Radiologia最新文献

英文中文

A comparative study between two ultrasound classifications for postnatal urinary tract dilatation 两种超声分类对产后尿路扩张的比较研究

Radiologia

Pub Date : 2025-09-01 DOI: 10.1016/j.rxeng.2025.101579

J. Panach-Navarrete , P. Hernández-Rovira , L. Valls-González , R. Gil-Viana , S. Ferrando-Monleón , J. Marín-Serra , H. Rodríguez-Parra , J.M. Martínez-Jabaloyas

Background and objectives

The objective was to test whether the Society for Foetal Urology (SFU) and urinary tract dilatation (UTD) ultrasound classifications for postnatal urinary tract dilatation were able to predict the need for surgical treatment or spontaneous resolution of dilatation.

Materials and methods

Retrospective observational study, involving cases whose first ultrasound scans for congenital hydronephrosis were performed between 2008 and 2011.

Clinical variables were recorded and each case was classified according to the SFU and UTD classifications. Univariate analysis and binary logistic regression were performed to establish which clinical and ultrasound variables were related to the need for surgery or medical/non-surgical resolution of dilatation.

Results

Data was collected on 231 kidneys. Spontaneous resolution of dilatation occurred in 41.5% of cases and 40.2% required surgery at some point.

Age (odds ratio (OR) 1.03) and high degrees of dilatation (P2-P3) in the UTD classification (OR 2.33) were associated with an increased risk of needing surgery, while age (OR 0.95) and high degrees of dilatation (P2-P3) in both the UTD and SFU (3−4) classifications were associated with a lower likelihood of spontaneous resolution (OR 0.23 and 0.27 respectively).

Conclusions

Both the UTD and SFU classifications are good predictors of spontaneous resolution of postnatal urinary tract dilatation, while only the UTD classification is predictive of the need for surgery. Older age at the time of the first ultrasound is associated with a higher risk of needing surgery and a lower likelihood of spontaneous resolution of hydronephrosis.

背景和目的目的是测试胎儿泌尿学会（SFU）和尿路扩张（UTD）超声分类是否能够预测需要手术治疗或扩张自行消退。材料与方法回顾性观察研究，纳入2008 - 2011年间首次超声检查先天性肾积水的病例。记录临床变量，并根据SFU和UTD分类对每个病例进行分类。采用单因素分析和二元逻辑回归来确定哪些临床和超声变量与手术或药物/非手术解决扩张的需要有关。结果收集了231个肾脏的数据。41.5%的病例自发消退，40.2%的病例需要手术。年龄（比值比（OR） 1.03）和UTD分类中的高度扩张（P2-P3）（OR 2.33）与需要手术的风险增加相关，而UTD和SFU（3 - 4）分类中的年龄（OR 0.95）和高度扩张（P2-P3）与较低的自发消退可能性相关（OR分别为0.23和0.27）。结论UTD和SFU分类都能很好地预测产后尿路扩张的自发消退，而只有UTD分类能预测是否需要手术。第一次超声检查时年龄越大，需要手术的风险越高，肾积水自然消退的可能性越低。

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引用次数: 0

Two cases of lipoid pneumonia 脂质性肺炎2例

Radiologia

Pub Date : 2025-09-01 DOI: 10.1016/j.rxeng.2025.101643

C. Delange Izurrategui , J. Collada-Carrasco , P. Caballero Sánchez-Robles

引用次数: 0

Post-traumatic pelvic haemorrhage: What do I need to know? 创伤后盆腔出血：我需要知道什么？

Radiologia

Pub Date : 2025-09-01 DOI: 10.1016/j.rxeng.2025.101552

S. Cayón Somacarrera , M.L. Parra Gordo , A. Mingo Basaíl , I. Galán González

In patients with blunt pelvic trauma, haemodynamic instability resulting from vascular lesions and active bleeding is the main cause of morbidity and mortality. In order to make treatment decisions, an accurate diagnosis of the origin and characteristics of the bleeding is required, whether from arteries, veins or bony surfaces.

This article describes the anatomy of the pelvic vessels and the CT protocol for the diagnosis of vascular lesions. In addition, it presents a map of pelvic vascularisation that can help us quickly determine the artery most likely responsible for the bleeding in order to guide the interventional radiologist should embolisation be necessary. Early transarterial embolisation is the most effective intervention for managing arterial bleeding associated with pelvic fracture, and it has been proved useful in controlling bleeding and increasing survival.

在钝性骨盆创伤患者中，由血管病变和活动性出血引起的血流动力学不稳定是发病率和死亡率的主要原因。为了做出治疗决定，需要准确诊断出血的来源和特征，无论是动脉、静脉还是骨表面。本文介绍了骨盆血管的解剖和血管病变的CT诊断方案。此外，它还提供了盆腔血管化图，可以帮助我们快速确定最有可能导致出血的动脉，以便指导介入放射科医生在必要时进行栓塞。早期经动脉栓塞是治疗骨盆骨折相关动脉出血最有效的干预措施，它已被证明对控制出血和提高生存率有用。

引用次数: 0

Hypothenar hammer syndrome: A work-related condition 鱼际下锤综合征：一种与工作有关的疾病

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101642

E. Sierra Beltrán, E. Pascual Pérez, E. Mayayo Sinues

引用次数: 0

European Diploma in Radiology (EDiR) clinical cases 欧洲放射学文凭（EDiR）临床病例

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101661

Editorial Board of Radiology

引用次数: 0

Comparing ChatGPT and medical student performance in a real image-based Radiology and Applied Physics in Medicine exam 比较ChatGPT和医学生在基于真实图像的放射学和医学应用物理考试中的表现

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101638

R. Salvador , D. Vas , L. Oleaga , M. Matute-González , À. Castillo-Fortuño , X. Setoain , C. Nicolau

Introduction

Artificial intelligence models can provide textual answers to a wide range of questions, including medical questions. Recently, these models have incorporated the ability to interpret and answer image-based questions, and this includes radiological images. The main objective of this study is to analyse the performance of ChatGPT-4o compared to third-year medical students in a Radiology and Applied Physics in Medicine practical exam. We also intend to assess the capacity of ChatGPT to interpret medical images and answer related questions.

Materials and methods

Thirty-three students set an exam of 10 questions on radiological and nuclear medicine images. Exactly the same exam in the same format was given to ChatGPT (version GPT-4) without prior training. The exam responses were evaluated by professors who were unaware of which exam corresponded to which respondent type. The Mann–Whitney U test was used to compare the results of the two groups.

Results

The students outperformed ChatGPT on eight questions. The students’ average final score was 7.78, while ChatGPT’s was 6.05, placing it in the 9th percentile of the students’ grade distribution.

Discussion

ChatGPT demonstrates competent performance in several areas, but students achieve better grades, especially in the interpretation of images and contextualised clinical reasoning, where students’ training and practical experience play an essential role. Improvements in AI models are still needed to achieve human-like capabilities in interpreting radiological images and integrating clinical information.

人工智能模型可以为广泛的问题提供文本答案，包括医学问题。最近，这些模型结合了解释和回答基于图像的问题的能力，这包括放射图像。本研究的主要目的是分析chatgpt - 40与三年级医学生在医学放射学和应用物理实践考试中的表现。我们还打算评估ChatGPT解释医学图像和回答相关问题的能力。材料与方法33名学生以放射学和核医学图像为题编了10道试题。ChatGPT（版本GPT-4）在没有事先培训的情况下，以相同的格式进行了完全相同的考试。这些考试的回答是由不知道哪一种考试对应哪一种答卷类型的教授来评估的。采用Mann-Whitney U检验比较两组结果。结果学生在8个问题上的表现优于ChatGPT。学生的平均期末成绩为7.78分，而ChatGPT的平均期末成绩为6.05分，在学生的年级分布中处于第9百分位。讨论：chatgpt在几个领域表现出色，但学生取得了更好的成绩，特别是在图像解释和情境化临床推理方面，学生的训练和实践经验起着至关重要的作用。在解释放射图像和整合临床信息方面，人工智能模型仍然需要改进，以实现类似人类的能力。

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引用次数: 0

Radiology and career development: Reflections from mid-career 放射学与职业发展：来自职业中期的思考

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.501682

E.N. Arenas Rivera , R. Alcántara Souza

引用次数: 0

How to measure peritoneal carcinomatosis 如何测量腹膜癌

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101593

A. Mesa Álvarez , M. da Silva Torres , A. Fernández del Valle , A. Cernuda García , E. Turienzo Santos , L. Sanz Álvarez

Peritoneal carcinomatosis (PC) is the spread of a tumour in the peritoneum, sometimes originating from a primary tumour (mesothelioma, peritoneal serous carcinoma) and other times arising from a metastasis from another organ (ovary, colon, appendix, stomach). While it was previously considered incurable, significant improvements have been made thanks to new techniques such as cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). Patients who can benefit from these treatments are identified by radiologists who use imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET-CT). It is important to have an awareness of the different forms of presentation, methods of quantifying tumour burden (peritoneal carcinomatosis index, PCI), and criteria for unresectability for an accurate assessment of the disease’s status. All this information should be shared and discussed in multidisciplinary boards for optimal and consensus-driven decision-making.

腹膜癌（PC）是肿瘤在腹膜内的扩散，有时起源于原发肿瘤（间皮瘤、腹膜浆膜癌），有时源于其他器官（卵巢、结肠、阑尾、胃）的转移。虽然它以前被认为是无法治愈的，但由于新技术的出现，如细胞减少手术和高温腹腔化疗（HIPEC），已经取得了重大进展。可以从这些治疗中受益的患者是由放射科医生识别的，他们使用成像技术，如计算机断层扫描（CT）、磁共振成像（MRI）和正电子发射断层扫描（PET-CT）。了解不同的表现形式、量化肿瘤负担的方法（腹膜癌指数，PCI）和不可切除的标准对于准确评估疾病状态是很重要的。所有这些信息都应该在多学科委员会中共享和讨论，以实现最佳和共识驱动的决策。

引用次数: 0

Acute aortic syndrome: What do you need to know? 急性主动脉综合征：你需要知道什么？

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101613

S. Pereiro Pérez, S. Lojo-Lendoiro, M. Pérez Costas, A. Robles Gómez, S. García Benito, P. Rodríguez Fernández

Acute aortic syndrome is a potentially fatal clinical entity that encompasses different pathologies affecting the wall of the aorta: aortic dissection, intramural haematoma, penetrating aortic ulcer and other less common entities. All are characterised by the sudden onset of thoracic-abdominal pain and all share similar features, preventing differentiation. Computed tomography plays a crucial role in the diagnostic process, enabling a rapid and accurate assessment and contributing to early therapeutic management.

This article reviews the main entities that make up acute aortic syndrome, their aetiologies, pathophysiology and characteristic radiological findings. Imaging tests are mainly used to confirm the diagnosis and determine the location and extent as well as possible complications.

急性主动脉综合征是一种潜在致命的临床疾病，包括影响主动脉壁的不同病理：主动脉夹层、壁内血肿、穿透性主动脉溃疡和其他不太常见的疾病。所有的特征都是突然发作的胸腹疼痛，所有的特征都相似，防止分化。计算机断层扫描在诊断过程中起着至关重要的作用，能够快速准确地评估并有助于早期治疗管理。本文综述了构成急性主动脉综合征的主要因素、病因、病理生理学和影像学特征。影像学检查主要用于确诊，确定病变部位、程度及可能的并发症。

引用次数: 0

Sudden cardiac death: Risk stratification using cardiac MRI 心源性猝死：使用心脏MRI进行风险分层

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101639

B. Domenech-Ximenos , R. Jiménez-Arjona , J.T. Ortiz-Pérez , R.J. Perea , M. Sánchez , S. Prat-González , A. Doltra

Sudden cardiac death (SCD) is recognised as a public health problem and can be caused by multiple heart diseases, which vary depending on the age of the patient. SCD risk stratification is a controversial topic surrounded by debate, since it is not easy to determine the appropriate timing for implanting an automatic defibrillator. Given that arrhythmic events are associated with myocardial scars, SCD stratification should go beyond the assessment of systolic function. Cardiac magnetic resonance imaging (MRI) plays a fundamental role since it enables the non-invasive characterisation of macroscopic and interstitial myocardial fibrosis, revealing the pattern and extent. This article reviews the role of cardiac MRI in SCD risk prediction.

心源性猝死（SCD）被认为是一个公共卫生问题，可能由多种心脏疾病引起，这些疾病因患者的年龄而异。SCD风险分层是一个充满争议的话题，因为确定植入自动除颤器的合适时间并不容易。鉴于心律失常事件与心肌瘢痕相关，SCD分层应超越对收缩功能的评估。心脏磁共振成像（MRI）在宏观和间质性心肌纤维化的无创表征中发挥着重要作用，揭示了其模式和程度。本文综述了心脏MRI在SCD风险预测中的作用。

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