Journal of Computer Assisted Tomography最新文献

{"title":"Biomechanical Characterization of the Pelvic Floor in Patients With Organ Prolapse: A Finite Element Analysis Based on MRI and Defecography.","authors":"Zhen Yu, Taipeng Zeng, Chengkun Hong, Miyang Yang, Xiaoyang Wang, Hao Huang, Yonggang Liang, Liyuan Fu","doi":"10.1097/RCT.0000000000001892","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001892","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic organ prolapse (POP) is a prevalent condition with complex biomechanical mechanisms. This retrospective observational study aimed to quantitatively evaluate pelvic floor biomechanics in healthy and POP subjects using subject-specific finite element (FE) models derived from high-resolution MRI and dynamic magnetic resonance defecography (MRD).</p><p><strong>Methods: </strong>Subject-specific 3D FE models of the pelvic floor were reconstructed for a healthy control and patients with anterior, apical, and posterior POP. To ensure anatomic representativeness, cases closest to the median levator ani muscle (LAM) volume of each cohort were selected. Nonlinear hyperelastic properties were assigned, and physiological intra-abdominal pressures (eg, Valsalva) were simulated to analyze mechanical responses.</p><p><strong>Results: </strong>Under Valsalva loading, the LAM acted as the primary load-bearing structure. In the healthy model, maximum stress was concentrated at the puborectalis region (1.43 kPa). Conversely, POP models exhibited pathologic remodeling (increased LAM volume and surface area) and significantly altered biomechanics. The posterior POP model demonstrated the most severe mechanical deterioration, with peak stress reaching 5.34 kPa and broader stress concentration zones compared with the control. Furthermore, maximum structural deformation in POP models was substantially greater under identical loads, aligning with clinically observed macroscopic injury patterns.</p><p><strong>Conclusions: </strong>MRD-driven FE modeling effectively quantifies the biomechanical deterioration in POP. The pathologic stress concentration at the puborectalis and the progressive loss of the LAM's load-dispersing capacity provide crucial imaging-based biomechanical evidence to guide individualized surgical planning and pelvic rehabilitation.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of the Visualization of the Adamkiewicz Artery Using a Virtual Non-Electrocardiogram-Gated Reconstruction in Electrocardiogram-Gated Computed Tomography Angiography for Aortic Diseases.","authors":"Masaki Takemitsu, Shohei Kudomi, Kazuki Takegami, Takuya Uehara, Yu Teranaka, Masahiro Tanabe, Kenichiro Ihara, Katsuyoshi Ito","doi":"10.1097/RCT.0000000000001888","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001888","url":null,"abstract":"<p><strong>Objective: </strong>Retrospective electrocardiogram (ECG)-gated CT angiography of the whole aorta is one of the most reasonable acquisition methods for simultaneously evaluating the aorta, coronary arteries, and the Adamkiewicz artery in the preoperative evaluation of aortic diseases. However, in retrospective ECG-gated reconstruction (ECG recon) of the Adamkiewicz artery, only a portion of the acquired data per heartbeat is used for image reconstruction. Therefore, we propose a virtual non-ECG-gated reconstruction (VNECG recon) for the Adamkiewicz artery by editing the ECG, which utilizes all acquired data. The purpose of this study is to evaluate the visualization of the Adamkiewicz artery using the VNECG recon.</p><p><strong>Methods: </strong>Fifty-three cases were analyzed using retrospective ECG-gated CT of the whole aorta from April 2023 to April 2024. We measured the signal-to-noise ratio (SNR) of the aorta and the contrast-to-noise ratio (CNR) of the anterior spinal artery relative to the spinal cord for both ECG recon and VNECG recon. The visualization scores of the Adamkiewicz artery were evaluated by 2 radiologists on a 4-point scale.</p><p><strong>Results: </strong>The SNR and CNR were improved with VNECG recon compared with those of ECG recon (P<0.001). The visualization scores of both observers were higher with VNECG recon than those with ECG recon (observer 1, 3.2±1.0 vs. 2.8±1.1, mean difference 0.4, 95% CI: 0.3-0.6, P<0.001; observer 2, 3.2±1.0 vs. 3.0±1.1, mean difference 0.2, 95% CI: 0.0-0.3, P=0.010, respectively).</p><p><strong>Conclusions: </strong>The visualization of the Adamkiewicz artery was improved by using a VNECG recon method, which avoided discarding any acquired data during the retrospective ECG-gated CT acquisition.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image Quality and Diagnostic Accuracy of Third-Generation Dual-Source CT With High-Pitch Scanning for Coronary CTA in Patients With Atrial Fibrillation and Breath-Holding Inability.","authors":"Yimin Li, Dan Huang, Ruigang Huang, Huijun Xiao, Nan Luo, Xiaohong Huang, Guangyu Lin, Qingwen Huang, Weihua Lin","doi":"10.1097/RCT.0000000000001886","DOIUrl":"10.1097/RCT.0000000000001886","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the image quality and diagnostic accuracy of third-generation dual-source CT with high-pitch scanning for coronary computed tomography angiography (CCTA) in patients with atrial fibrillation (AF) who were unable to hold their breath.</p><p><strong>Methods: </strong>A total of 144 patients with AF and inability to hold their breath were enrolled and assigned into 2 groups: the high-pitch scanning group (N=70) and the prospective ECG-triggered sequential scanning group (N=74). Image quality, radiation dose, and diagnostic performance were compared between the 2 groups.</p><p><strong>Results: </strong>The subjective image quality in the high-pitch group was significantly superior to that in the sequential group ( P <0.001), and it was particularly noticeable in mid-distal coronary artery segments. Radiation dose was significantly lower in the high-pitch group (effective dose: 1.52±0.57 vs. 6.23±3.41 mSv, P <0.001). The diagnostic performance for detecting significant coronary artery stenosis (≥50%), as assessed by the area under the curve (AUC) and diagnostic accuracy, was significantly superior in the high-pitch group compared with the sequential group ( P <0.05).</p><p><strong>Conclusion: </strong>Third-generation dual-source CT with high-pitch scanning demonstrated superior image quality, significantly reduced radiation dose, and enhanced diagnostic performance in CCTA for patients with AF who were unable to perform breath-holding. Therefore, it can be recommended as the preferred noninvasive imaging technique for this patient population.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Features of Double-hit Lymphoma on Contrast-enhanced Neck CT.","authors":"Inseon Ryoo, Karen Buch, Elly Arizono, Osamu Sakai","doi":"10.1097/RCT.0000000000001887","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001887","url":null,"abstract":"<p><strong>Objective: </strong>Double-hit lymphoma (DHL) is a type of high-grade diffuse large B-cell lymphoma (DLBCL) with a dual rearrangement of myelocytomatosis oncogene (MYC) and either B-cell CLL/lymphoma 2 (BCL2) and/or BCL6 genes. Patients with DHL frequently present with aggressive clinical features, and long-term survivors are rare. Previous reports have shown that high-grade lymphomas, such as Burkitt lymphoma, exhibit infiltrative tumor masses, distinct from those of conventional DLBCLs. In this study, we evaluated differences in neck CT imaging findings between patients with DHL and those with non-double-hit, conventional DLBCL.</p><p><strong>Materials and methods: </strong>This was an IRB-approved, retrospective study that included 13 DHL patients and 26 age and sex-matched non-double-hit, conventional DLBCL patients who underwent contrast-enhanced neck CTs at our health care system. All CT images were reviewed, and imaging features including the largest tumor mass size (measured in the long and short axes) and the presence/absence of gross internal necrosis, infiltrative margins, and matted patterns of lymph nodes were recorded. These findings were compared between the DHL and conventional DLBCL groups. Multiple logistic regression analyses were conducted to determine which factors independently discriminated DHL from conventional DLBCL.</p><p><strong>Results: </strong>The long and short axis diameters of the largest tumor mass showed no significant difference between the two groups (P = 0.50 and 0.98, respectively). The DHL patients demonstrated a greater frequency of gross internal necrosis and infiltrative patterns than conventional DLBCL patients (P < 0.001 and P = 0.002, respectively). DHL patients more frequently had matted lymphadenopathy than conventional DLBCL patients; however, statistical significance for this finding was not achieved (P = 0.099). The presence of gross internal necrosis independently distinguished DHL from conventional DLBCL (P = 0.04; odds ratio, 14.14; 95% CI, 1.16-172.86).</p><p><strong>Conclusion: </strong>DHL patients more frequently had gross internal necrosis and infiltrative patterns on the neck CT images than conventional DLBCL patients.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Noncontrast Images Derived From Photon-Counting CT Enhance Inter-Reader Reproducibility of Myocardial ECV Measurement in Patients With Cardiac Devices.","authors":"Yosuke Yamakami, Kensuke Hirasawa, Hiroto Hada, Ken Takahashi, Takahiro Tsunoda, Mari Ohmori, Yoshinori Kanno, Taishi Yonetsu, Tetsuo Sasano","doi":"10.1097/RCT.0000000000001880","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001880","url":null,"abstract":"<p><strong>Objective: </strong>The standard 2-scan computed tomography (CT) for quantifying the extracellular volume fraction (ECV) of the left ventricle is limited by misregistration errors, particularly in patients with atrial fibrillation (AF) or cardiac implants such as prosthetic valves and/or cardiac implantable electronic devices (CIEDs). This study aimed to evaluate whether a single-scan virtual noncontrast (VNC) method using photon-counting CT (PCCT) improves the reproducibility of measurement compared with the standard subtraction method in these challenging patient populations.</p><p><strong>Methods: </strong>We retrospectively analyzed 59 patients undergoing PCCT, stratified into the following 3 groups: control (n=20), AF (n=20), and cardiac implants, including prosthetic valves and/or CIEDs (n=19). Myocardial ECV was quantified using both standard subtraction and VNC methods. Reproducibility was assessed by intraclass correlation coefficients (ICCs) and mean absolute error.</p><p><strong>Results: </strong>In the cardiac implant group, the VNC method demonstrated a significantly lower interobserver mean absolute error compared with the standard subtraction method (1.66% vs. 2.54%, P=0.029). No significant differences were observed in the AF (1.35% vs. 1.54%, P=0.648) or control (1.39% vs. 1.68%, P=0.674) groups. The VNC method demonstrated good to excellent interobserver (all ICCs >0.89) and intraobserver (all ICCs >0.90) agreement. Intraobserver agreement was also excellent for both methods, with no significant difference between them.</p><p><strong>Conclusions: </strong>The PCCT-derived VNC method significantly improves interobserver reproducibility of ECV measurement in patients with cardiac devices, establishing it as a more reproducible technique for myocardial tissue characterization in this challenging population.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MR Imaging in Penile Trauma and Tumors.","authors":"Noor Fatima Majeed, Diana M Salazar","doi":"10.1097/RCT.0000000000001890","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001890","url":null,"abstract":"<p><p>Magnetic resonance imaging (MRI) enables noninvasive interrogation of penile pathology and can address uncertainties in cases of penile trauma and tumors, helping form critical management decisions. Specifically, MRI can assess the integrity of the tunica albuginea following penile trauma, thereby directing the patient to surgery versus nonoperative care. MRI also serves an adjunctive role to physical examination in local staging of penile cancer, and is especially useful for evaluation of corporal invasion, while simultaneously allowing a preliminary assessment of pelvic nodal status. In this review, we detail the normal anatomy of the penis, protocol considerations for MRI of the penis, and interpretation of penile MRI for trauma and tumors.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric Analysis of Deep Cerebellar and Thalamic Nuclei in Spastic Cerebral Palsy.","authors":"Nolan W Rizzo, Wen Li, Arya J Shetty, Caroline L Hanan, Ahmed T Massoud, Arash Kamali, Christine A Hill, Stacey L Hall, Simra Javaid, Sarah Lund Wilson, Nivedita Thakur, Stuart Fraser, Surya N Mundluru, Sam Nicholas Russo, Manish N Shah","doi":"10.1097/RCT.0000000000001881","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001881","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral palsy (CP) encompasses various movement disorders, most commonly spasticity, although other motor phenotypes such as dystonia may occur. Certain structural magnetic resonance imaging (MRI) findings, such as periventricular leukomalacia, are strongly correlated with spasticity. Due to their contributions in motor system modulation, thalamic structures and deep cerebellar nuclei (DCN) are appealing volumes of interest for investigating spasticity and CP-related motor pathway injuries. The goal of this study is to determine the validity of using scaled volumetric analysis of thalamic and deep cerebellar nuclei for distinguishing patients with spastic cerebral palsy.</p><p><strong>Materials and methods: </strong>All MRI scans were processed with FreeSurfer's recon-any pipeline, which integrates the deep-learning tools SynthSeg and SynthSR to generate standardized 1 mm isotropic T1-weighted images and robust segmentations independent of input contrast or resolution. DCN volumes were obtained using the SUIT toolbox, which employs an atlas-based segmentation of the cerebellum. To account for individual differences in brain size, volumes were allometrically scaled relative to total brain volume (TBV). Age-matched healthy controls were used from the Calgary Preschool MRI Dataset to ensure that observed volumetric differences reflected pathology rather than typical developmental variation. Statistical analyses were performed using Welch t test to account for unequal variances and sample size, as well as Spearman rank correlation analyses to evaluate the monotonic relationship between DCN and Gross Motor Function Classification System (GMFCS) scores.</p><p><strong>Results: </strong>Relative to TBV, all 14 thalamic nuclei were significantly smaller in the spastic CP group. Scaled DCN volumes revealed a heterogeneous and lateralized pattern. Overall, this cohort demonstrated reduced left dentate volume and relative enlargement of the left interposed and bilateral fastigial nuclei. This enlargement was confined to individuals with mild motor impairment, while more severe impairment was associated with progressively reduced volumes.</p><p><strong>Conclusions: </strong>Patients with spastic CP demonstrate widespread reductions in TBV-adjusted thalamic volumes and a lateralized pattern of DCN volume alterations, which may reflect compensatory or maladaptive plasticity following cerebellothalamic pathway injury. Allometrically scaled volumetric analysis of these subcortical structures may provide a reliable approach for characterizing CP-related movement disorders and identifying potential neuroanatomical targets for future surgical interventions, including deep brain stimulation.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underreporting of Coronary Stents in LDCT for Lung Cancer Screening and Their Differentiation From Severe Coronary Artery Calcifications.","authors":"Carlo Tessa, Giulia Picozzi, Diletta Cozzi, Edoardo Cavigli, Luca Gozzi, Jasmine Giovannoli, Giuseppe Gorini, Stefano Diciotti, Mario Mascalchi","doi":"10.1097/RCT.0000000000001826","DOIUrl":"10.1097/RCT.0000000000001826","url":null,"abstract":"<p><p>Lung Cancer (LC) screening with low-dose CT (LDCT) is recommended in smokers and former smokers irrespective of cardiovascular disease (CVD) history. Differentiating coronary stents from moderate-to-severe coronary artery calcifications (CACs) on LDCT examinations can be challenging and have clinical implications. We hypothesized that coronary stents are inadequately reported in screening LDCT examinations and conducted a retrospective analysis nested within an LC screening study. Moreover, we devised a postprocessing procedure to differentiate coronary stents and severe CACs in LDCT examinations and assessed its potential. Among 592 participants with detailed CVD history at baseline, the LDCT report mentioned coronary stents in 13 and severe CACs in 60 of 73 (12.3%). Two radiologists independently and blindly reviewed the LDCT examinations, providing a binary judgment (yes/no) on stent presence using images optimized with a window setting optimized to view detail in bone (window width 1800 to 2000 HU and window level 300 to 500 HU) reformatted parallel or perpendicular to the coronary arteries. The review identified stents in 26 subjects and was inconclusive in 2. On images viewed with such \"bone\" window setting, stents appeared as \"tram-track\" (large stents) or \"pencil-lead\" (narrow stents) configurations in parallel views, and as a \"rim-of-wheel\" shape in perpendicular views. In contrast, CACs lacked these configurations due to their irregular distribution along vessel walls. No difference in attenuation was observed between stents and severe CACs. Concordance with the history of PTCA with stent placement was 42.8% (12/28) for the original LDCT reports and 92.8% (26/28) for the review ( P =0.0014). Our study suggests that coronary stents are often under-reported in screening LDCT, but their characteristic shapes on images viewed with a \"bone\" window setting with multiplanar reformatting can aid in accurate identification.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"419-425"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13174938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Dose Reduction Techniques With Subtraction Coronary CT Angiography for Patients With High Calcification Scores.","authors":"Peikai Huang, Mengqiang Xiao, Hongyi Li, Jun Chen, Rulin Xu, Jinfeng Liu, Wenfeng Wang, Chao Peng","doi":"10.1097/RCT.0000000000001829","DOIUrl":"10.1097/RCT.0000000000001829","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effectiveness of various dose reduction strategies in subtraction coronary CT angiography (S-CCTA) for patients with elevated coronary artery calcification scores.</p><p><strong>Methods: </strong>Fifty sequential patients, each possessing a calcification score of at least 400, were subjected to scans employing several dose reduction methods, such as narrowed acquisition windows, decreased tube voltage, diminished tube currents, isocentric scanning, and adaptive iterative dose reduction (AIDR). This study involved the execution of both subjective and objective evaluations to assess the image quality and diagnostic precision of contrast-enhanced CCTA (C-CCTA) and subtraction CCTA (S-CCTA). A quantitative analysis of coronary artery calcification was performed by measuring the circumferential extent of cross-sections, and patients were classified in accordance with the Coronary Artery Disease Reporting and Data System (CAD-RADS) guidelines. To assess the diagnostic accuracy of CCTA in relation to subtraction data, invasive coronary angiography (ICA) was utilized as the gold standard reference.</p><p><strong>Results: </strong>The mean effective radiation dose recorded was 1.08±0.29 mSv. No notable disparities in image quality, either subjective or objective, were detected between C-CCTA and S-CCTA ( P >0.05); however, an exceptionally strong correlation (ICC=0.95, 0.94) was observed between the subjective assessments of the 2 modalities. Within 768 assessable segments, S-CCTA exhibited superior sensitivity (87.50% vs. 78.52%) and specificity (92.58% vs. 82.42%) compared with C-CCTA ( P <0.001). S-CCTA significantly enhanced diagnostic accuracy in severely calcified segments from 49.12% to 74.56% ( P <0.001), with notable improvements also in moderately (57.41% to 82.41%, P <0.001) and mildly calcified segments (65.56% to 85.56%, P =0.002).</p><p><strong>Conclusion: </strong>Employing multiple dose reduction techniques markedly diminishes the radiation exposure in subtraction coronary CTA and improves the diagnostic accuracy in classifying calcified coronary stenoses.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"411-418"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic Outlet Syndrome: Unraveling the Anatomy, Reviewing the Computed Tomography Angiography Protocol, and Organizing the Report.","authors":"Natália R L Mágero, Patrícia Yokoo, Murilo M Silva, Eduardo K U Nunes, Gilberto Szarf, Adriano Tachibana","doi":"10.1097/RCT.0000000000001822","DOIUrl":"10.1097/RCT.0000000000001822","url":null,"abstract":"<p><p>The thoracic outlet is an anatomic region that extends from the supraclavicular fossa to the axilla. It passes through an important neurovascular bundle composed of the brachial plexus, artery, and subclavian vein. The relationships between the multiple structures comprising the thoracic outlet are dynamic due to the great mobility of the shoulder joint, which may cause compression of the bundle during movement of the upper limb. However, identification of positional changes in the caliber of the subclavian vessels and the brachial nervous plexus alone in imaging examinations may not have clinical significance and should be interpreted in light of the signs and symptoms of the physical examination. The radiologist must be familiar not only with the different imaging presentations of this pathology but also with its predisposing factors, main maneuvers that sensitize symptoms, possible complications, and expected findings after treatment for decompression. Along with this, it is essential to know the directed protocol of computed tomography angiography (CTA) for acquisition of adequate images, which, together with a directed, specific report, allows proper communication with the attending physician.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"403-410"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}