European Radiology最新文献

{"title":"Contrast-enhanced mammography vs MRI: Which breast imaging modality leads in lesion detection?","authors":"Yoav Amitai","doi":"10.1007/s00330-024-11306-1","DOIUrl":"10.1007/s00330-024-11306-1","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3068-3069"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could MR elastography be a way to make violent contact sports safer?","authors":"Tzu-Chao Chuang, Yu-Hsiu Lee, Hsiao-Wen Chung","doi":"10.1007/s00330-025-11531-2","DOIUrl":"10.1007/s00330-025-11531-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3610-3612"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESR Bridges: imaging and treatment in brain tumours-a multidisciplinary view.","authors":"Marion Smits, Niels Verburg, Martin J van den Bent","doi":"10.1007/s00330-024-11279-1","DOIUrl":"10.1007/s00330-024-11279-1","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3382-3384"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided high-intensity focused ultrasound for symptomatic uterine fibroids: clinical outcome of two European centers.","authors":"Sara Dohmen, Florian Recker, Yoana Ivanova, Holger M Strunk, Tolga Tonguc, Olga Ramig, Marcus Thudium, Judith M Stader, Rupert Conrad, Markus Essler, Eva-Katharina Egger, Alexander Mustea, Grigor A Gortchev, Dobromir Dimitrov, Milka Marinova","doi":"10.1007/s00330-024-11230-4","DOIUrl":"10.1007/s00330-024-11230-4","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to assess the clinical outcome and mid-term efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) as a treatment for symptomatic uterine fibroids at two major European HIFU centers.</p><p><strong>Materials and methods: </strong>This bi-center longitudinal clinical study involved the treatment of 100 patients with symptomatic uterine fibroids using USgHIFU (n = 59 in Germany, n = 41 in Bulgaria). Clinical outcomes were evaluated at 6 weeks, 6 months, and 1 year follow-up utilizing the uterine fibroid symptoms-quality of life questionnaire for fibroid-related symptoms and health-related quality of life as well as MRI imaging for determining the fibroid volume.</p><p><strong>Results: </strong>The mean fibroid volume reduction rate was 33.2 ± 22.9%, 51.3 ± 24.2%, and 59.1 ± 28.0% at 6 weeks, 6 months, and 1 year, respectively (each p < 0.001). The mean symptom severity score decreased from 43.9 ± 18.8 at baseline to 35.4 ± 18.2 at 6 weeks, 31.1 ± 20.0 at 6 months, and 23.1 ± 14.0 at 1 year (each p < 0.001). The mean QOL score improved from 56.5 ± 23.4 at baseline to 65.4 ± 22.2 at 6 weeks, 72.5 ± 19.5 at 6 months, and 79.4 ± 15.3 at 1 year (each p < 0.001). No major complications were observed, though two patients experienced temporary sciatic nerve irritation following the procedure. Four patients had pregnancies and deliveries without any complications after USgHIFU therapy.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first longitudinal study conducted in two major European HIFU centers that reveals the clinical efficacy of USgHIFU ablation on symptomatic uterine fibroids. Our results confirm that USgHIFU is a non-invasive approach with a low risk of complications, offering an innovative treatment option for affected women.</p><p><strong>Key points: </strong>Question To evaluate mid-term clinical efficacy and safety of US-guided high-intensity focused ultrasound (HIFU) for treating symptomatic uterine fibroids and patient outcomes across two European centers. Findings US-guided HIFU treatment resulted in significant fibroid volume reduction (up to 59.1% after 1 year) improving symptoms and quality of life with no major complications. Clinical relevance This prospective longitudinal study provides preliminary data assessing mid-term efficacy and clinical outcomes of ultrasound-guided HIFU. It is shown to be a low-risk, non-invasive treatment option for symptomatic uterine fibroids that reduces fibroid size and improves patients' quality of life.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3638-3648"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid artery intima-media thickness values in obese or overweight children: a meta-analysis.","authors":"Jean-Baptiste Moretti, Alexandre Korban, Émilie Alchourron, Sylvie Gervais, Ramy El Jalbout","doi":"10.1007/s00330-024-11284-4","DOIUrl":"10.1007/s00330-024-11284-4","url":null,"abstract":"<p><strong>Objective: </strong>Carotid artery intima-media thickness (IMT) is a non-invasive ultrasound marker of early atherosclerosis. This systematic review and meta-analysis aim to report the published differences in IMT values in children living with overweight or obesity compared to controls with normal weight.</p><p><strong>Methods: </strong>This review was conducted according to PRISMA guidelines, including only cohorts with normal controls. Inclusion criteria were IMT measured using B-mode or radiofrequency (RF) techniques and based on the four consensuses: American Heart Association, Association for European Pediatric Cardiology, Mannheim Consensus, and American Society of Echocardiography. We used the body mass index based on the World Health Organization growth standard definitions of obesity in children. Relevant articles were extracted from PubMed, Cochrane Library, Embase, and Web of Science searched from inception to February 2024. A meta-analysis was done by a biostatistician using the R-software version 4.0.2.</p><p><strong>Results: </strong>We obtained 15 B-mode-based and two RF echo-tracking-based IMT measurement studies. IMT is significantly increased in children living with obesity. The mean IMT was 0.041 mm, 95% confidence interval (CI): 0.052; 0.031 higher in children with overweight/obesity, using the B-mode technique, and 0.045 mm, 95% CI: 0.062; 0.029 higher in children with overweight/obesity using RF technique.</p><p><strong>Conclusion: </strong>This meta-analysis shows that IMT is significantly increased in children with obesity compared to normal-weight children according to both techniques.</p><p><strong>Key points: </strong>Question IMT measured according to known consensuses is significantly increased in children living with obesity. Findings Mean IMT was 0.041 mm higher in children living with obesity using the B-mode technique and 0.045 mm using the RF technique. Clinical relevance There are different techniques to measure IMT in children. This meta-analysis, using cohorts of children living with obesity compared to normal weight controls, shows a significantly increased IMT in children living with obesity.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3305-3313"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of lumbar paraspinal muscles in patients with chronic low back pain and its relationship to pain duration, pain intensity, and quality of life.","authors":"Sihai Liu, Sandra Reitmaier, Lukas Mödl, Daishui Yang, Tianwei Zhang, Luis Becker, Bernhard Hoehl, Lukas Schönnagel, Torsten Diekhoff, Matthias Pumberger, Hendrik Schmidt","doi":"10.1007/s00330-024-11236-y","DOIUrl":"10.1007/s00330-024-11236-y","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).</p><p><strong>Methods: </strong>Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.</p><p><strong>Results: </strong>Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.</p><p><strong>Conclusion: </strong>CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.</p><p><strong>Key points: </strong>Question What is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life? Findings cLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration. Clinical relevance Understanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3652-3660"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherosclerotic plaque evolution predicts cerebral ischemic events in patients with intracranial atherosclerosis: a multicentre longitudinal study using high-resolution MRI.","authors":"Weihe Yao, Hongbing Chen, Kangmo Huang, Wenjia Peng, Xuefeng Zhang, Dahong Yang, Zhongzhao Teng, Jinhua Shen, Jialuo Yang, Xiaoqing Cheng, Yunfei Han, Wusheng Zhu, Junjun Wang, Juan Du, Xinfeng Liu","doi":"10.1007/s00330-024-11248-8","DOIUrl":"10.1007/s00330-024-11248-8","url":null,"abstract":"<p><strong>Background: </strong>Intracranial atherosclerosis (ICAS) is the leading cause of ischemic stroke in Asians and the recurrent rate remains high despite the optimal medical treatment. This study aimed to confirm that follow-up high-resolution magnetic resonance imaging (hrMRI) provided essential values in predicting subsequent cerebral ischemic events in patients with ICAS.</p><p><strong>Methods: </strong>Patients with moderate to severe stenosis in the middle cerebral artery (MCA) defined by magnetic resonance (MRA) or computed tomography angiography (CTA) were recruited from three centers retrospectively. Detailed plaque composition was analyzed on baseline and follow-up hrMRI. Multivariate Cox proportional hazards regression analysis was used to identify the key risk factors for predicting subsequent ischemic events.</p><p><strong>Results: </strong>Among 152 patients, a total of 86 patients with MCA atherosclerotic stenosis underwent follow-up hrMRI exams and ipsilateral cerebral ischemic events occurred in 12 patients during a 1-year follow-up. Analyses showed the predictors of ischemic events were age (adjusted Hazard ratio (HR) = 0.942; 95% Confidence Interval (CI), [0.903, 0.983]; p = 0.006), progression of plaque burden (HR = 3.818; 95% CI [1.117, 13.051]; p = 0.033), vessel expansion (HR = 5.173; 95% CI [1.077, 24.838]; p = 0.040) and enhancement ratio progression (HR = 6.144; 95% CI [1.480, 25.511]; p = 0.012). The combined model achieved a concordance index of 0.804 (95% CI [0.658, 0.950]).</p><p><strong>Conclusion: </strong>Longitudinal hrMRI evaluation improved the accuracy in identifying higher-risk patients with intracranial atherosclerosis.</p><p><strong>Key points: </strong>Question Can longitude high-resolution magnetic resonance imaging (hrMRI) help clinicians observe intracranial plaque evolution? Findings Compared with the baseline exam, intracranial plaque evolution distinguished by follow-up hrMRI exam showed a higher accuracy in predicting subsequent ischemic events. Clinical relevance Longitudinal high-resolution magnetic resonance vessel wall imaging enables dynamic observation and evaluation of the changes in plaque characteristics among intracranial atherosclerosis patients. Atherosclerotic plaque evolution revealed by repeated exams can strengthen the risk stratification of patients with intracranial atherosclerosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3238-3248"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-based radiomic prognostic vector (RPV) predicts survival and stromal histology in high-grade serous ovarian cancer: an external validation study.","authors":"Georg J Wengert, Haonan Lu, Eric O Aboagye, Georg Langs, Nina Poetsch, Ernst Schwartz, Zsuzsanna Bagó-Horváth, Christina Fotopoulou, Stephan Polterauer, Thomas H Helbich, Andrea G Rockall","doi":"10.1007/s00330-024-11267-5","DOIUrl":"10.1007/s00330-024-11267-5","url":null,"abstract":"<p><strong>Objectives: </strong>In women with high-grade serous ovarian cancer (HGSOC), a CT-based radiomic prognostic vector (RPV) predicted stromal phenotype and survival after primary surgery. The study's purpose was to fully externally validate RPV and its biological correlate.</p><p><strong>Materials and methods: </strong>In this retrospective study, ovarian masses on CT scans of HGSOC patients, who underwent primary cytoreductive surgery in an ESGO-certified Center between 2002 and 2017, were segmented for external RPV score calculation and then correlated with overall survival (OS) and progression-free survival (PFS). A subset of tissue samples subjected to fibronectin immunohistochemistry were evaluated by a gynaeco-pathologist for stromal content. Kaplan-Meier log-rank test and a Cox proportional hazards model were used for outcome analysis.</p><p><strong>Results: </strong>Among 340 women with HGSOC, 244 ovarian lesions were available for segmentation in 198 women (mean age 59.8 years, range 34-92). Median OS was 48.69 months (IQR: 27.0-102.5) and PFS was 19.3 months (IQR: 13-32.2). Using multivariate Cox analysis, poor OS was associated with RPV-high (HR 3.17; 95% CI: 1.32-7.60; p = 0.0099), post-operative residual disease (HR 2.04; 95% CI: 1.30-3.20; p = 0.0020), and FIGO stage III/IV (HR 1.79; 95% CI: 1.11-2.86; p = 0.016). Age did not influence OS. RPV-high tissue had higher stromal content based on fibronectin expression (mean 48.9%, SD 10.5%) compared to RPV-low cases (mean 14.9%, SD 10.5%, p < 0.0001). RPV score was not significantly associated with PFS.</p><p><strong>Conclusion: </strong>Patients with HGSOC and RPV-high ovarian mass on pre-operative CT had significantly worse OS following primary surgery and a higher stromal content compared to RPV-low masses, externally validating the RPV and its biological interpretation.</p><p><strong>Key points: </strong>Question Can the performance of a previously described RPV in women with HGSOC be replicated when licenced to an external institution? Findings External validation of RPV among 244 ovarian lesions demonstrated that, on multivariate analysis, OS was associated with RPV, stage, and postoperative residual disease, replicating previous findings. Clinical relevance External validation of a radiomic tool is an essential step in translation to clinical applicability and provides the basis for prospective validation. In clinical practice, this RPV may allow more personalized decision-making for women with ovarian cancer being considered for extensive cytoreductive surgery.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3110-3119"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing prone CT use for suspected interstitial lung abnormalities.","authors":"Jiyoung Song, Kum Ju Chae, Jong Eun Lee, Masahiro Yanagawa, Jonathan H Chung, David A Lynch, Myoung-Jin Jang, Jin Mo Goo, Soon Ho Yoon","doi":"10.1007/s00330-024-11259-5","DOIUrl":"10.1007/s00330-024-11259-5","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated whether supine chest CT alone suffices for diagnosing ILAs, thereby reducing the need for prone chest CT.</p><p><strong>Materials and methods: </strong>Patients who underwent prone chest CT for suspected ILAs from January 2021 to July 2023, with matching supine CT within 1 year, were retrospectively evaluated. Five multinational thoracic radiologists independently rated ILA suspicion and fibrosis scores (1 to 5-point) and ILA extent (1-100%) using supine CT first, then combined supine-prone CT after a 1-month washout. We categorized ILA suspicion and fibrosis scores into four diagnostic groups; normal, non-fibrotic, indeterminate-type, and fibrotic ILAs. The areas under the receiver operating characteristic curve (AUCs) of ILA suspicion scores, inter-reader agreement on diagnostic categories, and intra-reader/inter-reader reliability for ILA extent were evaluated.</p><p><strong>Results: </strong>This study included 69 patients (mean age 67.2 ± 7.2 years; 36 women), with 23 age- and sex-matched patients in each group: normal, non-fibrotic ILAs, and fibrotic ILAs. The pooled AUC for ILA suspicion and inter-reader agreement on diagnostic categories improved for non-fibrotic ILAs with prone CT (AUC 0.76 to 0.92, p < 0.001; Fleiss kappa 0.25 to 0.51, p = 0.004), but not for fibrotic ILAs (AUC 0.94 to 0.99, p = 0.06; Fleiss kappa 0.63 to 0.72, p = 0.08). ILA extent was 1-2% smaller with prone CT for both ILA types (p < 0.001).</p><p><strong>Conclusion: </strong>For fibrotic ILAs, supine CT alone exhibited substantial diagnostic accuracy and inter-reader agreement, while the diagnosis of non-fibrotic ILAs benefited from adding prone CT. Supine CT alone slightly overestimated extent regardless of ILA type.</p><p><strong>Key points: </strong>Question Prone CT is recommended when interstitial lung abnormalities (ILAs) are suspected on supine CT, but its benefits remain underexplored. Findings Supine CT alone sufficed for diagnosing fibrotic ILAs, while prone CT improved non-fibrotic ILA diagnosis and reduced extent overestimation for both types. Clinical relevance Omitting prone CT reduces extra time, space, and radiation exposure without compromising the diagnosis of fibrotic ILAs, which have higher rates of progression and mortality risks, enhancing patient comfort and simplifying patient management.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3021-3029"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transjugular mesenteric-caval shunt for portal vein cavernous transformation with recurrent variceal bleeding: preliminary results.","authors":"Jun Tie, Xulong Yuan, Zhengcai Liu, Xiaoyuan Gou, Ying Zhu, Jing Niu, Jiao Xu, Shuqiang Yue, Yongquan Shi","doi":"10.1007/s00330-024-11041-7","DOIUrl":"10.1007/s00330-024-11041-7","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the feasibility, safety, and efficacy of the transjugular mesenteric-caval shunt (TMCS) as a treatment for the cavernous transformation of the portal vein (CTPV) and recurrent variceal bleeding.</p><p><strong>Methods: </strong>This retrospective case series was conducted with approval from the institutional review board. It involved seven patients diagnosed with CTPV and recurrent variceal bleeding who underwent the TMCS procedure. We analyzed the rate of procedural complications, incidents of rebleeding, stent stenosis, hepatic encephalopathy, and overall survival to assess treatment outcomes.</p><p><strong>Results: </strong>The TMCS was successfully performed in all seven patients without any life-threatening complications. Postoperatively, one patient developed a lung infection and pleural effusion, which resolved with appropriate treatment. Additionally, two patients experienced an increase in total bilirubin levels, but there was no further deterioration in liver function. The median portal pressure gradient significantly decreased from a preoperative value of 27 mmHg (range 20-36 mmHg) to a postoperative value of 6 mmHg (range 4-11 mmHg). A notable improvement was observed in one cirrhotic patient, with liver function progressing from Child-Pugh class B (score 9) to class A (score 6). Over a median follow-up period of 14 months (range 7-18 months), none of the patients encountered rebleeding, stent stenosis, hepatic encephalopathy, or mortality.</p><p><strong>Conclusion: </strong>The TMCS appears to be a viable and effective alternative for managing CTPV with recurrent variceal bleeding. Its long-term outcome requires further evaluation.</p><p><strong>Clinical relevance statement: </strong>TMCS provides a promising treatment for patients with life-threatening CTPV complications when occluded portal vein cannot be recanalized and portal vein recanalization TIPS is not an option.</p><p><strong>Key points: </strong>Performing TIPS in patients with portal vein cavernoma is complex due to the requirement for recanalization of the occluded portal vein. Creating a mesenteric-caval shunt through a transjugular approach is a feasible technique. Establishing a TMCS provides a means to manage life-threatening complications arising from portal vein cavernoma.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3256-3261"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}