Radiologia最新文献_第6页

Transarterial chemoembolization with doxorubicin-loaded radiopaque beads for hepatocellular carcinoma: Safety, efficacy, and distribution 载多柔比星不透射线珠经动脉化疗栓塞治疗肝癌：安全性、有效性和分布

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101656

A. Páez-Carpio , P. Bermúdez , M. Sanduzzi Zamparelli , M. Barrufet , O. Arrabal , A. Forner , A. Darnell , J. Bruix , F. Torres , M. Reig , M. Burrel

Aim

To evaluate the safety and efficacy of transarterial chemoembolization with radio-paque doxorubicin-loaded microspheres (rDEB-TACE) in patients with hepatocellular carcinoma (HCC).

Materials and methods

This single-center, retrospective, observational study included all patients 18 years and older diagnosed with HCC and treated with rDEB-TACE from 2017 to 2020 at our institution. rDEB-TACE efficacy was evaluated by type of response after treatment at 1-,3- and 6-month, time to progression (TTP), and overall survival (OS). Safety of the techniquewas assessed based on the occurrence of adverse events (AEs). rDEB distribution was classified by overall distribution as type 1: intratumoral, type 2: intratumoral-feeding artery, and type 3: feeding artery and by intratumoral distribution in 0–50% and 50–100%.

Results

Twenty-one patients with 36 lesions treated with rDEB-TACE were included. Median follow-up time was 17 months (IQR: 6.0–45.5). Local and overall objective response at 1, 3 and 6 months was 86%, 85%, 84% and 91%, 78% and 84%, respectively. Median TTP was 27.0 months (95%CI: 8.9–28.1) and median OS was 54.9 months (95%CI: 16.3-NE). No major AEs were reported. The most common particle distribution was type 2 (69.4%). Concordance of particle distribution between intraprocedural cone beam CT and follow-up CT was high (kappa = 0.80). Most lesions treated showed a 50-100% intratumoral particle distribution, with higher rates of local (95.5% vs 71.4%) and overall objective response in this group (100% vs 71.4%) compared with the 0–50% group.

Conclusion

rDEB-TACE is a safe and effective treatment for patients with HCC. Distribution of rDEB can be accurately assessed during and after the procedure and may predict early response.

目的评价放射性多柔比星微球（rDEB-TACE）经动脉化疗栓塞治疗肝细胞癌（HCC）的安全性和有效性。材料和方法本研究为单中心、回顾性、观察性研究，纳入我院2017年至2020年期间所有18岁及以上确诊为HCC并接受rDEB-TACE治疗的患者。rDEB-TACE的疗效通过治疗后1、3和6个月的反应类型、进展时间（TTP）和总生存期（OS）来评估。该技术的安全性是根据不良事件（ae）的发生来评估的。rDEB分布按总体分布分为1型：瘤内，2型：瘤内供血动脉，3型：供血动脉，按瘤内分布0-50%和50-100%。结果采用rDEB-TACE治疗的36例病变共21例。中位随访时间为17个月（IQR: 6.0 ~ 45.5）。1个月、3个月和6个月的局部和总体客观缓解率分别为86%、85%、84%和91%，78%和84%。中位TTP为27.0个月（95%CI: 8.9-28.1），中位OS为54.9个月（95%CI: 16.3-NE）。没有重大爆炸事件的报告。最常见的颗粒分布为2型（69.4%）。术中锥束CT与随访CT颗粒分布一致性高（kappa = 0.80）。大多数治疗的病变显示50-100%的瘤内颗粒分布，与0-50%组相比，该组局部（95.5% vs 71.4%）和总体客观缓解率（100% vs 71.4%）更高。结论rdeb - tace治疗肝癌安全有效。rDEB的分布可以在手术期间和手术后准确评估，并可以预测早期反应。

{"title":"Transarterial chemoembolization with doxorubicin-loaded radiopaque beads for hepatocellular carcinoma: Safety, efficacy, and distribution","authors":"A. Páez-Carpio , P. Bermúdez , M. Sanduzzi Zamparelli , M. Barrufet , O. Arrabal , A. Forner , A. Darnell , J. Bruix , F. Torres , M. Reig , M. Burrel","doi":"10.1016/j.rxeng.2025.101656","DOIUrl":"10.1016/j.rxeng.2025.101656","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the safety and efficacy of transarterial chemoembolization with radio-paque doxorubicin-loaded microspheres (rDEB-TACE) in patients with hepatocellular carcinoma (HCC).</div></div><div><h3>Materials and methods</h3><div>This single-center, retrospective, observational study included all patients 18 years and older diagnosed with HCC and treated with rDEB-TACE from 2017 to 2020 at our institution. rDEB-TACE efficacy was evaluated by type of response after treatment at 1-,3- and 6-month, time to progression (TTP), and overall survival (OS). Safety of the techniquewas assessed based on the occurrence of adverse events (AEs). rDEB distribution was classified by overall distribution as type 1: intratumoral, type 2: intratumoral-feeding artery, and type 3: feeding artery and by intratumoral distribution in 0–50% and 50–100%.</div></div><div><h3>Results</h3><div>Twenty-one patients with 36 lesions treated with rDEB-TACE were included. Median follow-up time was 17 months (IQR: 6.0–45.5). Local and overall objective response at 1, 3 and 6 months was 86%, 85%, 84% and 91%, 78% and 84%, respectively. Median TTP was 27.0 months (95%CI: 8.9–28.1) and median OS was 54.9 months (95%CI: 16.3-NE). No major AEs were reported. The most common particle distribution was type 2 (69.4%). Concordance of particle distribution between intraprocedural cone beam CT and follow-up CT was high (kappa = 0.80). Most lesions treated showed a 50-100% intratumoral particle distribution, with higher rates of local (95.5% vs 71.4%) and overall objective response in this group (100% vs 71.4%) compared with the 0–50% group.</div></div><div><h3>Conclusion</h3><div>rDEB-TACE is a safe and effective treatment for patients with HCC. Distribution of rDEB can be accurately assessed during and after the procedure and may predict early response.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 4","pages":"Article 101656"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of radiation dose in contrast-enhanced spectral mammography (CESM), full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) 对比增强光谱x线摄影（CESM）、全视场数字x线摄影（FFDM）和数字乳腺断层合成（DBT）放射剂量的比较

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101546

I. Suñén , A.I. García Barrado , S. Cruz Ciria , J.G. Maroto , S. Lozares Cordero , B. Gros Bañeres , C. García Mur

Introduction

The use of contrast-enhanced spectral mammography (CESM) has increased in recent years, as has awareness of radiation dose safety among professionals and patients. The principal aim of this study was to compare radiation exposure measured using the entrance surface dose (ESD) and the average glandular dose (AGD) in CESM, Full-Field Digital Mammography (FFDM) and Digital Breast Tomosynthesis (DBT). Our second objective was to evaluate differences caused by compressed breast thickness, compression force and patient age.

Methods

A retrospective observational study included all patients who had undergone a CESM between May 2021 and May 2022. Data was collected on ESD and AGD from the different CESM studies, and breast density and volume were determined by two expert radiologists. The comparative analysis focused on the dose of radiation received during the craniocaudal (CC) projection of the right breast in CESM studies and FFDM or DBT, performed within a 12-month period. Lastly, a statistical analysis was performed to determine the influence of breast compression thickness, compression force and patient age.

Results

Seventy-seven patients participated in the comparative study and forty-four in the dosimetric study. Differences in radiation dose (ESD/AGD) were found among the three breast imaging techniques. The dose in CESM (1.70/5.39 mGy) was lower than in DBT (2.19/6.79 mGy) and higher than in FFDM (1.26/4.06 mGy) for an average breast compression thickness of 59.64 mm. A positive correlation was observed between the dose received in CESM and breast compression thickness (ρ = 0.55), and a negative correlation was observed with patient age (ρ = −0.27). No differences in dosimetric variables were observed for different compression forces.

Conclusions

The ESD and AGD in the CC projection of the right breast in CESM are higher than in FFDM but lower than in DBT. The dose had a positive correlation with breast compression thickness and a negative correlation with patient age.

近年来，随着专业人员和患者对辐射剂量安全意识的提高，对比增强光谱乳房x光检查（CESM）的使用有所增加。本研究的主要目的是比较CESM、全场数字乳房x线摄影（FFDM）和数字乳房断层合成（DBT）中使用入口表面剂量（ESD）和平均腺体剂量（AGD）测量的辐射暴露。我们的第二个目的是评估乳房压缩厚度、压缩力和患者年龄造成的差异。方法回顾性观察研究纳入了2021年5月至2022年5月期间接受CESM的所有患者。从不同的CESM研究中收集ESD和AGD数据，并由两名放射科专家确定乳房密度和体积。比较分析的重点是在12个月内进行的CESM研究和FFDM或DBT中右乳房颅侧（CC）投影期间接受的辐射剂量。最后，统计分析乳房压缩厚度、压缩力和患者年龄的影响。结果77例患者参加了比较研究，44例患者参加了剂量学研究。三种乳腺成像技术在辐射剂量（ESD/AGD）上存在差异。乳房平均压迫厚度为59.64 mm时，CESM组的剂量（1.70/5.39 mGy）低于DBT组（2.19/6.79 mGy），高于FFDM组（1.26/4.06 mGy）。CESM接受的剂量与乳房压迫厚度呈正相关（ρ = 0.55），与患者年龄负相关（ρ = −0.27）。不同的压缩力在剂量学变量上没有差异。结论CESM组右乳CC投影的ESD和AGD高于FFDM组，低于DBT组。剂量与乳房压迫厚度呈正相关，与患者年龄负相关。

{"title":"Comparison of radiation dose in contrast-enhanced spectral mammography (CESM), full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT)","authors":"I. Suñén , A.I. García Barrado , S. Cruz Ciria , J.G. Maroto , S. Lozares Cordero , B. Gros Bañeres , C. García Mur","doi":"10.1016/j.rxeng.2025.101546","DOIUrl":"10.1016/j.rxeng.2025.101546","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of contrast-enhanced spectral mammography (CESM) has increased in recent years, as has awareness of radiation dose safety among professionals and patients. The principal aim of this study was to compare radiation exposure measured using the entrance surface dose (ESD) and the average glandular dose (AGD) in CESM, Full-Field Digital Mammography (FFDM) and Digital Breast Tomosynthesis (DBT). Our second objective was to evaluate differences caused by compressed breast thickness, compression force and patient age.</div></div><div><h3>Methods</h3><div>A retrospective observational study included all patients who had undergone a CESM between May 2021 and May 2022. Data was collected on ESD and AGD from the different CESM studies, and breast density and volume were determined by two expert radiologists. The comparative analysis focused on the dose of radiation received during the craniocaudal (CC) projection of the right breast in CESM studies and FFDM or DBT, performed within a 12-month period. Lastly, a statistical analysis was performed to determine the influence of breast compression thickness, compression force and patient age.</div></div><div><h3>Results</h3><div>Seventy-seven patients participated in the comparative study and forty-four in the dosimetric study. Differences in radiation dose (ESD/AGD) were found among the three breast imaging techniques. The dose in CESM (1.70/5.39 mGy) was lower than in DBT (2.19/6.79 mGy) and higher than in FFDM (1.26/4.06 mGy) for an average breast compression thickness of 59.64 mm. A positive correlation was observed between the dose received in CESM and breast compression thickness (ρ = 0.55), and a negative correlation was observed with patient age (ρ = −0.27). No differences in dosimetric variables were observed for different compression forces.</div></div><div><h3>Conclusions</h3><div>The ESD and AGD in the CC projection of the right breast in CESM are higher than in FFDM but lower than in DBT. The dose had a positive correlation with breast compression thickness and a negative correlation with patient age.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 4","pages":"Article 101546"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiation-induced angiosarcoma of the breast: A rare but aggressive pathology warranting ongoing attention 放射引起的乳腺血管肉瘤：一种罕见但具有侵袭性的病理，需要持续关注

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101645

F.L. Begliardo, P. Cebrián Villar, J.C. Diez Hernández, D. Martin Hernández, M.E. Bonal González

Radiation-induced angiosarcoma of the breast is a rare and highly aggressive malignant neoplasm. Its incidence is likely to rise in the coming years due to the increasing use of breast-conserving surgery techniques.

Changes in the skin colour of the irradiated area in a patient treated with conservative surgery should raise suspicion of this pathology. The diagnostic work‐up for this disease includes different imaging modalities including mammography, ultrasound, or magnetic resonance imaging. However, the most accurate diagnostic method is skin biopsy. Treatment typically involves surgical resection, while the role of chemotherapy and radiotherapy is not well established.

摘要辐射引起的乳腺血管肉瘤是一种罕见且高度侵袭性的恶性肿瘤。由于越来越多地使用保乳手术技术，其发病率在未来几年可能会上升。在接受保守手术治疗的患者中，照射区皮肤颜色的变化应引起对这种病理的怀疑。该疾病的诊断工作包括不同的成像方式，包括乳房x线摄影、超声或磁共振成像。然而，最准确的诊断方法是皮肤活检。治疗通常包括手术切除，而化疗和放疗的作用尚未得到很好的确定。

引用次数: 0

Percutaneous ablation of tumours in the hepatic dome assisted by CT navigation systems. Description of technique and initial experience CT导航系统辅助下肝穹窿肿瘤的经皮消融。描述技术和初步经验

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101542

J.A. Gómez Patiño , M.T. Fontanilla Echeveste , M. Alfageme Zubillaga , S. Méndez Alonso , A. Royuela Vicente , R. González Costero , A. García Suárez

Introduction and objective

CT navigation systems enable access to lesions that are in difficult locations, with poor ultrasound visualisation, and adjacent to vulnerable structures. The objective of this study is to show how navigation systems can increase safety and precision in the ablative treatment of lesions in the hepatic dome.

Materials and methods

A retrospective single-centre study was carried out from April 2018 to February 2022. Percutaneous ablation procedures were performed with CT-navigation system assistance on 75 patients, of which 18 had lesions in the hepatic dome (16 HCCs and 5 metastatic tumours). Syngo.via VB30 software was used to analyse the volume of lesions and ablation areas in pre- and post-treatment CT images. Technical success was determined 24 h following the procedure and according to the length of time free from tumour viability (through imaging tests every three months).

Results

A volumetric study was carried out for 20 of the 21 lesions (95%) and technical success was achieved in 11 of the 21 lesions (52%). In 9 of the 12 lesions that completed a year of follow-up (75%), no signs of tumour viability were detected, achieving local control of the disease. Furthermore, in five of these nine lesions (56%) no progression was observed in other locations of the liver. The syngo.via software version VB30 was able to predict the area of recurrence in 71% of cases. No permanent side effects or death were secondary to the procedure.

Conclusion

CT navigation systems provide increased safety and precision in the percutaneous ablative treatment of tumours in the hepatic dome, making this technique a good treatment option.

引入和目标导航系统可以访问位于困难位置的病变，超声可视化效果差，靠近易损结构。本研究的目的是展示导航系统如何提高肝穹窿病变消融治疗的安全性和准确性。材料与方法于2018年4月至2022年2月进行回顾性单中心研究。在ct导航系统辅助下，对75例患者进行了经皮消融手术，其中18例在肝穹内有病变（16例hcc和5例转移性肿瘤）。Syngo。通过VB30软件对治疗前后CT图像的病灶体积和消融面积进行分析。手术后24小时，根据肿瘤存活时间（通过每三个月的影像学检查）确定技术成功。结果21个病变中有20个（95%）进行了体积研究，其中11个（52%）获得了技术成功。在完成一年随访的12个病变中，有9个（75%）未检测到肿瘤生存迹象，实现了疾病的局部控制。此外，在这9个病变中，有5个（56%）在肝脏的其他部位未观察到进展。syngo。通过VB30软件版本能够预测71%的病例的复发面积。该手术没有永久性副作用或死亡。结论ct导航系统可提高经皮肝穹窿肿瘤消融治疗的安全性和准确性，是一种较好的治疗方法。

{"title":"Percutaneous ablation of tumours in the hepatic dome assisted by CT navigation systems. Description of technique and initial experience","authors":"J.A. Gómez Patiño , M.T. Fontanilla Echeveste , M. Alfageme Zubillaga , S. Méndez Alonso , A. Royuela Vicente , R. González Costero , A. García Suárez","doi":"10.1016/j.rxeng.2025.101542","DOIUrl":"10.1016/j.rxeng.2025.101542","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>CT navigation systems enable access to lesions that are in difficult locations, with poor ultrasound visualisation, and adjacent to vulnerable structures. The objective of this study is to show how navigation systems can increase safety and precision in the ablative treatment of lesions in the hepatic dome.</div></div><div><h3>Materials and methods</h3><div>A retrospective single-centre study was carried out from April 2018 to February 2022. Percutaneous ablation procedures were performed with CT-navigation system assistance on 75 patients, of which 18 had lesions in the hepatic dome (16 HCCs and 5 metastatic tumours). Syngo.via VB30 software was used to analyse the volume of lesions and ablation areas in pre- and post-treatment CT images. Technical success was determined 24 h following the procedure and according to the length of time free from tumour viability (through imaging tests every three months).</div></div><div><h3>Results</h3><div>A volumetric study was carried out for 20 of the 21 lesions (95%) and technical success was achieved in 11 of the 21 lesions (52%). In 9 of the 12 lesions that completed a year of follow-up (75%), no signs of tumour viability were detected, achieving local control of the disease. Furthermore, in five of these nine lesions (56%) no progression was observed in other locations of the liver. The syngo.via software version VB30 was able to predict the area of recurrence in 71% of cases. No permanent side effects or death were secondary to the procedure.</div></div><div><h3>Conclusion</h3><div>CT navigation systems provide increased safety and precision in the percutaneous ablative treatment of tumours in the hepatic dome, making this technique a good treatment option.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 4","pages":"Article 101542"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

RANO 2.0: Update to the response assessment for gliomas RANO 2.0：胶质瘤反应评估的更新

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101621

C. Pineda Ibarra , L. Oleaga Zufiria , I. Valduvieco Ruiz , E. Pineda Losada , T. Pujol Farré , S. González Ortiz

Follow-up of patients with gliomas remains a challenge in the field of the neuro-oncology. The RANO group published its first follow-up criteria for high-grade gliomas in 2010, originally focused on clinical trials, but can served as a guide in the clinical practice. Subsequently, variations were published, including follow-up criteria for low-grade tumours, immunotherapy, and modifications to the original criteria.

In 2023, they published a more comprehensive guide, RANO 2.0, which included all glioma types and different treatments. For the first time, they considered the latest WHO classification and objective data in addition to expert opinion. RANO 2.0 establishes which type of MRI should be used for the baseline MRI, describes the different responses of contrast-enhanced and non-contrast-enhanced tumour components, and determines in what circumstances a confirmatory MRI is required.

In light of these changes, it is worth reviewing these new criteria to enable a better understanding of the revisions and their applicability in routine radiological practice.

神经胶质瘤患者的随访仍然是神经肿瘤学领域的一个挑战。RANO小组于2010年发布了第一个高级别胶质瘤的随访标准，最初专注于临床试验，但可以作为临床实践的指南。随后，发表了一些变化，包括低级别肿瘤的随访标准、免疫治疗和对原始标准的修改。2023年，他们发布了一份更全面的指南RANO 2.0，其中包括所有胶质瘤类型和不同的治疗方法。除了专家意见外，他们还首次考虑了世卫组织的最新分类和客观数据。RANO 2.0确定了哪种类型的MRI应该用于基线MRI，描述了对比增强和非对比增强肿瘤成分的不同反应，并确定了在什么情况下需要进行确认性MRI。鉴于这些变化，有必要对这些新标准进行审查，以便更好地理解修订后的标准及其在常规放射实践中的适用性。

{"title":"RANO 2.0: Update to the response assessment for gliomas","authors":"C. Pineda Ibarra , L. Oleaga Zufiria , I. Valduvieco Ruiz , E. Pineda Losada , T. Pujol Farré , S. González Ortiz","doi":"10.1016/j.rxeng.2025.101621","DOIUrl":"10.1016/j.rxeng.2025.101621","url":null,"abstract":"<div><div>Follow-up of patients with gliomas remains a challenge in the field of the neuro-oncology. The RANO group published its first follow-up criteria for high-grade gliomas in 2010, originally focused on clinical trials, but can served as a guide in the clinical practice. Subsequently, variations were published, including follow-up criteria for low-grade tumours, immunotherapy, and modifications to the original criteria.</div><div>In 2023, they published a more comprehensive guide, RANO 2.0, which included all glioma types and different treatments. For the first time, they considered the latest WHO classification and objective data in addition to expert opinion. RANO 2.0 establishes which type of MRI should be used for the baseline MRI, describes the different responses of contrast-enhanced and non-contrast-enhanced tumour components, and determines in what circumstances a confirmatory MRI is required.</div><div>In light of these changes, it is worth reviewing these new criteria to enable a better understanding of the revisions and their applicability in routine radiological practice.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 4","pages":"Article 101621"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Orbital infections and their complications: A review in images 眼眶感染及其并发症：影像学回顾

Radiologia

Pub Date : 2025-07-01 DOI: 10.1016/j.rxeng.2025.101597

A. Martinez , G. Mattiello , A. Oliva , D. Tovar , P. Cuadras , P. Puyalto

Infection remains the most common cause of non-traumatic acute orbital pathology and a relatively common reason for requesting radiological examinations in the emergency department. Infection can affect any part of the orbit but postseptal involvement most frequently justifies imaging requests, due to its potential severity and associated complications. The differential diagnosis of acute orbital pathology is broad and includes not only infectious entities but also inflammatory and neoplastic conditions. It is important to know how to recognise these entities in order to establish early treatment and avoid serious complications. This article reviews, through case images, orbital pathologies of infectious origin, their potential complications and their differential diagnosis.

感染仍然是非创伤性急性眼眶病理的最常见原因，也是急诊科要求放射检查的一个相对常见的原因。感染可影响眼眶的任何部位，但由于其潜在的严重性和相关并发症，中隔后受累最常需要影像学检查。急性眼眶病理的鉴别诊断是广泛的，不仅包括感染性实体，也包括炎症和肿瘤条件。重要的是要知道如何识别这些实体，以便建立早期治疗和避免严重的并发症。本文回顾，通过病例图像，眼眶病变的传染性起源，其潜在的并发症和鉴别诊断。

引用次数: 0

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。

{"title":"Role of diffusion-weighted MR imaging in the initial diagnosis of soft tissue tumours","authors":"R. Oca Pernas , N. Hormaza Aguirre , T. Salinas Yeregui , T. Palomares Casado , B. Fernández Ruanova , C. Trinidad López","doi":"10.1016/j.rxeng.2023.09.008","DOIUrl":"10.1016/j.rxeng.2023.09.008","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Purpose</h3><div>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.</div></div><div><h3>Material and methods</h3><div><span>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 </span>multivariate analysis<span> was performed to determine the ability of ADC to adequately diagnose the nature of STTs when associated with other morphological characteristics.</span></div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>The inclusion of ADC DWI values improves the diagnostic accuracy of MRI for STTs, especially when used in combination with conventional MRI sequences.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 3","pages":"Pages 263-272"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Radiologists and trainees’ perspectives on artificial intelligence","authors":"A. Catanese , G. Mattiello , S. Azam , P. Puyalto","doi":"10.1016/j.rxeng.2024.01.002","DOIUrl":"10.1016/j.rxeng.2024.01.002","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 3","pages":"Pages 287-298"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Anxiety reduction in patients undergoing MRI: A single institutional study of two novel non pharmacological interventions","authors":"S. Panda , A. Malhotra , S. Chandak , A. Agarwal , S. Dash , P. Singh","doi":"10.1016/j.rxeng.2024.01.004","DOIUrl":"10.1016/j.rxeng.2024.01.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>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 1.5T scanner.</div></div><div><h3>Methods</h3><div>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 <em>P</em>  =.002) and counselling Group (<em>P</em>  =.001) and counselling Group (<em>P</em>  =.01) as evaluated by Chi Square test. No significant difference was achieved when comparing controls with counselling Group (<em>P</em>  <!-->.07).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":94185,"journal":{"name":"Radiologia","volume":"67 3","pages":"Pages 299-308"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0