Current Medical Imaging Reviews最新文献

{"title":"Improvement in the Image Quality of Bile and Pancreatic Ducts with Dual-Layer Spectral CT.","authors":"Xiaoyi Bai, Kai Liao, Zhihan Wu, Mo Chen, Rui Wang, Kai Deng","doi":"10.2174/0115734056442763260317072250","DOIUrl":"https://doi.org/10.2174/0115734056442763260317072250","url":null,"abstract":"<p><strong>Background: </strong>While multiple imaging modalities have been developed for the evaluation of biliary and pancreatic ducts, none is considered ideal. Dual-layer Spectral Computed Tomography (DSCT) offers potential advantages through dual-energy acquisition and spectral imaging, but its application for biliopancreatic ducts remains unclear. The objective of this retrospective observational study was to evaluate image quality and determine the optimal energies of Virtual Monoenergetic Images (VMIs) from DSCT of biliary and pancreatic ducts.</p><p><strong>Materials and methods: </strong>We analyzed contrast-enhanced abdominal DSCT images of 75 patients with normal ductal anatomy. Both conventional Polyenergetic Images (PEIs) and VMIs at energy levels ranging from 40-140 keV (10-keV intervals) were reconstructed. The ductal system was categorized into four groups: intrahepatic bile ducts (Group A), extrahepatic bile ducts (Group B), pancreatic ducts (Group C), and the main pancreatic ducts (Group D). Objective image quality parameters, including CT values, image noise, the Contrast-to-Noise Ratio (CNR), and the Signal-to-Noise Ratio (SNR), were systematically measured and compared across different energy levels.</p><p><strong>Results: </strong>Compared with the PEIs, the VMIs reconstructed at low keV levels via DSCT demonstrated superior image quality across the four groups. Significant differences in CNR values were observed between VMIs at 40 keV and PEIs in Group A [4.30 (2.79, 6.15) vs. 3.37 (2.52, 4.32), p = 0.013], Group B [10.46 (8.41, 12.43) vs. 5.83 (4.47, 6.94), p < 0.001], Group C [11.50 (9.05, 14.48) vs. 5.34 (4.31, 6.56), p < 0.001], and Group D [9.11 (7.00, 11.86) vs. 5.36 (4.34, 6.95), p < 0.001].</p><p><strong>Discussion: </strong>This suggests a clear advantage of low-energy VMIs in depicting subtle ductal anatomy that is poorly visualized on standard CT. The consistent reduction in image quality metrics with increasing energy further supports the use of low-keV settings for soft-tissue duct evaluation. Limitations, including the retrospective design and single-vendor platform, are acknowledged.</p><p><strong>Conclusion: </strong>Compared with conventional images, VMIs at low keV exhibit superior image quality; thus, VMIs may be incorporated into routine clinical imaging protocols.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677284","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":"Stent Geometry Matters: Impact of Tapered vs. Straight Stents On Persistent Hemodynamic Depression After Carotid Artery Stenting.","authors":"Mustafa Demir, Yunus Yasar, Abdulbaki Agackiran, Emine Yilmaz, Aslihan Semiz-Oysu","doi":"10.2174/0115734056439426260326041814","DOIUrl":"https://doi.org/10.2174/0115734056439426260326041814","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid Artery Stenting (CAS) is an established alternative to carotid endarterectomy, particularly in patients with elevated surgical risk. Hemodynamic Depression (HD) is a common complication that is usually transient; however, persistent HD may compromise cerebral perfusion. The specific impact of stent geometry on persistent HD remains underexplored.</p><p><strong>Methods: </strong>This retrospective study included 109 patients who underwent primary CAS between October 2020 and October 2023. HD was defined as intraoperative hypotension (systolic blood pressure < 90 mmHg) and/or bradycardia (heart rate < 60 bpm), while persistent HD was defined as lasting more than 24 hours despite medical therapy. Patients were evaluated according to stent geometry (straight vs. tapered), carotid bulb involvement, plaque characteristics, and procedural variables. Multivariable logistic regression was performed, adjusting for demographic, clinical, anatomical, and procedural factors.</p><p><strong>Results: </strong>Periprocedural HD occurred in 40.4% of patients, and persistent HD in 25.7%. Persistent HD was significantly more frequent in patients treated with straight stents than in those treated with tapered stents (39.5% vs. 18.6%). Carotid bulb involvement and the use of a straight stent were significantly associated with persistent HD. In multivariable analysis, straight stent use (OR: 1.446; 95% CI: 1.041-2.018) and carotid bulb involvement (OR: 1.490; 95% CI: 1.102-2.015) remained independently associated with persistent HD. Twelve-month clinical outcomes did not differ between stent groups.</p><p><strong>Discussion: </strong>Persistent hemodynamic depression after carotid artery stenting appears to be influenced not only by patient-related factors but also by procedural characteristics, particularly stent geometry and carotid bulb anatomy. The independent association of straight stent use with prolonged hemodynamic instability underscores the clinical relevance of device selection beyond technical success. Incorporating anatomical conformity into preprocedural planning may reduce prolonged baroreceptor-mediated instability and improve periprocedural safety.</p><p><strong>Conclusion: </strong>Persistent HD is a clinically relevant complication after CAS. Individualized stent selection may help reduce prolonged hemodynamic instability.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678192","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":"Differentiation of Fat-poor and Atypical Adrenal Adenomas from Metastases: MRI-based Radiomic, Radiologic, and Radiomic-radiologic Machine Learning Models.","authors":"Ceyda Turan Bektaş, Hasan Bulut, Ece Ates Kus, Melis Baykara Ulusan, Abdullah Soydan Mahmutoğlu","doi":"10.2174/0115734056399745260330003149","DOIUrl":"https://doi.org/10.2174/0115734056399745260330003149","url":null,"abstract":"<p><strong>Introduction: </strong>The accurate differentiation of fat-poor and atypical adrenal adenomas from metastases remains a diagnostic challenge. This study aimed to evaluate the predictive value of MRI-based radiomic, radiologic, and combined radiomic-radiologic machine learning (ML) models.</p><p><strong>Methods: </strong>This single-center retrospective study included 37 patients with 44 adrenal masses (19 adenomas; 25 metastases). Data were split into training and testing sets (2:1). To expand the training set, data augmentation was performed by multiple sampling (56 labeled slices from 30 masses). Radiomic features were extracted from T2-weighted (T2W), in-phase, out-of-phase, and apparent diffusion coefficient (ADC) sequences, while mass size, T2W signal intensity, heterogeneity, and signal drop were assessed as radiologic features. Dimension reduction was performed by reliability analysis and wrapper-based feature selection with five algorithms. A support vector machine was used for classification, and performance was assessed using 10-fold cross-validation and unseen testing. Friedman test and post-hoc analyses compared bootstrapped unseen test AUCs.</p><p><strong>Results: </strong>Only 12% of radiomic features demonstrated excellent reproducibility. A significant difference was observed among the three models, χ2(2)=779.5, p<0.001. The combined radiomic-radiologic model achieved the best performance (AUC 0.939; accuracy 85.7%), outperforming radiomic-only (AUC 0.898; accuracy 85.7%) and radiologic-only (AUC 0.857; accuracy 78.5%) models (adjusted p<0.001).</p><p><strong>Discussion: </strong>Integrating radiomic and radiologic features improved classification performance compared to using either feature set alone. Although the reproducibility of radiomic features was limited, their complementary value enhanced model robustness.</p><p><strong>Conclusion: </strong>A combined radiomic-radiologic ML model based on multi-sequence MRI may serve as a promising non-invasive tool for differentiating atypical adrenal adenomas from metastases.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678706","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":"Case Report of Taeniasis with Gastric Manifestations on CT and Worm Expulsion Post CT Examination.","authors":"Yifan Liu, Zha Xi Ci Ding, Si Nan Yong Zong, TianMing Bai, Siqi Li, Tao Jiang","doi":"10.2174/0115734056430817260324102152","DOIUrl":"https://doi.org/10.2174/0115734056430817260324102152","url":null,"abstract":"<p><strong>Introduction/background: </strong>In March 2025, a 31-year-old female patient was admitted to Mangkang County People's Hospital in Tibet, complaining of upper abdominal pain for two days, which worsened after meals. She reported a habit of consuming raw beef. This case is unique as it highlights the diagnostic value of CT imaging in identifying taeniasis, particularly when worms are expelled post-CT examination. Previous imaging studies often lacked specific signs, with many cases only confirmed post-surgery. This case provides a valuable reference for the radiological characteristics of taeniasis.</p><p><strong>Case presentation: </strong>The patient presented with upper abdominal pain that worsened after meals. Physical examination revealed a soft abdomen with significant tenderness in the upper abdomen, no rebound tenderness, no muscle tension, no palpable liver or spleen below the costal margin, negative McBurney's sign, negative Murphy's sign, no renal percussion tenderness, negative shifting dullness, normal bowel sounds, and no abnormalities in the anus or rectum. Blood tests showed a white blood cell count of 15.15 x 10^9/L, neutrophil percentage of 92.4%, absolute neutrophil count of 14.0 x 10^9/L, high-sensitivity C-reactive protein of 1.3 mg/L, and amylase of 997.15 U/L. Abdominal CT revealed an irregular, poorly defined mass-like heterogeneous density shadow in the stomach, measuring approximately 83 mm x 38 mm x 51 mm (anteroposterior x transverse x craniocaudal), with an enlarged pancreas and surrounding exudation. After the CT scan, the patient vomited inside the CT room, expelling two white worms. The worms were milky white, ribbon-like, about 200 cm long, with a spoon-shaped scolex, body covered in transverse folds, and a slightly thinner tail. A follow-up CT scan after vomiting showed that the gastric mass had disappeared. Based on the worm morphology, epidemiological history, and laboratory findings, the diagnosis was taeniasis and pancreatitis. The patient was treated with fasting, intravenous administration of H2 receptor antagonists and somatostatin to relieve pancreatitis, and albendazole (2 tablets/day for 3 days) for deworming. Follow-up two months later showed no abnormalities.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering taeniasis in patients presenting with gastric symptoms and abnormal CT findings. The main takeaway lesson is that prompt recognition and appropriate treatment can lead to successful management of taeniasis, even in unusual presentations. Immediate diagnosis after CT examination and expulsion of worms provides valuable insights into the radiological features of taeniasis.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678676","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":"Clinical and 18F-FDG PET/CT Imaging Characteristics of Post-radiotherapy Sacral Insufficiency Fractures in Cervical Cancer Patients.","authors":"Wanling Qi, Fengxiang Liao, Zhehuang Luo, Mingyan Shao","doi":"10.2174/0115734056428627260223054010","DOIUrl":"https://doi.org/10.2174/0115734056428627260223054010","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Sacral Insufficiency Fractures (SIFs) are a common yet frequently misdiagnosed late complication following pelvic radiotherapy for cervical cancer. Accurate differentiation from bone metastases is crucial to avoid unnecessary interventions. While MRI is sensitive for early marrow edema, integrated 18F-FDG PET/CT offers a unique simultaneous assessment of bone metabolism and systemic tumor status. However, comprehensive studies detailing the qualitative and quantitative PET/CT characteristics of post-radiotherapy SIFs are lacking. This study aims to systematically define these features and establish their discriminative value.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this retrospective study, we analyzed 32 cervical cancer patients who developed SIFs following pelvic radiotherapy and underwent 18F-FDG PET/CT imaging between January 2018 and January 2024. Diagnosis was based on characteristic radiologic findings, clinical correlation, and a minimum 12-month follow-up. Qualitative (fracture patterns, FDG uptake morphology) and quantitative (SUVmax, SUR-BP ratio, CT densitometry) parameters on 18F-FDG PET/CT were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;SIFs predominantly occurred in postmenopausal women (93.7%, 30/32) at a median of 14 months post-radiotherapy. Sacral involvement was observed as follows: unilateral ala (53.1%, 17/32), bilateral alae (37.5%, 12/32), and extension to the sacral body (9.4%, 3/32). The affected segments were primarily located at S1-S3. Concomitant pelvic fractures were also frequently identified, including pubic (28.1%, 9/32), iliac (25%, 8/32), and bilateral L5 transverse process fractures (6.2%, 2/32). Common CT findings included ill-defined osteosclerosis near the sacroiliac joint (87.5%, 28/32) and linear or curvilinear hypoattenuating fracture lines (68.7%, 22/32). PET revealed characteristic mild, diffuse/patchy FDG uptake parallel to the sacroiliac joint (96.8%, 31/32) with low metabolic activity (mean SUVmax 2.45±0.74, mean SUR-BP 1.46±0.38). Quantitative CT confirmed significant osteopenia within the radiation field (mean HU 36.8±28.6 vs. 78.0±37.3 outside, p&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Post-radiation SIFs predominantly affect postmenopausal cervical cancer patients due to radiotherapy-induced osteoporosis and bone vulnerability. These fractures often present with nonspecific pain and require differentiation from bone metastases, for which 18F-FDG PET/CT is essential due to its ability to detect characteristic metabolic patterns and associated osteoporotic changes. Key diagnostic features include linear or curvilinear hypoattenuating fracture lines, mild diffuse/patchy FDG uptake parallel to the sacroiliac joint, and background osteoporotic changes within radiation fields. Integrated PET/CT outperformed single-modality imaging by enabling simultaneous assessment of bone metabolism and systemic tumor status, a critical advantage over MRI (superior for ma","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678685","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":"A Case Report of an Inflammatory Hepatocellular Adenoma Mimicking Hepatocellular Carcinoma in a Patient with Alcoholic Cirrhosis.","authors":"Weon Jang, Woo Sung Moon, Ji Soo Song","doi":"10.2174/0115734056447538260331115432","DOIUrl":"https://doi.org/10.2174/0115734056447538260331115432","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular adenoma (HCA) is a benign liver tumor that can mimic hepatocellular carcinoma (HCC), especially in patients with cirrhosis. Inflammatory HCA, a subtype of HCA, is characterized by increased expression of inflammation-related proteins such as serum amyloid A (SAA). Distinguishing inflammatory HCA from other liver lesions, such as HCC, can be challenging on imaging, especially in cirrhotic livers.</p><p><strong>Case presentation: </strong>A 44-year-old male with alcoholic liver cirrhosis was found to have a hepatic lesion in segment 8, which gradually increased in size from 15 mm to 47 mm over four years. The lesion exhibited arterial phase hyperenhancement (APHE) and washout on delayed imaging. It fulfilled the Liver Imaging Reporting and Data System (LI-RADS) v2018 criteria for LR-5, indicating definite HCC. The patient underwent laparoscopic subsegmentectomy of segment 8 without prior biopsy. Histopathological examination confirmed the diagnosis of inflammatory HCA. Immunohistochemistry showed strong and diffuse expression of SAA and C-Reactive Protein (CRP), and no aberrant β-catenin expression. The lesion was initially diagnosed as HCC based on radiologic features; the final diagnosis was inflammatory HCA. The patient recovered well after surgery and was discharged nine days later.</p><p><strong>Conclusion: </strong>Inflammatory HCA can mimic HCC on imaging, especially in patients with alcoholic cirrhosis. In such cases, relying solely on imaging may lead to misdiagnosis. Correlation with clinical history, pathology, and immunohistochemical findings is important to avoid unnecessary surgery and ensure accurate diagnosis.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619312","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":"The Association between Remnant Cholesterol Levels and Computed Tomography-based Low Bone Mass, Low Muscle Mass, and Osteosarcopenia in Older Adults.","authors":"Rongzhou Wang, Yu Wang, Jingjing Liu, Zicheng Wei, Hongye Tang, Xiao Chen","doi":"10.2174/0115734056432895260322132111","DOIUrl":"https://doi.org/10.2174/0115734056432895260322132111","url":null,"abstract":"<p><strong>Objective: </strong>The associations between remnant cholesterol (RC) and low bone mass and sarcopenia have not been well studied. This study aimed to demonstrate the link between serum RC and the prevalence of low bone mass, low muscle mass, and osteosarcopenia in older adults.</p><p><strong>Methods: </strong>This retrospective study involved 1995 individuals aged 50 and above who received CT scans for lung cancer screening from 2016 to 2020. Remnant cholesterol (RC) was calculated as follows: total cholesterol (TC) - (low-density lipoprotein-cholesterol (LDL-c) + high-density lipoprotein-cholesterol (HDL-c)). Low bone mass was defined as bone CT attenuation < 110 HU. Low muscle mass was defined when the area of the erector spinae muscles was < 20 cm2 in women and < 25 cm2 in men. Osteosarcopenia was defined as bone CT attenuation < 110 HU and muscle area < 20 cm2 in women or < 25 cm2 in men.</p><p><strong>Results: </strong>A total of 469 (23.5%) patients with low bone mass, including 268 women and 201 men, were observed. Serum RC was not associated with low bone mass. Elevated serum RC was associated with a lower prevalence of low muscle mass in both women and men (OR = 0.71, 95% CI: 0.50-1.00; OR = 0.53, 95% CI: 0.38-0.75). Serum RC was also associated with osteosarcopenia in women (OR = 0.59, 95% CI: 0.34-1.00) and men (OR = 0.53, 95% CI: 0.29-0.99).</p><p><strong>Discussion: </strong>RC may be a valuable factor for the early identification and management of sarcopenia or osteosarcopenia. However, further studies are needed to investigate the causal relationships and the mechanisms by which RC affects bone and muscle quality.</p><p><strong>Conclusion: </strong>Serum RC was not associated with low bone mass but was negatively associated with low muscle mass and osteosarcopenia in older adults.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619343","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":"Comparative Analysis of Diagnostic Accuracy of OPG and CBCT in the Evaluation of Impacted Mandibular third Molar Proximity to the Mandibular Canal.","authors":"Sujanamulk Bhavana, Ahmed A Almeshari, Nayanala Venkata Anusha, Chaganti Ashok, Bharani Krishna Takkella, Rohith Vadlamani","doi":"10.2174/0115734056307388260321064549","DOIUrl":"https://doi.org/10.2174/0115734056307388260321064549","url":null,"abstract":"<p><strong>Introduction: </strong>Mandibular third molars are the most frequently impacted teeth. The proximity of impacted third molars to the inferior alveolar canal requires particular consideration during extraction. Hence, we aimed to compare the diagnostic accuracy of CBCT and OPG using radiographic signs of Rood and Shebab's and find out the risk of mandibular nerve injury.</p><p><strong>Methods: </strong>A prospective study was conducted in 50 subjects. All patients underwent digital OPG evaluation based on Winter's classification of impacted teeth and Rood and Shehab's classification of seven radiographic signs. Cases with any positive finding were examined using CBCT to assess the positioning of the mandibular canal and alveolar ridge.</p><p><strong>Results: </strong>Horizontal and mesioangular impactions were at higher risk of inferior alveolar nerve damage (p< 0.01 and p < 0.05) along with lingual position of canal (p<0.001), Darkening of roots, interruption of the mandibular canal (p<0.001), and diversion of the mandibular canal (p< 0.04) were associated with a higher risk of damage during extractions.</p><p><strong>Discussion: </strong>The current study confirmed that horizontal and mesioangular impactions showed a significant association with the absence of cortication between the mandibular canal and third molar roots, indicating a high risk of nerve injury, similar to other studies. Also, CBCT has been proven to be the best imaging modality owing to its high diagnostic accuracy.</p><p><strong>Conclusion: </strong>In the current study, CBCT was considered the gold standard, and diagnostic accuracy was higher than OPG. There was fair agreement about the mesioangular and horizontal impaction and their proximity to the mandibular nerve.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619281","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":"Utility of Diffusion-weighted Magnetic Resonance Imaging in Differentiating Connective Tissue Disease-associated Optic Neuritis from Idiopathic Optic Neuritis.","authors":"Yanli Hou, Hang Zhou, Rui Li, Jing Li, Hongyang Li, Yanling Wang","doi":"10.2174/0115734056469568260318053345","DOIUrl":"https://doi.org/10.2174/0115734056469568260318053345","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the feasibility of using diffusion-weighted magnetic resonance imaging (DWI) to differentiate connective tissue disease-associated optic neuritis(CTD-ON) from idiopathic optic neuritis (IDON).</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted on 66 acute optic neuritis(ON) patients. Twenty-five patients (36 eyes) were comorbid with CTD, and 41 patients (49 eyes) had idiopathic ON and served as controls. All patients underwent routine magnetic resonance imaging (MRI) of the orbit and DWI. Affected optic nerves were evaluated for laterality, visual acuity, papilledema, visual outcome, and signal characteristics on DWI and conventional MRI. Clinical characteristics were compared using two-sample t-tests and chi-square tests. Spearman's rank correlation, logistic regression, and receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic value of DWI for CTD-ON.</p><p><strong>Results: </strong>Compared with the IDON group, patients with CTD-ON showed significantly more severe visual impairment and worse prognosis (P < 0.05). Optic nerve hyperintensity on DWI (DWI-H) was a significant risk factor for visual acuity at onset and final visual outcome in ON patients [ORs = 1.893 (95% CI: 1.322-2.711, P < 0.001), 1.716 (95% CI: 1.094-2.691, P = 0.019), respectively]. Acute CTD-ON patients were at higher risk of poor visual outcomes [OR = 2.593 (95% CI: 1.384-4.857, P = 0.003)]. ROC analysis showed that the combination of DWI-H and poor visual outcome yielded an AUC of 0.889 (95% CI: 0.820-0.959, P < 0.001), with a sensitivity of 88.9% and specificity of 77.6%.</p><p><strong>Discussion: </strong>The pathogenesis of CTD-ON may involve the following mechanisms. First, CTD-related small-vessel vasculopathy, necrosis, and hypercoagulability-induced thrombosis may lead to vasculitic infarction and ischemic injury of the optic nerve, which manifests as hyperintensity on DWI. Second, autoantibodies induced by CTD may cross-react with neuronal cells.</p><p><strong>Conclusion: </strong>Patients with CTD-ON demonstrate more severe visual impairment than those with IDON. The presence of DWI hyperintensity and poor prognosis in patients with ON should raise suspicion for CTD-ON in the appropriate clinical setting.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619330","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":"Superselective Lipiodol CT-guided Microwave Ablation for Small Hepatocellular Carcinoma: A Novel Imaging Guidance Strategy.","authors":"Yun-Liang Wang, Ya-Pan Guo, Lei Li, Xin-Guo Zhu, Tong-Qing Xue, Zhi Li","doi":"10.2174/0115734056467384260327043315","DOIUrl":"https://doi.org/10.2174/0115734056467384260327043315","url":null,"abstract":"<p><strong>Introduction: </strong>Microwave Ablation (MWA) is a well-established curative therapy for early-stage Hepatocellular Carcinoma (HCC). However, conventional Non- Contrast CT (NCCT) guidance for MWA faces limitations, including poor visualization of isodense lesions and significant needle artifacts, which can compromise targeting accuracy. This study evaluated a novel imaging-guidance strategy utilizing superselective lipiodol CT to explore its feasibility in addressing these challenges.</p><p><strong>Materials and methods: </strong>Treatment-naïve patients with BCLC 0/A HCC within the Milan criteria were included in this retrospective study. All patients underwent superselective transarterial lipiodol-only marking followed by CT-guided MWA within 1 week. Treatment efficacy was evaluated based on technical success, Local Tumor Progression (LTP), Intrahepatic Distant Recurrence (IDR), Recurrence-Free Survival (RFS), and Overall Survival (OS). Imaging-guidance performance was descriptively evaluated based on intraprocedural lesion visualization and operator-adjusted window settings used to facilitate needle positioning.</p><p><strong>Results: </strong>Forty-five patients with 57 lesions were enrolled. The mean lesion diameter was 18.2 ± 8.8 mm. The initial technical success rate was 95.5% (43/45). The 1-, 2-, and 3-year rates were: LTP: 2.2%, 4.4%, 4.4%; IDR: 24.4%, 37.7%, 44.4%; RFS: 68.9%, 52.7%, 38.2%; OS: 85.1%, 72.4%, and 60.5%. During lipiodol CT-guided procedures, lesions that were isodense and poorly visualized on pre-procedural NCCT were identifiable to the operator, and the window level settings used for final needle positioning confirmation had a mean value of 252.2 ± 75.8 Hounsfield Units.</p><p><strong>Discussion: </strong>The superselective lipiodol CT guidance strategy demonstrated feasibility in addressing several practical limitations of conventional NCCT. It allowed visualization of otherwise inconspicuous isodense lesions, supported needle positioning under reduced metallic artifact conditions at empirically adjusted window levels, and aided the visualization of adjacent portal vein branches during the procedure. This approach utilizes Lipiodol primarily as a long-lasting contrast agent for enhanced CT visualization, rather than for its chemotherapeutic or embolic effect.</p><p><strong>Conclusion: </strong>Superselective lipiodol CT guidance is a feasible imaging approach for intraprocedural lesion visualization and needle positioning during MWA of small HCC in selected procedural scenarios. Controlled comparative or quantitative validation studies are warranted.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619301","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}