreased by 8.56-32.55% (FBP: 47.56 ± 5.93 mm³ vs. ADMIRE 5: 21.77 ± 3.46 mm³; F = 32.310); mass decreased by 8.73-32.57% (F = 29.477); and Agatston scores decreased by 8.77-33.13% (F = 31.104). Risk stratification shifted in 24/161 patients (14.91%) with detectable CAC. The effective radiation dose was 0.61 ± 0.18 mSv.

Conclusions: ADMIRE reconstruction reduces image noise but progressively lowers CAC quantification (volume, mass, Agatston score) and maximum CT values, leading to underestimation of cardiovascular risk in a subset of patients. Caution is warranted when applying ADMIRE iterative reconstruction for CAC scoring.

Purpose: Muscle injuries are common in competitive sports. Magnetic resonance imaging (MRI) and ultrasound (US) are the most commonly used methods for evaluating muscle injuries. Several classification systems for muscle injuries have been published. Mueller-Wohlfahrt et al. introduced a new classification system in 2013, currently the most widely used, employing grading to reflect the diverse spectrum of muscle injuries observed in athletes. The differentiation between lesions classified as type 3A (minor partial muscle tear) and 3B (moderate partial muscle tear) remains to be precisely established. In relation to recovery time, we researched possible statistically significant differences.

Material and methods: We conducted a comprehensive analysis of 100 MRI studies that were performed on high-level professional athletes who exhibited clinical signs of lower limb muscle injuries. We selected individuals whose myotendinous or myofascial lesions could be classified as 3A or 3B, based on the Mueller-Wohlfarth (MW) classification. The athletes were then categorised into groups based on the presence or absence of fluid collection at the site of injury. The study's medical practitioner provided data regarding the duration of the injury and the return to sporting activities. Regarding statistical analyses, a linear regression test was conducted to examine the correlation between the variable "fluid collections" and the duration of the injury. Following this, Fisher's t-test or the Mann-Whitney test was applied.

Results: The results of the association between "blood collection" and "duration of injury" revealed a statistically significant correlation. The median value of return to play (RTP) in patients with haemorrhagic collection (median = 29) was significantly higher in comparison with patients without haemorrhagic collection (median = 19), with a difference between the 2 samples of 10 days.

Conclusions: Our study highlights how this distinction could be easily practiced by recognizing the presence of a haemorrhagic collection and how it predominates in determining a worsening of the prognosis and therefore an extension of the RTP. Hence, we can conclude that athletes who do not have blood collection, but only interstitial haemorrhage between fibres can be considered as type 3A, while athletes with interstitial haemorrhage at diagnosis can be considered as type 3B.

Diffusion tensor imaging (DTI) and tractography are powerful non-invasive techniques for studying the human brain's white matter pathways. The uncinate fasciculus (UF) is a key frontotemporal tract involved in emotion regulation, memory, and language. Despite advancements, challenges persist in accurately mapping its structure and function due to methodological limitations in data acquisition and analysis. This review aims to provide a comprehensive overview of the strengths and limitations of DTI and tractography in studying the UF, focusing on its anatomy, data acquisition techniques, and associated neurological and psychiatric disorders. A systematic review of over 30 years of literature on UF was conducted, encompassing anatomical studies, DTI methodologies, and clinical applications. Studies involving both postmortem dissections and in vivo imaging were analysed, with particular attention to different DTI acquisition parameters, fibre tracking algorithms, and their impact on imaging accuracy. DTI has significantly improved our understanding of UF anatomy and its role in neurocognitive functions. However, methodological constraints such as low spatial resolution, crossing fibres, and inter-subject variability limit its precision. Advances in higher-field magnetic resonance imaging, improved diffusion models, and artificial intelligence-enhanced tractography offer promising solutions. UF abnormalities have been linked to various disorders, including schizophrenia, depression, autism spectrum disorders, and neurodegenerative diseases. While DTI and tractography are invaluable tools for studying the UF, their limitations necessitate cautious interpretation of results. Future research should focus on refining imaging techniques to enhance accuracy and clinical applicability, paving the way for better diagnostic and therapeutic strategies.

Purpose: To evaluate the effectiveness of head magnetic resonance imaging (MRI) with the diffusion weighted imaging without echo-planar imaging (DWI non-EPI) sequence in detecting cholesteatoma recurrence, focusing on the analysis of false results.

Material and methods: A retrospective study was conducted involving 156 patients diagnosed with cholesteatoma, who underwent reoperation between 2015 and 2021. All patients underwent preoperative MRI with the DWI non-EPI sequence. Data from surgical protocols, medical histories, outpatient records, and imaging results were analysed. MRI scans were reviewed by experienced radiologists and otosurgeons. The study was approved by the local Bioethics Committee.

Results: Clinical and radiological concordance was found in 80% of patients. True positive results were observed in 77.5% of cases, while true negative results were noted in 2.5%. False positive results occurred in 8% of cases, mainly due to wax in the external auditory canal. False negative results were found in 12% of cases, often due to small or mural cholesteatomas. The sensitivity of MRI DWI non-EPI in detecting cholesteatoma was 87%.

Conclusions: MRI DWI non-EPI is an effective tool for detecting cholesteatoma recurrence, potentially avoiding unnecessary second-look surgeries. Awareness of false positive and negative results is crucial, and correlation of MRI findings with clinical examinations is recommended. To minimise false results, ear cleaning before MRI and repeated examinations at intervals are advised.

X-ray velocimetry (XV) is a novel imaging technique that allows for real-time viewing and dynamic analysis of air and blood flow. Traditional imaging techniques frequently cannot capture high-resolution, real-time flow patterns, which limits their diagnostic utility. This evaluation assesses the efficacy and dependability of XV compared to traditional imaging techniques. Our principal aim was to conduct a systematic review of studies that compare the accuracy of dynamic flow measurements of XV in comparison to existing imaging methods. A systematic review was conducted according to PRISMA criteria. Fourteen papers from indexed journals, including ScienceDirect and PubMed, were examined to determine the benefits of XV for capturing dynamic flow patterns. The data show that XV outperforms traditional imaging techniques by providing higher spatial and temporal resolution, allowing for exact tracking of airflow and blood flow dynamics. These enhanced visuals help to improve diagnosis accuracy and comprehension of physiological processes. XV is a significant improvement in medical imaging, providing real-time, high-resolution insights that help with patient evaluation and clinical decision-making. Its application may improve diagnostic capabilities and patient outcomes in pulmonary and vascular examinations.

Quantitative magnetic resonance imaging (MRI) volumetry has become a pivotal component in modern neurology, bridging the gap between detailed neuroimaging and clinical decision-making. By employing advanced imaging techniques like 3D T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences, MRI volumetry enables clinicians to objectively quantify brain volume changes associated with neurological conditions such as Alzheimer's disease, multiple sclerosis, epilepsy, and myotonic dystrophy. Automated segmentation tools, including FreeSurfer, NeuroQuant, volBrain, and AccuBrain, facilitate precise and reproducible analysis of structural brain changes, contributing significantly to early diagnosis, patient monitoring, and therapeutic planning. In Alzheimer's disease, volumetric MRI enables the detection of early hippocampal and temporal lobe atrophy, providing a crucial biomarker for diagnosis and monitoring disease progression. Similarly, in multiple sclerosis, volumetric analyses quantify grey and white matter degeneration, reflecting motor and cognitive impairment severity. Moreover, quantitative MRI techniques precisely delineate structural abnormalities like hippocampal sclerosis and focal cortical dysplasia in epilepsy, crucial for accurate surgical intervention. Ongoing advances in artificial intelligence and machine learning are set to further enhance these volumetric approaches, addressing current limitations such as inter-observer variability and expanding their clinical applicability. This review outlines the existing landscape and future trajectory of quantitative MRI volumetry, underscoring its expanding role in clinical neurology and personalised medicine.

The aim of this study is to determine the usefulness of contrast-enhanced ultrasound (CEUS) in liver biopsy. The popularisation of imaging techniques that visualise the abdominal cavity, especially ultrasonography (USG), has resulted in an increase in the detection of focal liver lesions (FLL). If the results of other imaging modalities (magnetic resonance imaging [MRI] or computed tomography [CT]) are inconclusive, percutaneous liver biopsy should be considered. Taking into account the limitations of using MRI and CT in liver biopsy, this procedure is mostly performed with ultrasound. It is economical, safe, and swift. Whenever it is impossible to visualise lesions in B-mode (a condition necessary for a safe and effective biopsy), it is advisable to use advanced ultrasound techniques - CEUS or fusion imaging. Limitations of fusion imaging include prolonged time of data processing and difficulties in achieving optimal overlap of images. Conversely, CEUS enhances lesion visualisation but is devoid of the mentioned limitations - it is rapid and requires no additional processing. Furthermore, considering the potential of CEUS in the visualisation of focal liver lesions and differentiation of necrotic areas, accompanied by the ability to detect neuroendocrine tumours or its metastasis, we strongly believe that biopsy procedures - especially core needle biopsies - with CEUS assistance are potent tools in contemporary diagnostics. In this paper we want to share the experience of our centre and review the available literature on performing liver biopsies under CEUS guidance.