{"title":"Case of the Season: CNS Manifestation of ACTA2-Related Smooth Muscle Arteriopathy in an Adolescent.","authors":"Sakina Kazmi, Swati Mody","doi":"10.1016/j.ro.2026.150985","DOIUrl":"https://doi.org/10.1016/j.ro.2026.150985","url":null,"abstract":"","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"63 ","pages":"150985"},"PeriodicalIF":1.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857576","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":"Letter from the Guest Editor.","authors":"Jayapalli Rajiv Bapuraj","doi":"10.1016/j.ro.2026.150988","DOIUrl":"https://doi.org/10.1016/j.ro.2026.150988","url":null,"abstract":"","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"63 ","pages":"150988"},"PeriodicalIF":1.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823300","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}
Danish Vaiyani , Mudit Gupta , Aaron G. DeWitt , Rachel Shustak , Emmanuelle Favilla , Erin Pinto , Lauren Biroc , Meghan Yowell , Yoav Dori , Christopher L. Smith
{"title":"Lymphatic Complications in Congenital Heart Disease","authors":"Danish Vaiyani , Mudit Gupta , Aaron G. DeWitt , Rachel Shustak , Emmanuelle Favilla , Erin Pinto , Lauren Biroc , Meghan Yowell , Yoav Dori , Christopher L. Smith","doi":"10.1016/j.ro.2026.150983","DOIUrl":"10.1016/j.ro.2026.150983","url":null,"abstract":"<div><div>Lymphatic disease results from abnormal perfusion of lymph to various compartments such as the peritoneum, duodenum and the pleural space. However, this often occurs concurrently with congenital heart disease, especially single ventricle congenital heart disease. By understating the physiologic principles of the lymphatic and circulatory system and how this can be impacted by congenital heart disease, one can appreciate the pathophysiology of lymphatic disease in the setting of congenital heart disease.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150983"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693400","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}
Michael Pratt, Jeanne Dillenbeck, Sheena Pimpalwar, Jaewon Yang, Robert Carson Sibley
{"title":"Complex Lymphatic Anomalies: A Comprehensive Review of Imaging Features and Diagnostic Considerations","authors":"Michael Pratt, Jeanne Dillenbeck, Sheena Pimpalwar, Jaewon Yang, Robert Carson Sibley","doi":"10.1016/j.ro.2025.150967","DOIUrl":"10.1016/j.ro.2025.150967","url":null,"abstract":"<div><div>Within the overarching diagnosis of lymphatic anomalies, the subgroup of complex lymphatic anomalies (CLAs) has classically been comprised of 4 entities which are characterized by multisystem involvement, structural complexity, and functional impairment of the lymphatic system. The 4 subtypes generalized lymphatic anomaly, kaposiform lymphangiomatosis, Gorham-Stout disease, and central conducting lymphatic anomaly, share overlapping characteristics which can make differentiating between them a challenge. Recently, a fifth subtype, generalized lymphatic dysplasia, has been defined as a separate classification. CLAs may contribute to significant morbidity for affected patients, and a multidisciplinary approach is critical to optimize treatment approaches. From a diagnostic perspective, it is imperative that readers interpreting those images for patients with CLAs are aware of various manifestations of the different subtypes, and that the readers have a strong understanding of follow-up imaging recommendations when needed. In conjunction, the utility of images to guide intervention continues to grow, and maintaining an updated perspective on the diagnostician’s role is critical to facilitating excellent patient care. We aim to provide an overview of current practices and approaches to further the readers' knowledge base on CLAs.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150967"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685028","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}
Wesley Jong, Sydney Yee, Rohan Srivastava, Hussain Alkhars, John P. Lichtenberger III
{"title":"Pulmonary Venous Anomalies in the Adult","authors":"Wesley Jong, Sydney Yee, Rohan Srivastava, Hussain Alkhars, John P. Lichtenberger III","doi":"10.1016/j.ro.2025.150966","DOIUrl":"10.1016/j.ro.2025.150966","url":null,"abstract":"","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150966"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580169","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}
Abhay Srinivasan , Christopher L. Smith , Mudit Gupta , Pablo Laje , Katsuhide Maeda , Fernando Escobar , Yoav Dori , Ganesh Krishnamurthy
{"title":"Lymphatic Interventions and Treatment: Current Techniques and Applications in Pediatric and Adult Patients","authors":"Abhay Srinivasan , Christopher L. Smith , Mudit Gupta , Pablo Laje , Katsuhide Maeda , Fernando Escobar , Yoav Dori , Ganesh Krishnamurthy","doi":"10.1016/j.ro.2025.150968","DOIUrl":"10.1016/j.ro.2025.150968","url":null,"abstract":"<div><div>The lymphatic system is a crucial component of human physiology, maintaining fluid homeostasis, supporting immune surveillance, and transporting macronutrients from the gastrointestinal tract. Disorders of lymphatic conduction—whether congenital or acquired—can result in debilitating complications including chylothorax, protein-losing enteropathy, plastic bronchitis, and generalized anasarca. Advances in imaging and percutaneous interventions have brought great progress in management of these conditions, offering less invasive, targeted approaches with improved outcomes. This review provides a discussion of lymphatic anatomy and physiology, classification of flow disorders, imaging modalities, and the technical execution of percutaneous lymphatic interventions. It then highlights disease-specific approaches, with attention to recent innovations in embolization techniques.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150968"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883788","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}
Ankita Chauhan MD, Stephanie El Omeiri MD, Joice Prodigios MD, Marcus Meneses MD, Erica Riedesel MD, Abass Noor MD, Hansel J. Otero MD, Seth Vatsky DO, Jordan B. Rapp MD, Ammie M. White MD
{"title":"Systemic Venous Anomalies","authors":"Ankita Chauhan MD, Stephanie El Omeiri MD, Joice Prodigios MD, Marcus Meneses MD, Erica Riedesel MD, Abass Noor MD, Hansel J. Otero MD, Seth Vatsky DO, Jordan B. Rapp MD, Ammie M. White MD","doi":"10.1016/j.ro.2025.150965","DOIUrl":"10.1016/j.ro.2025.150965","url":null,"abstract":"<div><div>The persistence or regression of venous segments of the primitive venous network during embryologic development can cause developmental venous anomalies. Systemic venous anomalies and variants are rare, often found incidentally, and usually asymptomatic. Venous variants can be isolated or associated with congenital heart disease and sometimes can be mistaken for masses or lymphadenopathy. Recognizing these anomalies helps avoid unnecessary imaging and treatment. Knowledge of variant venous anatomy is crucial before procedures such as central catheter placement and cardiothoracic surgery to prevent complications. Preoperative imaging enables the accurate mapping of vascular structures, ensuring proper surgical planning. Hence, evaluation of venous structures should be included in the radiologist's search pattern. This article reviews venous anomalies of systemic veins and their clinical relevance.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150965"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580168","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":"Letter from the Editor: Demystifying Lymphatic and Venous Imaging","authors":"Prachi Agarwal MD, MS, FNASCI, FACR","doi":"10.1016/j.ro.2026.150984","DOIUrl":"10.1016/j.ro.2026.150984","url":null,"abstract":"","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150984"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147649940","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}
Joice Prodigios MD , Stephanie El Omeiri MD , Marcus Meneses MD , Bethelhem Belachew MD , Hansel J. Otero MD , David M. Biko MD , Jordan B. Rapp MD
{"title":"Pediatric Pulmonary Vein Stenosis and Treatment","authors":"Joice Prodigios MD , Stephanie El Omeiri MD , Marcus Meneses MD , Bethelhem Belachew MD , Hansel J. Otero MD , David M. Biko MD , Jordan B. Rapp MD","doi":"10.1053/j.ro.2025.09.006","DOIUrl":"10.1053/j.ro.2025.09.006","url":null,"abstract":"<div><div>Pulmonary vein stenosis (PVS) is an uncommon but often progressive condition in children, associated with high morbidity and mortality despite advances in diagnosis and treatment. Etiologies include primary congenital disease and secondary causes such as postoperative total or partial anomalous pulmonary venous return repair, bronchopulmonary dysplasia, and anatomic compression. PVS can occur in isolation or in association with complex congenital heart disease and is frequently characterized by restenosis after intervention. Multimodality imaging is essential for diagnosis, treatment planning, and follow-up in pediatric PVS. Transthoracic echocardiography remains the first-line screening tool, although limited acoustic windows and small vessel caliber may reduce accuracy. Cross-sectional imaging with cardiac magnetic resonance and computed tomography angiography provides high-resolution anatomical assessment and is increasingly complemented by dual-energy computed tomography with iodine perfusion mapping to evaluate the functional impact of stenosis. Cardiac catheterization remains the reference standard for hemodynamic assessment and offers therapeutic capabilities. This review summarizes the epidemiology, anatomy, pathophysiology, and imaging features of PVS in children, with emphasis on the role of multimodality imaging in both congenital and acquired forms. We discuss current interventional, surgical, and medical treatment strategies, highlight challenges in pediatric imaging, and outline recommendations for long-term surveillance to detect restenosis and guide timely reintervention.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150963"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700723","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}
Stephanie El Omeiri MD , Bethelhem Belachew MD , Marcus Meneses MD , Joice Prodigios MD , Taisa Guarilha MD , Ankita Chauhan MD , Dario J. Teplisky MD , Ammie White MD , Hansel J. Otero MD , Abass M. Noor MD , Jordan B. Rapp MD , David M. Biko MD
{"title":"Lymphatic Imaging Techniques: Evaluation of the Central Lymphatic System","authors":"Stephanie El Omeiri MD , Bethelhem Belachew MD , Marcus Meneses MD , Joice Prodigios MD , Taisa Guarilha MD , Ankita Chauhan MD , Dario J. Teplisky MD , Ammie White MD , Hansel J. Otero MD , Abass M. Noor MD , Jordan B. Rapp MD , David M. Biko MD","doi":"10.1053/j.ro.2025.09.007","DOIUrl":"10.1053/j.ro.2025.09.007","url":null,"abstract":"<div><div>The central lymphatic system plays a pivotal role in fluid homeostasis, immune regulation and macromolecular transport. In children, lymphatic flow disorders are increasingly recognized as contributors to a wide spectrum of clinical conditions, particularly in those with congenital heart disease or postsurgical single ventricle physiology. Conditions such as chylothorax, plastic bronchitis, protein-losing enteropathy and generalized lymphatic anomaly often require detailed imaging for diagnosis and therapeutic planning.</div><div>Advances in cross-sectional imaging have transformed the evaluation of pediatric lymphatic disorders. Traditional techniques like lymphoscintigraphy and conventional lymphangiography offer limited anatomical detail and functional insight. In contrast, noninvasive modalities such as noncontrast MR lymphangiography, contrast-enhanced ultrasound, CT lymphangiography and dynamic contrast-enhanced MR lymphangiography now enable high-resolution visualization of central conducting lymphatics, including the thoracic duct and cisterna chyli.</div><div>This review describes the current techniques used to image the central lymphatic system in children, with a focus on dynamic contrast-enhanced MR lymphangiography, which has emerged as the reference standard for both anatomical mapping and functional assessment. We review clinical indications, access techniques, protocol optimization, interpretation frameworks and technical pitfalls to facilitate broader adoption and reproducibility of these techniques.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"62 ","pages":"Article 150964"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700735","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}