Radiology. Cardiothoracic imaging最新文献

{"title":"<i>Radiology: Cardiothoracic Imaging</i> Highlights 2025.","authors":"Daniel Pinos, Lucas de Pádua Gomes de Farias, Carlotta Onnis, Dominika Suchá, Joanna G Escalon, Kate Hanneman, Suhny Abbara, Harold I Litt, Gaurav S Gulsin, Domenico Mastrodicasa","doi":"10.1148/ryct.260065","DOIUrl":"10.1148/ryct.260065","url":null,"abstract":"<p><p><i>Radiology: Cardiothoracic Imaging</i> publishes novel research and technical developments in cardiac, thoracic, and vascular imaging. This review article, led by the <i>Radiology: Cardiothoracic Imaging</i> Early Career Editorial Board, highlights selected articles published in the journal between November 2024 and October 2025. Featured articles span the breadth of cardiothoracic and vascular imaging, including cardiac CT assessment of prosthetic heart valves, photon-counting CT for improved coronary stent evaluation, and streamlined multiparametric cardiac MRI acquisition techniques. Additional topics include imaging of mitral annular disjunction; cardiac MRI markers of diastolic dysfunction, myocardial heterogeneity, and myocarditis prognosis; and cardiac MRI-based assessment of sarcopenia as a novel prognostic marker. Ongoing research and future directions include accelerated cardiac MRI, opportunistic cardiovascular risk assessment from incidental findings at routine imaging, and expanding applications of quantitative and artificial intelligence-driven techniques across cardiac, thoracic, oncologic, and vascular imaging. <b>Keywords:</b> Deep Learning, CT, CT-Coronary Angiography, CT Angiography, CT-Photon Counting, CT-Quantitative, Aorta, Coronary Arteries, Clinical Testing, MR Imaging, MRI, Cardiac, Pulmonary, Heart, Lung, Artificial Intelligence, Mitral Valve, Thoracic Tumor Staging, Vascular © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e260065"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219539","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}

{"title":"Association of Deep Learning-based Myocardial Infarction Size Quantification in Cardiac MRI with Cardiac Biomarker Levels.","authors":"Matthias Schwab, Mathias Pamminger, Christian Kremser, Enrique Almar-Munoz, Sebastian Johannes Reinstadler, Martin Reindl, Bernhard Metzler, Markus Haltmeier, Agnes Mayr","doi":"10.1148/ryct.250235","DOIUrl":"10.1148/ryct.250235","url":null,"abstract":"<p><p>Purpose To evaluate the reliability and clinical applicability of an artificial intelligence (AI)-based infarct size quantification method based on cardiac MR images in patients with ST-elevation myocardial infarction (STEMI). Materials and Methods This retrospective study included patients with acute STEMI who underwent cardiac MRI between January 2005 and October 2024. A convolutional neural network (CNN) was trained on 468 unique cardiac MRI examinations, with manual infarct segmentations serving as the reference standard. On a test set, correlations between manual and AI-determined infarct sizes and peak creatine kinase (CK) and cardiac troponin T (cTnT) levels were assessed using Pearson and Spearman correlation analyses. The predictive value of the manual and AI-based measurements for the occurrence of left ventricular adverse remodeling (LVAR) was compared using the DeLong test. Results The test set comprised 800 patients (median age, 58 years [IQR, 51-67 years]; 83% male). The CNN estimated a larger median infarct size than the manual measurements did (26.5 vs 20.1 mL; <i>P</i> < .001). The correlation with peak CK levels was greater (<i>P</i> < .001) for the automated measurements (<i>r</i> = 0.76, ρ = 0.80) than for manual segmentations (<i>r</i> = 0.68, ρ = 0.72). The same relationship was observed for peak cTnT levels (<i>r</i> = 0.66 vs <i>r</i> = 0.57; <i>P</i> = .004). Manual and AI-based measurements demonstrated comparable predictive value for LVAR (<i>P</i> = .24). Conclusion The AI-based infarct size quantification method based on cardiac MRI is comparable to manual measurement and is strongly correlated with cardiac biomarkers. <b>Keywords:</b> MR-Imaging, Cardiac, Heart, Ischemia/Infarction, Segmentation, Late Gadolinium Enhancement, ST Elevation Myocardial Infarction, Convolutional Neural Networks, Cardiac Biomarkers <i>Supplemental material is available for this article.</i> © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. ClinicalTrials.gov identifier: NCT04113356.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250235"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318841","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}

{"title":"Cardiac Radiation Dose and Subclinical Coronary Artery Disease Progression after Breast Cancer Radiotherapy: 2-year Cardiac CT Results from the EARLY-HEART Study.","authors":"Elie Mousseaux, Damian Craiem, Rozemarijn Vliegenthart, Sophie Jacob, Arantxa Eraso, Susana Constantino Rosa Santos, Kai Borm, Johannes A Langendijk, Médéa Locquet, Montse Ventura, Manuela Fiúza, Stephanie E Combs, Daan S Spoor, Anne P G Crijns","doi":"10.1148/ryct.250342","DOIUrl":"10.1148/ryct.250342","url":null,"abstract":"<p><p>Purpose To evaluate the relationship between cardiac radiation dose and progression of subclinical coronary artery disease using cardiac CT at baseline and 24 months after breast cancer radiation therapy. Materials and Methods This secondary analysis of the prospective multicenter EARLY-HEART study (ClinicalTrials.gov identifier: NCT03297346) included asymptomatic participants with breast cancer treated with radiation therapy after lumpectomy who underwent cardiac CT before radiation therapy (T0) and at 24-month follow-up (T24). Cardiac radiation dose to the whole heart, left ventricle, right ventricle, and left anterior descending coronary artery was quantified using mean dose and volume-based metrics. Coronary artery calcium (CAC) progression was assessed as changes in CAC score between T0 and T24 at noncontrast CT, and stenosis progression was assessed at coronary CT angiography using Coronary Artery Disease Reporting and Data System classification. Associations between cardiac radiation dose and imaging-based progression were evaluated using multivariable linear and logistic regression models adjusted for cardiovascular risk factors. Results The final analysis included 224 participants (58.4 years ± 8.0; all female participants). CACS was higher at T24 than at T0 (median, 0 [IQR, 0-25] vs 0 [IQR, 0-17]; <i>P</i> < .001). Among 88 participants with CAC scores greater than 0 at T24, CACS increased more from T0 in the highest quartile of cardiac radiation dose compared with the remaining participants (whole heart mean dose, <i>P</i> < .001). The proportion of participants with CAC progression above the cohort median (16 participants) was also greater in those receiving the highest radiation doses (relative risk: whole heart, 2.0 [95% CI: 1.5, 2.8]; left ventricle, 1.8 [95% CI: 1.2, 2.5]; right ventricle, 1.7 [95% CI: 1.2, 2.5]; left anterior descending coronary artery, 1.5 [95% CI: 1.0, 2.3]). In contrast, progression of coronary stenosis at coronary CT angiography (36 of 224) was not associated with cardiac radiation dose but was strongly associated with higher baseline CACS and greater CAC progression (both <i>P</i> < .001). Conclusion Higher cardiac radiation dose during breast cancer radiation therapy was associated with increased CAC progression at 2-year follow-up, particularly in participants with preexisting calcification, whereas coronary stenosis progression was unrelated to dose. <b>Keywords:</b> Radiotherapy, Cardiac CT, Atherosclerosis, Coronary Artery Plaque <i>Supplemental material is available for this article.</i> ClinicalTrials.gov identifier: NCT03297346 © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250342"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982979","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}

{"title":"Comparison between Dark-Blood LGE Sequence and Standard Bright-Blood LGE in the Assessment of Ventricular Myocardial Scarring: A Systematic Review and Meta-Analysis.","authors":"Thiago de Gaultier Paulo, Stephan Altmayer, Giovanni Torri, Meiri Silva, Marília da Cruz Fagundes, Brian Pogatchnik, Bruno Hochhegger, Rhanderson Cardoso","doi":"10.1148/ryct.250567","DOIUrl":"10.1148/ryct.250567","url":null,"abstract":"<p><p>Purpose To perform a meta-analysis of the head-to-head performance of dark-blood (DB) late gadolinium enhancement (LGE) and bright-blood (BB) LGE for myocardial scar detection. Materials and Methods This systematic review and meta-analysis included studies identified from PubMed, Embase, and the Cochrane Library, from database inception through October 2025, in which both DB LGE and BB LGE were acquired in the same patient sample. In eligible studies, at least one prespecified outcome (per-segment or per-patient LGE detection, papillary enhancement, scar-to-blood contrast-to-noise ratio [CNR], or reader confidence) was reported. Outcomes were pooled as odds ratios (ORs), mean differences (MDs), or standard MDs (SMDs) using a random-effects model, and heterogeneity was assessed with the <i>I</i>² statistic. Subgroup analyses according to LGE etiology were performed when data permitted. Results Twenty-three studies including 1823 patients were analyzed. DB LGE was associated with higher overall segment-level LGE detection (OR, 1.26 [95% CI: 1.10, 1.44]), overall per-patient LGE detection (OR, 1.19 [95% CI: 1.01, 1.40]), ischemic segment-level detection (OR, 1.31 [95% CI: 1.15, 1.49]), and papillary muscle LGE detection (OR, 2.82 [95% CI: 1.81, 4.42]). DB LGE was also associated with a higher scar-to-blood CNR (MD, 10.48 [95% CI: 5.95, 15.01]) and greater reader confidence in the detection of ischemic LGE (SMD, 0.72 [95% CI: 0.23, 1.20]). Conclusion DB LGE was associated with higher myocardial scar detection and greater scar-to-blood contrast than BB LGE, particularly for ischemic patterns and papillary muscle fibrosis. <b>Keywords:</b> MR Imaging, Cardiac, Heart, Myocardium, Ischemia/Infarction, Technical Aspects, Meta-Analysis, Cardiac Magnetic Resonance, Late Gadolinium Enhancement, Dark Blood, Bright Blood <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250567"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219606","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}

{"title":"Anomalous Origin of Right Pulmonary Artery from Ascending Aorta: Pre- and Postoperative Noninvasive Hemodynamic Evaluation.","authors":"Cheng-Wei Yang, Qian-Wen Liu, Jiang-Hong Qian, Wei-Guo Ma, Jian-Shi Liu, Wei-Wei Qi, Lei Xu, Lian-Jun Huang, Yuan-Ming Luo, Li-Zhong Sun","doi":"10.1148/ryct.250449","DOIUrl":"10.1148/ryct.250449","url":null,"abstract":"<p><p>This report describes the innovative use of computational fluid dynamics (CFD) in managing a case in a 17-year-old male patient with anomalous origin of the right pulmonary artery from the ascending aorta, presenting with hemoptysis. Given the high risk of late repair, patient-specific CFD models were created. Preoperative simulation replicated invasive pressure measurements, and a virtual surgery predicted favorable outcomes. The patient underwent successful surgical reimplantation. Postoperatively, CFD findings at 1 week and 4 months closely matched the virtual prediction and were validated by synchronous four-dimensional flow MRI, demonstrating progressive hemodynamic normalization. Our experience suggests that CFD is a valuable adjunct for surgical planning and longitudinal assessment in complex congenital heart disease. <b>Keywords:</b> Congenital, Cardiac, CT-Angiography, Hemodynamics/Flow Dynamics, MR-Imaging, Pulmonary Arteries, Aorta <i>Supplemental material is available for this article.</i> ©The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250449"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219533","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}

{"title":"Fully Automated Quantification of Functional Small Airway Disease at Inspiratory and Expiratory Chest CT Using Deep Learning.","authors":"Stefan Gherca, Shan Yang, Jens Bremerich, Jörg Halter, Daiana Stolz, David J Winkel, Katrin Hostettler, Maurice Pradella","doi":"10.1148/ryct.250215","DOIUrl":"10.1148/ryct.250215","url":null,"abstract":"<p><p>Purpose To evaluate the accuracy and time efficiency of a deep learning (DL)-based tool for automated quantification of functional small airway disease (fSAD) at chest CT compared with a conventional semimanual method. Materials and Methods This retrospective study included paired inspiratory and expiratory chest CT examinations performed from January 2016 to July 2022, with fSAD defined according to established criteria. Semimanual fSAD assessment (fSADman) was performed using commercial postprocessing software with multiple manual steps, whereas automatic fSAD assessment (fSADauto) used a DL-based tool to fully automate the analysis. Time for fSADman was measured by two cardiothoracic radiologists in 20 randomly selected cases. The Wilcoxon signed rank test assessed systematic differences between reader measurements. Agreement between fSADman and fSADauto was evaluated using Spearman correlation and Bland-Altman analysis. Classification accuracy for clinically relevant fSAD (≥28% lung involvement) was also assessed. Results The study included 249 CT examinations from 196 patients (median age, 56 [IQR, 48-65] years; 120 [61.2%] male). Median lung volumes were 5196 mL (IQR, 4315-6192 mL) at inspiration and 2802 mL (IQR, 2401-3451 mL) at expiration. Agreement between fSADman and fSADauto was excellent (Spearman <i>r</i> = 0.93 [95% CI: 0.89, 0.96]; <i>P</i> < .01), with a small bias of -1.7% on Bland-Altman analysis. For detecting fSAD of 28% or greater, fSADauto achieved 100% sensitivity, 96.8% specificity, and 97.2% accuracy. No significant systematic difference was observed between readers (Wilcoxon W = 1; <i>P</i> = .66). Median semimanual analysis times were 3.47 (IQR, 3.06-3.97) minutes and 5.21 (IQR, 3.57-6.65) minutes, respectively. Conclusion DL-based automated quantification of fSAD demonstrated excellent agreement with semimanual assessment and high diagnostic accuracy and may serve as an efficient and reliable alternative to the traditional semimanual method. <b>Keywords:</b> Pulmonary, Lung, Machine Learning, Workflow Optimization, Segmentation <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250215"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043597","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}

{"title":"Cardiac MRI Monitoring of Myocardial Tissue Changes in a Myocarditis Mouse Model with Histologic Validation.","authors":"Qinfang Miao, Wenjing Zhao, Zhenfeng Lyu, Hongzhang Huang, Yan Chen, Yujie Chen, Chuangwei Wei, Zhaoying Wen, Haikun Qi","doi":"10.1148/ryct.250488","DOIUrl":"10.1148/ryct.250488","url":null,"abstract":"<p><p>Purpose To evaluate multiparametric cardiac MRI for assessing myocardial inflammation, fibrosis, and spatiotemporal distribution in autoimmune myocarditis, with histologic reference. Materials and Methods This study (December 2022 to January 2024) included 84 BALB/c mice (42 with experimental autoimmune myocarditis, 42 controls). Multiparametric cardiac MRI, including T1 mapping, T2 mapping, and extracellular volume fraction (ECV) mapping, was performed at 14 days, 28 days, and 3 months after immunization using a 9.4-T scanner. Cardiac tissues were collected at each time point for histopathologic assessment of inflammation (inflammatory index) and fibrosis (collagen volume fraction). Cardiac MRI parameters were analyzed at global, regional, and segmental levels to evaluate temporal and spatial changes. Group comparisons were performed using one-way analysis of variance with Tukey post hoc tests or Student <i>t</i> tests, and associations were assessed using Pearson or Spearman correlation coefficients, as appropriate. Results Among 81 mice analyzed, experimental autoimmune myocarditis (<i>n</i> = 39) demonstrated progression from inflammation to fibrosis. T2 values were elevated on days 14 and 28 (<i>P</i> < .001) and normalized at 3 months. Precontrast T1 and ECV increased progressively. T2 correlated with the inflammatory index (rho = 0.72, <i>P</i> < .001), and ECV correlated with collagen volume fraction (<i>r</i> ≥ 0.70, <i>P</i> < .01). T2 mapping showed the highest diagnostic performance on day 14 (area under the receiver operating characteristic curve [AUC], 0.89; 95% CI: 0.72, 0.99; <i>P</i> < .001) and day 28 (AUC, 0.81; 95% CI: 0.60, 0.97; <i>P</i> = .01), whereas ECV performed best at 3 months (AUC, 0.85; 95% CI: 0.69, 0.99; <i>P</i> < .001). Spatial distribution of abnormalities was heterogeneous across disease stages. Conclusion Multiparametric cardiac MRI characterizes myocardial inflammation and fibrosis and demonstrates stage-dependent spatial patterns in autoimmune myocarditis. <b>Keywords:</b> Animal Studies, MR-Imaging, Cardiac, Myocardium, Tissue Characterization <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250488"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219565","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}

{"title":"Evaluating Coronary Arteries and Predicting Major Adverse Cardiovascular Events in Patients with Esophageal Cancer Using Coronary CT Angiography.","authors":"Rui Yang, Qian Xu, Chunrong Tu, Yuhang Xie, Tao Liu, Xiaoqing Li, Hesong Shen, Jiuquan Zhang","doi":"10.1148/ryct.240534","DOIUrl":"10.1148/ryct.240534","url":null,"abstract":"<p><p>Purpose To evaluate alterations in coronary arteries in individuals with esophageal squamous cell carcinoma (ESCC) who received chemotherapy or chemoradiotherapy using coronary CT angiography (CCTA) parameters and explore their association with major adverse cardiovascular events (MACEs). Materials and Methods Between July 2020 and August 2022, individuals with ESCC scheduled for chemotherapy or chemoradiotherapy who underwent CCTA were prospectively included. MACEs were defined as myocardial infarction, stroke, complete heart block, cardiovascular death, or rehospitalization due to heart failure or aggravated angina symptoms. The outcome time frame was measured from treatment initiation until the occurrence of MACEs or the end of follow-up, whichever occurred first. Associations between CCTA parameters and MACEs were analyzed by Cox regression analyses. Results Among the 140 enrolled participants (mean age ± SD, 65 years ± 8.39; 76 [54%] male), 60 received chemotherapy, and 80 received chemoradiotherapy. The CT fractional flow reserve (FFR) decreased and the fat attenuation index (FAI) increased after chemotherapy or chemoradiotherapy. Moreover, a lower CT FFR (left anterior descending artery [LAD], 0.75 vs 0.82; left circumflex artery [LCX], 0.74 vs 0.77; right coronary artery [RCA], 0.74 vs 0.77; <i>P</i> < .001) and higher FAI (LAD, -70.0 vs -75.0 HU; LCX, -75.0 vs -77.5 HU; RCA, -76.0 vs -78.5 HU; <i>P</i> < .001) were observed after chemoradiotherapy than after chemotherapy. The baseline FAIs of the LAD, LCX, and RCA were independently associated with the occurrence of MACE (hazard ratio = 3.99, 3.85, and 3.41, respectively; <i>P</i> < .001). Conclusion CT FFR decreased and the FAI increased after chemotherapy or chemoradiotherapy in individuals with ESCC. The baseline FAI was a predictor of MACEs. <b>Keywords:</b> CT-Coronary Angiography, Radiation Therapy/Oncology, Cardiac, Coronary Arteries, Esophagus, Esophageal Neoplasms, Chemoradiotherapy, Fractional Flow Reserve, Major Adverse Cardiac Events <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e240534"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219570","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}

{"title":"Association between Impaired Lung Function and Pulmonary Perfusion Defects Assessed by Phase-resolved Functional Lung MRI.","authors":"Tao Ouyang, Qiming Liu, Andreas Voskrebenzev, Jens Vogel-Claussen, Qi Yang","doi":"10.1148/ryct.250334","DOIUrl":"10.1148/ryct.250334","url":null,"abstract":"<p><p>Purpose To investigate the association between impaired lung function and pulmonary perfusion defect percentage (QDP) using phase-resolved functional lung (PREFUL) MRI. Materials and Methods In this prospective study (March 2023-July 2024), participants underwent spirometry to assess lung function, including forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC). Lung function was classified as either normal or impaired, with the impaired category including airflow obstruction (AO), restrictive physiology (RP), and preserved ratio impaired spirometry (PRISm). Additionally, all participants underwent PREFUL MRI for ventilation and perfusion assessment and CT for emphysema evaluation. Linear regression models were used to evaluate associations between QDP and pulmonary function status, and restricted cubic spline (RCS) analysis was applied to explore potential nonlinear relationships. Results A total of 287 participants were included (mean age ± SD, 60 years ± 13; 228 males). Compared with normal spirometry, PRISm (β = 3.20; 95% CI: 1.40, 5.01; <i>P</i> = .002), RP (β = 3.88; 95% CI: 1.63, 6.12; <i>P</i> = .002), and AO (β = 8.49; 95% CI: 6.59, 10.39; <i>P</i> < .001) were significantly associated with QDP. Lower FEV₁% predicted, FVC% predicted, and FEV₁/FVC ratio, as well as increased emphysema percentage, were associated with higher QDP. RCS analysis revealed nonlinear associations between pulmonary function indicators and QDP. Subgroup analysis demonstrated significant interactions between lung function impairment and factors such as body mass index and age. Conclusion Impaired lung function was associated with increased pulmonary perfusion defects as detected by PREFUL MRI. <b>Keywords:</b> Thorax, MR-Functional Imaging, Preserved Ratio Impaired Spirometry, Phase-resolved Functional Lung, Perfusion Defects, Ventilation Defects, Lung Emphysema Chinese Clinical Trial Registry: ChiCTR2300077789 and ChiCTR2300074883 <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250334"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157840","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}

{"title":"Free-breathing Dynamic MRI Analysis of Three-dimensional Diaphragm Curvatures in Pediatric Patients with Thoracic Insufficiency Syndrome.","authors":"Sina Dindarian, Shiva Shaghaghi, Mahdie Hosseini, You Hao, Yubing Tong, Yusuf Akhtar, Mostafa Al-Noury, Caiyun Wu, Samantha Gogel, Oscar H Mayer, David M Biko, Joseph M McDonough, Patrick J Cahill, Jason B Anari, Drew A Torigian, Jayaram K Udupa","doi":"10.1148/ryct.250345","DOIUrl":"10.1148/ryct.250345","url":null,"abstract":"<p><p>Purpose To quantify regional respiratory function using four-dimensional free-breathing dynamic MRI (dMRI) and evaluate vertical expandable prosthetic titanium rib surgery impact on diaphragm curvature in pediatric thoracic insufficiency syndrome (TIS) using pre- and postoperative and control comparisons. Materials and Methods Curvature was retrospectively analyzed in 149 pediatric patients with TIS from May 2010 to November 2022 (49 pre- and postoperative, 70 preoperative-only, 30 postoperative-only dMRI) and compared with 190 controls. Mean follow-up ± SD was 2.4 years ± 1.8. Diaphragm contours were delineated at end-expiration and end-inspiration, and curvature was quantified across 13 regions per hemidiaphragm. Analyses included paired <i>t</i> tests, one-way analysis of variance to compare with controls, and correlation analyses relating postoperative curvature to ventilatory status and thoracic Cobb angle. Results Patients with TIS (mean age, 3.5 years ± 3.5; 27 male) demonstrated region-, plane-, and phase-dependent preoperative curvature differences compared with controls (mean age, 11.9 years ± 3.6; 92 male). Significant pre- to postoperative curvature changes were limited to five region-plane-phase combinations. The right hemidiaphragm anterior-lateral region at end-expiration showed the only sagittal-plane change (6.3 m^-1 ± 0.7 to 8.2 m^-1 ± 0.6, <i>P</i> = .02), approaching control values (9.3 m^-1 ± 2.6). Several regions were no longer different from controls, most prominently in the right hemidiaphragm coronal plane at end-inspiration, whereas others, particularly sagittal end-inspiration regions, remained different (<i>P</i> < .05). Postoperative curvature correlated with ventilatory status, strongest in central sagittal regions (ρ ≤ 0.392, <i>P</i> < .001), and with thoracic Cobb angle in posterior sagittal regions (ρ ≤ 0.385, <i>P</i> < .001). Conclusion Surgery resulted in plane- and phase-specific improvements in diaphragm curvature, with partial normalization toward control values predominantly in coronal-plane regions. <b>Keywords:</b> Pediatrics, MR-Functional Lung Imaging, MR-Imaging, Pulmonary, Diaphragm, Anatomy, Treatment Effects, Outcomes Analysis, Comparative Studies, Curvature, Dynamic MRI, Quantitative Radiology, Shape, Thoracic Insufficiency Syndrome (TIS) <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 3","pages":"e250345"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}