Radiologia最新文献

英文中文

Role of diffusion-weighted MR imaging in the initial diagnosis of soft tissue tumours 弥散加权磁共振成像在软组织肿瘤初步诊断中的作用

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2023.09.008

R. Oca Pernas , N. Hormaza Aguirre , T. Salinas Yeregui , T. Palomares Casado , B. Fernández Ruanova , C. Trinidad López

Background

Soft tissue tumours (STT) constitute a heterogeneous group of lesions frequently studied by Magnetic Resonance Imaging (MRI). It has not yet been clearly established whether the inclusion of apparent diffusion coefficient (ADC) diffusion-weighted imaging (DWI) maps would better determine tumour aggressiveness.

Purpose

To assess the diagnostic value of quantitative ADC DWI maps in the initial diagnosis of STT; and to determine whether the inclusion of DWI provides more valuable information than conventional sequences alone.

Material and methods

Retrospective study of patients with histologically proven STT. Conventional morphological MRI sequences and the DWI sequence were analysed. The ADC was quantified using a region of interest (ROI) that covered the largest sectional area (global ADC) and another that selected the area of greatest restriction (selected ADC). Differences in ADC values were analysed between both benign and malignant lesions and high and low-grade sarcomas. A multivariate analysis was performed to determine the ability of ADC to adequately diagnose the nature of STTs when associated with other morphological characteristics.

Results

84 patients with STT, of which 40 were benign and 44 malignant. The malignant group included 10 low-grade sarcomas, 23 high-grade sarcomas, 4 non-sarcomatous neoplasms and 7 sarcomas with no histological grading. The ADC values were significantly higher in benign lesions for the selected ADC. Significantly higher selected ADC values were also obtained in low-grade sarcomas. In the multivariate analysis, the highest diagnostic precision values were obtained when morphological features and ADC were included, with a sensitivity, specificity, and area under the curve (AUC) of 84, 75 and 91%, respectively.

Conclusion

The inclusion of ADC DWI values improves the diagnostic accuracy of MRI for STTs, especially when used in combination with conventional MRI sequences.

背景：软组织肿瘤（STT）是磁共振成像（MRI）经常研究的一组异质性病变。目前尚不清楚是否包括表观扩散系数（ADC）扩散加权成像（DWI）图能更好地确定肿瘤的侵袭性。目的评价定量ADC DWI图在STT初诊中的诊断价值；并确定包含DWI是否比单独的常规序列提供更有价值的信息。材料和方法对组织学证实的STT患者进行回顾性研究。分析常规形态学MRI序列和DWI序列。使用覆盖最大截面积（全局ADC）的兴趣区域（ROI）和选择最大限制区域（选定ADC）的兴趣区域（ROI）对ADC进行量化。分析了良、恶性病变和高、低分级肉瘤之间ADC值的差异。我们进行了多变量分析，以确定ADC在与其他形态学特征相关联时充分诊断stt性质的能力。结果84例STT，其中良性40例，恶性44例。恶性组包括低级别肉瘤10例，高级别肉瘤23例，非肉瘤性肿瘤4例，无组织学分级的肉瘤7例。良性病变的ADC值明显高于所选ADC值。在低级别肉瘤中，选择的ADC值也明显更高。在多因素分析中，包括形态学特征和ADC的诊断精度值最高，灵敏度、特异性和曲线下面积（AUC）分别为84%、75%和91%。结论纳入ADC DWI值可提高MRI对stt的诊断准确性，特别是与常规MRI序列结合使用时。

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引用次数: 0

Radiologists and trainees’ perspectives on artificial intelligence 放射科医生和受训人员对人工智能的看法

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2024.01.002

A. Catanese , G. Mattiello , S. Azam , P. Puyalto

Background and objectives

The purpose of this study was to investigate perspectives held by radiologists on the use of artificial intelligence (AI) in their day-to-day work and to identify factors limiting its routine implementation.

Materials and methods

Spanish board-certified radiologists and trainees completed an online survey of 21 questions on general information and communications technology (ICT) and AI in radiology. Analysis was carried out for the subgroups of gender, age, and professional experience. Associations with a p-value <0.05 were considered statistically significant.

Results

A total of 102 radiologists and trainees completed the questionnaire. No se observaron diferencias estadísticas significativas entre los grupos de sexo. A significant difference was detected in ICT and AI knowledge between age groups, with participants under 40 and those between 40 and 55 years old demonstrating better ICT knowledge (p < 0.01). The survey results revealed that 77.4% of participants believed that AI represents an opportunity for the radiology profession in the future, while 9.8% believed it would have no impact. Three main practical application areas for AI in radiology were proposed: in screening (23.36%), in image interpretation and reporting (21.17%), and in the requesting of imaging and patient scheduling (14.6%). The biggest concern among the surveyed population was the potential increase in workload.

Conclusions

A positive attitude toward AI was observed among Spanish radiologists, with the majority believing that AI could offer opportunities for the radiology profession in the near future. AI training programmes may further improve its acceptance among professionals.

背景和目的本研究的目的是调查放射科医生在日常工作中使用人工智能（AI）的观点，并确定限制其常规实施的因素。材料和方法西班牙委员会认证的放射科医生和受训人员完成了一项关于放射学中一般信息和通信技术（ICT）和人工智能的21个问题的在线调查。对性别、年龄、职业经验等分组进行分析。p值为<；0.05的相关性被认为具有统计学意义。结果共102名放射科医师和实习医师完成问卷调查。两组间无显著性差异estadísticas。ICT和人工智能知识在不同年龄组之间存在显著差异，40岁以下和40 - 55岁的参与者表现出更好的ICT知识（p <； 0.01）。调查结果显示，77.4%的参与者认为人工智能代表了未来放射专业的机会，而9.8%的人认为它不会产生影响。提出了人工智能在放射学中的三个主要实际应用领域：筛查（23.36%）、图像解释和报告（21.17%）、成像请求和患者调度（14.6%）。被调查者最关心的是工作量可能增加。结论西班牙放射科医生对人工智能持积极态度，大多数人认为人工智能在不久的将来可以为放射专业提供机会。人工智能培训项目可能会进一步提高其在专业人士中的接受度。

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引用次数: 0

Acute abdomen secondary to torsion of a wandering spleen 由游离脾扭转引起的急腹症

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2024.11.006

C. García-Hidalgo , M. Abellán López , J.M. Plasencia Martínez

引用次数: 0

Anxiety reduction in patients undergoing MRI: A single institutional study of two novel non pharmacological interventions MRI患者焦虑减轻：两种新型非药物干预的单一机构研究

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2024.01.004

S. Panda , A. Malhotra , S. Chandak , A. Agarwal , S. Dash , P. Singh

Introduction and objectives

Patients undergoing Magnetic Resonance Imaging (MRI) might face feelings of anxiety and fear in different magnitudes, before and during the scanning process with incidence as high as 37% having been reported, which sometimes leads to motion artifacts or premature termination of the scan. This study was conducted to evaluate the efficacy of two novel interventions, namely, Mock Computerised Tomography (CT) run and counselling by consultant, in anxiety reduction of patients undergoing MRI by 1.5 T scanner.

Methods

This was a prospective study. 90 patients referred for non contrast MRI of Brain or Spine fulfilling inclusion criteria were enrolled in the study and randomized into three groups (Control Group, Mock CT Group and counselling by consultant Group) using chit and box method. Outcome measures included STAI questionnaire, heart rate measurements and motion artifact assessment by two Radiologists. Statistical significance was set at P < .05.

Results

ANCOVA showed statistically significant improvement in Post-intervention STAI scores in the Mock CT Group (P = .002) and counselling Group (P = .02) compared to controls. ANOVA demonstrated significantly lower heart rate elevations for the Mock CT Group compared to Control Group (P = .001) and counselling Group (P = .02). Motion artifacts were significantly lower in Mock CT Group compared to controls (P = .01) as evaluated by Chi Square test. No significant difference was achieved when comparing controls with counselling Group (P = .07).

Conclusion

This study showed that Mock CT can significantly lower anxiety levels in patients undergoing MRI, an intervention largely unexplored in existing literature. Although counselling by consultant lowered pre-MRI anxiety levels, this group did not perform as good as Mock CT when assessing anxiety during MRI. It is suggested that patients experiencing anxiety before MRI may undergo pre-MRI Mock CT with the option of counselling whenever feasible.

简介和目的磁共振成像（MRI）患者在扫描前和扫描过程中可能会面临不同程度的焦虑和恐惧情绪，据报道发病率高达37%，有时会导致运动伪影或过早终止扫描。本研究旨在评估两种新型干预措施的有效性，即模拟计算机断层扫描（CT）运行和咨询师咨询，以减少患者接受1.5 T扫描仪MRI的焦虑。方法前瞻性研究。选取符合纳入标准的90例脑或脊柱非对比MRI患者，采用划线盒法随机分为对照组、模拟CT组和咨询组。结果测量包括STAI问卷、心率测量和两名放射科医生的运动伪影评估。P <有统计学意义；. 05。结果sancova干预后模拟CT组（P = .002）和咨询组（P = .02）的STAI评分与对照组比较，差异有统计学意义。方差分析显示，与对照组（P = 0.001）和咨询组（P = 0.02）相比，模拟CT组的心率升高明显降低。经卡方检验，模拟CT组的运动伪影明显低于对照组（P = 0.01）。对照组与咨询组比较无显著差异（P = 0.07）。结论本研究表明，模拟CT可以显著降低MRI患者的焦虑水平，这一干预措施在现有文献中尚未被探索。虽然咨询师的咨询降低了MRI前的焦虑水平，但在MRI期间评估焦虑时，这一组的表现不如模拟CT。建议在MRI前经历焦虑的患者可以在可行的情况下进行MRI前模拟CT检查。

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引用次数: 0

CT assessment of complications from gastric or duodenal ulcers 胃或十二指肠溃疡并发症的CT评估

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2023.12.001

D. Herrán de la Gala , C. Cantolla Nates , M. Moris , R. Pellón Daben , J. Crespo del Pozo , F.J. González Sánchez , S. Sánchez Bernal

Gastric and duodenal ulcers (GDUs) are decreasing both in frequency and rate of mortality. However, GDUs with complications continue to have higher mortality rates and are seldom suspected in patients presenting with acute abdomen. Although upper endoscopy plays a central role in the diagnosis and treatment of GDUs, CT is crucial when serious complications appear, namely uncontrolled acute haemorrhage, perforation, organ penetration, or gastric obstruction. Radiologists have a special role to play in these situations, providing the diagnosis and extent of complications, thus contributing to decision making which can range from conservative management to endoscopic, surgical or interventional radiology procedures. The aim of our study is to describe the CT indications and protocols for patients with a suspected GDU with complications and present the main imaging findings for the different types of complications, while providing differential diagnoses.

胃和十二指肠溃疡（GDUs）的发病率和死亡率都在下降。然而，伴有并发症的GDUs仍然具有较高的死亡率，并且很少在急腹症患者中被怀疑。虽然上内镜在gdu的诊断和治疗中起着核心作用，但当出现严重并发症，如不受控制的急性出血、穿孔、器官穿透或胃梗阻时，CT是至关重要的。放射科医生在这些情况下发挥着特殊的作用，提供并发症的诊断和程度，从而有助于从保守管理到内窥镜、手术或介入放射治疗的决策。我们的研究目的是描述疑似GDU合并并发症患者的CT适应证和治疗方案，并介绍不同类型并发症的主要影像学表现，同时提供鉴别诊断。

引用次数: 0

Eduardo Amorós Martí: Radiology and the fight against cancer in the early decades of the 20th century Eduardo Amorós Martí： 20世纪早期的放射学和与癌症的斗争

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2025.04.001

E. Perdiguero Gil, B. Echániz Martínez, E. Bueno Vergara

This article highlights the role of radiologist Eduardo Amorós Martí (1888–1936) in the use of radioactivity for cancer treatment in Spain during the first third of the 20th century. Following the discovery of radium by the Curies in 1898, Amorós became interested in radiology and established his practice in Alicante. He acquired X-ray and radium equipment, contributing to the development of radiation therapy. He directed the Cancer Pavilion at the Provincial Hospital of Alicante, where he promoted the application of radiation in cancer treatment. Like other historical figures associated with radioactivity, his prolonged exposure deteriorated his health, leading to his premature death in 1936.

这篇文章强调了放射学家Eduardo Amorós Martí（1888-1936）在20世纪前三分之一的西班牙使用放射性治疗癌症中的作用。1898年居里夫妇发现镭后，Amorós对放射学产生了兴趣，并在阿利坎特建立了自己的诊所。他获得了x射线和镭设备，为放射治疗的发展做出了贡献。他领导了阿利坎特省医院的癌症馆，在那里他推广了放射治疗在癌症治疗中的应用。与其他与放射性有关的历史人物一样，他长期暴露在核辐射中，导致健康状况恶化，于1936年英年早逝。

引用次数: 0

Radiological diagnosis of malignant spinal cord compression syndrome: Consensus document from SENR, SERAU, SERME, SERAM 恶性脊髓压迫综合征的影像学诊断：来自SENR， SERAU， SERME， SERAM的一致文件

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2024.12.001

A. Pérez Lara , E. Arana , A. Bello Báez , D. de Araujo Martins-Romeo

Malignant spinal cord compression is a serious complication secondary to both primary and metastatic vertebral tumours, potentially leading to permanent loss of spinal functions. The Spanish Society of Neuroradiology (SENR), Spanish Society of Emergency Radiology (SERAU), and Spanish Society of Musculoskeletal Radiology (SERME) have convened to draft this consensus document, which describes practical aspects of the radiological management of malignant spinal cord compression. The document includes guidelines on appropriate indications for imaging studies, imaging modality options, technical specifications tailored to different clinical scenarios, recommended time intervals, and the type of facility where the imaging studies can be performed. Additionally, it provides recommendations on using spinal cord compression and instability scales, as well as structured reports for describing the radiological findings.

恶性脊髓压迫是原发性和转移性椎体肿瘤继发的严重并发症，可能导致脊柱功能的永久性丧失。西班牙神经放射学会（SENR）、西班牙急诊放射学会（SERAU）和西班牙肌肉骨骼放射学会（SERME）召集会议起草了这份共识文件，该文件描述了恶性脊髓压迫的放射学管理的实际方面。该文件包括关于成像研究的适当适应症、成像方式选择、针对不同临床情况量身定制的技术规范、推荐的时间间隔以及可以进行成像研究的设施类型的指南。此外，它还提供了使用脊髓压迫和不稳定量表的建议，以及描述放射学表现的结构化报告。

引用次数: 0

A radiological review of male nipple discharge 男性乳头溢液的放射学检查

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2023.11.006

J. Azcona Sáenz , C.V. Martinez Stocker , E.N. Arenas Rivera , S. Marsico , E. Arizaga Batiz , R. Alcantara Souza

Male nipple discharge is uncommon and highly associated with malignancy. However, it can also be due to benign processes. In addition to physical examination, all patients should undergo a radiological examination with mammography and/or ultrasound. Furthermore, we propose the use of contrast-enhanced mammography (CEM) in cases of suspicious nipple discharge due to the high negative predictive value of this technique, potentially reducing the number of unnecessary biopsies. The aim of this article is to review the imaging findings of the most common causes of male nipple discharge, both benign and malignant. Additionally, we would like to share our experience with the use of CEM in studying this condition.

男性乳头溢液不常见，且与恶性肿瘤高度相关。然而，它也可能是由于良性过程。除体格检查外，所有患者都应接受x光检查和/或超声检查。此外，我们建议在可疑乳头溢液的情况下使用对比增强乳房x光检查（CEM），因为这种技术的高阴性预测值，可能减少不必要的活检次数。本文的目的是回顾男性乳头溢液最常见原因的影像学表现，包括良性和恶性。此外，我们希望分享我们在研究这种情况时使用CEM的经验。

引用次数: 0

Imaging findings for severe traumatic brain injury 重型外伤性脑损伤的影像学表现

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2024.05.009

A. Hilario, E. Salvador, Z.H. Chen, A. Cárdenas, J. Romero, A. Ramos

Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in young patients. The Marshall classification predicts six-month mortality and divides severe TBI patients into six groups based on CT findings in the acute phase of trauma. MRI also has prognostic value because it detects 30% more traumatic lesions, especially brainstem injury and diffuse axonal injury. Diffuse axonal injury occurs in three different anatomical areas, graded according to severity, and the greater the trauma, the deeper the brain involvement extends. Traumatic brainstem injuries with the worst prognosis are those of posterior location, with bilateral or haemorrhagic involvement. This article analyses the prognostic value of CT and MRI in the assessment of severe TBI and describes the main intracranial traumatic injuries.

创伤性脑损伤（TBI）是年轻患者发病和死亡的主要原因。马歇尔分类预测六个月的死亡率，并根据创伤急性期的CT表现将严重TBI患者分为六组。MRI还具有预后价值，因为它能检测到30%以上的创伤性病变，特别是脑干损伤和弥漫性轴索损伤。弥漫性轴索损伤发生在三个不同的解剖区域，根据严重程度分级，创伤越大，大脑受累越深。外伤性脑干损伤的预后最差的是后侧位置，双侧或出血累及。本文分析了CT和MRI在评估重型颅脑损伤中的预后价值，并介绍了主要的颅内伤。

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Quantitative diffusion weighted imaging (DWI) improves the diagnostic accuracy of the O-RADS MRI scoring system in indeterminate adnexal lesions 定量扩散加权成像（DWI）提高了O-RADS MRI评分系统对不确定附件病变的诊断准确性

Radiologia

Pub Date : 2025-05-01 DOI: 10.1016/j.rxeng.2024.01.005

M. Arraiza , E. Chacón , A. Ezponda , D. Cano , J.Á. Mínguez , A. Benito , J.L. Alcázar

Introduction

Despite the overall high accuracy of the O-RADS MRI scoring system for characterization of indeterminate adnexal lesions, a non-negligible percentage of adnexal lesions remains indeterminate. Given this, the main objective of this study was to evaluate the value of adding quantitative diffusion-weighted imaging (DWI) to Ovarian-Adnexal Reporting and Data System (O-RADS) MRI to improve the diagnostic accuracy of the scoring system in a cohort of indeterminate adnexal lesions according to International Ovarian Tumor Analysis Group Simple Rules (IOTA-SR).

Methods and material

Seventy-nine women with 81 pelvic lesions classified as indeterminate according to IOTA-SR underwent 3-Tesla MRI with a conventional multiparametric protocol. DWI was quantitatively analyzed. Lesions were surgically removed or followed-up, according to a local protocol. Sensitivity, speciﬁcity, positive and negative predictive values and accuracy were determined for conventional multiparametric MRI and quantitative DWI-derived data.

Results

Twenty masses in 72 patients (27.8%) were malignant. An apparent diffusion coefficient (ADC) cut-off value of 1.30 × 10^–3 mm²/s had 89% sensitivity and 80% specificity for malignancy. Overall, adding quantitative DWI to O-RADS MRI increased the specificity (98.08%, P < .001), positive predictive value (94.12%, P < .001), and accuracy (93.06%, P = .05). In the specific O-RADS MRI score 4 subgroup, an ADC cut-off value of 1.22 × 10^–3 mm²/s had 86% sensitivity and 67% specificity for distinguishing benign from malignant lesions.

Conclusion

In IOTA-SR indeterminate adnexal lesions, quantitative DWI significantly improves the diagnostic performance of conventional multiparametric MRI in all O-RADS MRI score groups.

尽管O-RADS MRI评分系统在诊断不确定的附件病变方面具有很高的准确性，但仍有不可忽略的百分比的附件病变仍然是不确定的。鉴于此，本研究的主要目的是根据国际卵巢肿瘤分析组织简单规则（IOTA-SR），评估在卵巢-附件报告和数据系统（O-RADS） MRI上增加定量弥散加权成像（DWI）的价值，以提高评分系统对不确定附件病变队列的诊断准确性。方法和材料79例经IOTA-SR诊断为不确定骨盆病变的女性，采用常规多参数方案进行3-Tesla MRI检查。定量分析DWI。病变手术切除或随访，根据当地协议。对常规多参数MRI和定量dwi衍生数据的敏感性、特异性、阳性和阴性预测值和准确性进行了测定。结果72例患者中有20个肿块为恶性，占27.8%。表观扩散系数（ADC）截止值为1.30 × 10-3 mm2/s，对恶性肿瘤的敏感性为89%，特异性为80%。总体而言，在O-RADS MRI上添加定量DWI可提高特异性（98.08%,P <； .001）、阳性预测值（94.12%,P <； .001）和准确性（93.06%,P = .05）。在特定的O-RADS MRI评分4亚组中，ADC截止值为1.22 × 10-3 mm2/s，用于区分良恶性病变的敏感性为86%，特异性为67%。结论在IOTA-SR不确定的附件病变中，定量DWI在所有O-RADS MRI评分组中均显著提高了常规多参数MRI的诊断效能。

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