Quantitative Imaging in Medicine and Surgery最新文献

{"title":"Incidence, outcome, and risk factors of contrast media extravasation injury during contrast-enhanced computed tomography scans: an observational cohort study.","authors":"Lijian Wang, Qinlan Chen, Haipeng Liu, Xiaomi Wang, Qian Qian, Mengxi Xu, Linlin Ma, Xinhong Wang","doi":"10.21037/qims-24-2332","DOIUrl":"10.21037/qims-24-2332","url":null,"abstract":"<p><strong>Background: </strong>Contrast media (CM) is widely used in contrast-enhanced computed tomography (CECT) to enhance the visualization of abnormal structures. CM extravasation, a recognized complication, may cause mild swelling or severe injuries (e.g., ulceration, necrosis). Current research on severe extravasation is limited to case reports or lacks large-cohort analyses of risk factors. This study aimed to explore risk factors, validate incidence and outcomes, and compare patient/technique/CM-related factors between mild and severe CM extravasation injuries using large-scale clinical data to aid early recognition and prevention.</p><p><strong>Methods: </strong>This is a retrospective cohort study. A total of 586,812 CM injections were performed during CECT scans at a single institution between November 2012 and December 2023. Among these, 709 cases (334 males, 375 females; age: 62.9±15.2 years) with CM extravasation injuries were included. Extravasation injuries were classified by severity. The frequency and clinical outcomes of different severities of injuries were investigated. Risk factors of serious injuries were evaluated using logistic regression with generalized estimating equation analyses.</p><p><strong>Results: </strong>CM extravasation occurred in 0.12% (709/586,812) of cases. Of the 709 extravasation injuries, 672 (94.8%) were mild, 32 (4.5%) were moderate, and 5 (0.7%) were severe. Only 5 patients received consultations from dermatologists or burn specialists, and none required surgery. Multivariate analysis underscored the presence of diabetes mellitus [DM, odds ratio (OR) =8.04; P<0.01], injections in the dorsum of the hand (OR =4.86; P<0.01), without saline test (OR =2.58; P=0.02), and large-volume extravasation (OR =5.49; P<0.01) as potential risk factors of moderate or severe CM extravasation injury.</p><p><strong>Conclusions: </strong>Most CM extravasation injuries are mild and without serious consequences. Multiple modifiable risk factors for serious CM extravasation injury have been identified that could mitigate the severity of the injury.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7338-7351"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of specific components of pericardial fat on coronary high-risk plaque prediction.","authors":"Lihong Nan, Tongli Li, Wenyu Ding, Mengshan Wu, Jintang Feng, Tianzhu Zhang, Fan Yang, Dong Li, Chunyang Sun, Ningnannan Zhang, Zhang Zhang","doi":"10.21037/qims-24-1140","DOIUrl":"10.21037/qims-24-1140","url":null,"abstract":"<p><strong>Background: </strong>Coronary computed tomography angiography (CCTA) can be used to investigate the relationship between white adipose tissue (WAT) and brown adipose tissue (BAT) in pericardial fat (PF) and high-risk plaques (HRP) in patients with coronary artery disease (CAD). This study aimed to explore the association between specific components of PF and HRP/culprit ischemic plaques, as well as their mediating role in overall metabolic status, providing new imaging evidence for predicting adverse events in CAD.</p><p><strong>Methods: </strong>The clinical risk factors and imaging images of 107 CAD patients were retrospectively analyzed. Quantification of coronary artery calcium scores (CACS), PF, WAT, BAT, and pericardial fat attenuation (PFatt) were performed on non-contrast CT images. CCTA was used to evaluate myocardial ischemia and the presence of HRP. Fractional flow reserve derived from CCTA (CT-FFR) was performed in three major coronary arteries, with a threshold of ≤0.80 considered indicative of the presence of lesion-specific ischemia. HRP was defined as the presence of at least two of the four HRP features including positive remodeling (PR), low attenuation, napkin-ring sign (NRS), and spotty calcification. Mediator analysis was performed using Hayes (2018) Model-4.</p><p><strong>Results: </strong>A total of 107 CAD patients aged 65±8 years were included in this study. There were 49 patients (45.79%) with HRP and 57 patients (53.27%) with lesion-specific ischemia (CT-FFR ≤0.80). PF including WAT and BAT in the HRP group was significantly higher than that in the non-HRP group (PF: 241.28 <i>vs.</i> 204.94 cm³, P=0.005, WAT: 91.78 <i>vs.</i> 78.40 cm³, P=0.002, BAT: 56.25 <i>vs.</i> 46.71 cm³, P=0.008). Adding WAT to meaningful clinical risk factors and CACS increases the area under the curve (AUC) for HRP prediction {AUC [95% confidence interval (95% CI)]: 0.789 (0.692-0.887) <i>vs.</i> 0.655 (0.535-0.775), P<0.05}. Interestingly, adding PF to clinical risk factors and CACS decreased the AUC for the prediction of lesion-specific ischemia with no significant difference (P=0.083) [AUC (95% CI): 0.705 (0.592-0.817) <i>vs.</i> 0.796 (0.696-0.897), P<0.05]. Additionally, the mediation effect of PF accounted for 95.19% of the total effect of clinical risk factors on HRP (P<0.05).</p><p><strong>Conclusions: </strong>PF is associated with HRP, and clinical risk factors increase the risk of plaque rupture by promoting PF volume accumulation, especially WAT, which may be a potential predictor of HRP.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7309-7322"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between multimodality imaging features and molecular subtypes in breast cancer: a comparative study between young (≤30 years) and middle-aged (45-55 years) women.","authors":"Junlin Huang, Qing Lin","doi":"10.21037/qims-2025-434","DOIUrl":"10.21037/qims-2025-434","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although breast cancer is rare in young women under 30 years of age, its incidence has been increasing among younger populations in recent years. Identifying the immunohistochemical molecular subtype of early-stage noninvasive breast cancer is thus crucial for optimizing therapeutic strategies. This study aimed to investigate the correlation between multimodal imaging features-including ultrasound (US), digital mammography (DM), and digital breast tomosynthesis (DBT)-and immunohistochemical molecular subtypes in young patients with breast cancer (≤30 years) and middle-aged patients with breast cancer (45-55 years).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis included 146 young (≤30 years) and 292 middle-aged (45-55 years) patients with breast cancer diagnosed between January 2015 and March 2025. Imaging characteristics were assessed according to the Breast Imaging Report and Data System (BI-RADS) fifth edition. Mass lesions were evaluated for shape, margin, size, breast density, posterior features (on US), and vascularity (on US). Calcified lesions were analyzed for shape and distribution. Clinical and pathological parameters included age, symptoms, immunohistochemical classifications, T stage, histological grade, and lymph node metastasis status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The molecular subtype distribution in young and middle-aged patients, respectively, was as follows: luminal B, 70 and 140 cases; triple negative (TN), 32 and 64 cases; human epidermal growth factor receptor 2 (HER2) overexpression, 25 and 50 cases; and luminal A, 19 and 38 cases. (I) Younger patients demonstrated higher rates of nipple discharge (P=0.007), tumors &gt;5.0 cm (P=0.009), stage T3 lesions (P&lt;0.001), and lymph node metastasis (P&lt;0.001), whereas middle-aged patients had higher rates of more palpable masses, tumors ≤2.0 cm, and stage T1 lesions. (II) US analysis indicated that luminal B tumors in younger patients had increased calcified masses (P=0.004), indistinct margins (P=0.004), and enhanced posterior features (P&lt;0.001), which was in contrast to the noncalcified masses, spiculated margins, and shadowing found in middle-aged patients. TN tumors tended to be round/oval morphologies in younger patients (P=0.008). And TN tumors tended to appear as noncalcified masses in middle-aged patients (P=0.046). (III) DBT analysis indicated that younger patients with luminal B tumors were more likely to have isodense lesions (P=0.008) and microlobulated margins (P=0.003), while middle-aged patients tended to exhibit hyperdense lesions and indistinct margins; TN tumors in younger patients tended to have oval/round morphologies (P&lt;0.001) and microlobulated margins (P=0.03); HER2-overexpressed tumors in younger patients tended to show isolated calcifications (P=0.02) and fine linear or branching calcifications, while HER2-overexpressed tumors in middle-aged patients were more likely to be pleomorphic or coarse calcifications (P=0.006","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7537-7554"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telencephalic variant of the anterior choroidal artery: clinical significance and management considerations.","authors":"Lívio Pereira de Macêdo, Ítalo Emmanuel Lima Ferreira, Marcos Alcino Soares Siqueira Marques-Júnior, Renata Raizza Monterazzo-Cysneiros, Ubiratan Alves Viturino da Silva, Marcos Antonio Barbosa da Silva, Bruno Anderson Araújo da Mota, Romero Marques, José Laercio Júnior-Silva, Carlos Gustavo Coutinho Abath, Hildo Rocha Cirne Azevedo-Filho","doi":"10.21037/qims-2025-211","DOIUrl":"10.21037/qims-2025-211","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7663-7666"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective evaluation of arterial spin labeling and diffusion tensor imaging-magnetic resonance imaging for the non-invasive assessment of renal allograft dysfunction.","authors":"Jiali Ma, Changhao Cao, Chenqin Que, Jiayi Wan, Linkun Hu, Jie Li, Yixing Yu, Peng Wu, Chunhong Hu, Lingjie Wang, Mo Zhu","doi":"10.21037/qims-2025-604","DOIUrl":"10.21037/qims-2025-604","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The optimal management strategy for end-stage renal disease is renal transplantation, graft function must be monitored regularly postoperatively. This cross-sectional study aimed to explore the value of combining functional magnetic resonance imaging (MRI) parameters with laboratory parameters in assessing chronic allograft dysfunction (CAD), and to compare whether a combined approach was superior to single-parameter indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 86 subjects were enrolled in the study, of whom, 20 had stable renal function, and 66 had biopsy-confirmed CAD. Imaging was performed on a 1.5-T MRI system using T2-weighted imaging, arterial spin labeling (ASL), and diffusion tensor imaging (DTI). The serum creatinine, estimated glomerular filtration rate (eGFR), 24-hour urinary protein (24hUP), renal blood flow (RBF), and fractional anisotropy (FA) values of the subjects were measured. Correlation analysis was applied to assess MRI parameters' association with eGFR, while receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of fMRI parameters and clinical parameters for CAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The subjects were categorized into CAD groups based on their eGFR levels. The control group had higher renal RBF [277.69±67.17 &lt;i&gt;vs.&lt;/i&gt; 138.60 (99.54-193.51)] and FA values [cortex: 0.16 (0.14-0.16) &lt;i&gt;vs&lt;/i&gt;. 0.13 (0.11-0.16); medulla: 0.32±0.06 &lt;i&gt;vs.&lt;/i&gt; 0.24 (0.20-0.29)] than the CAD group (P&lt;0.01). Cortical RBF decreased progressively across the CAD subgroups [group 1 (mild: 213.33±67.07) &gt; group 2 (moderate: 151.14±53.21) &gt; group 3 (severe: 92.89±35.62); all P&lt;0.05]. Similarly, there was a gradual decrease in medullary FA across the CAD subgroups [group 1: 0.29±0.04; group 2: 0.24 (0.19-0.29); group 3: 0.20±0.06]. However, no statistically significant difference was found in medullary FA between groups 2 and 3 (P=0.102). The correlation analysis showed that cortical RBF and medullary FA were positively correlated with the eGFR in the CAD group (r=0.604, P&lt;0.001; r=0.574, P&lt;0.001). The combined RBF, medullary FA, 24hUP, and eGFR model (RBF-FA-24hUP-eGFR) had an area under the curve (AUC) of 0.95 [95% confidence interval (CI): 0.91-1.00], which was significantly better than the AUCs of the single indicators of 24hUP and medullary FA (AUC =0.78, 95% CI: 0.68-0.88; AUC =0.79, 95% CI: 0.69-0.89, P&lt;0.05). Further, the combined RBF, medullary FA, and, 24hUP model (RBF-FA-24hUP) was significantly superior to single 24hUP in differentiating among the subgroups (all P&lt;0.05). In the CAD subgroups, while the performance of RBF on its own was close to that of the RBF-FA-24hUP model, the AUC of the combined model showed an increasing trend compared with RBF. Notably, the RBF-FA-24hUP model (AUC =0.86, 95% CI: 0.76-0.97; P&lt;0.001) also surpassed medullary FA alone (AUC =0.69, 95% CI: 0.54-0.85; P=0.023) in distinguishing between the subjects in group 2 and group ","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"6882-6896"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningeal lymphatic dysfunction in sporadic cerebral small vessel diseases and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy by DCE-MRI.","authors":"Han Wang, Xiao Ren, Yu Shen, Yusen Qiu, Menghua Li, Si Luo, Zhi Zhang, Lin Wu, Meihong Zhou, Yixin Jiang, Fuqing Zhou, Daojun Hong","doi":"10.21037/qims-24-2429","DOIUrl":"10.21037/qims-24-2429","url":null,"abstract":"<p><strong>Background: </strong>The distinction between cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a prevalent hereditary cerebrovascular disease, and sporadic cerebrovascular disease has sparked significant interest among researchers. Meningeal lymphatic vessels (mLVs) have become a new research topic in recent years. This study aimed to investigate the function of meningeal lymphatics in cerebral small vessel disease (CSVD) and to develop a predictive model to assist in the diagnosis of CADASIL patients.</p><p><strong>Methods: </strong>We systematically examined the functional changes in the meningeal lymphatic system in both sporadic CSVD patients and CADASIL patients using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and the correlations among blood biomarkers were subsequently calculated. Finally, a nomogram was generated for the identification of CADASIL using multiple significant risk factors.</p><p><strong>Results: </strong>This study enrolled 41 sporadic CSVD (S-CSVD) patients, 15 CADASIL patients, and 18 normal controls (NC). Both CSVD and CADASIL groups demonstrated mLVs dysfunction compared to controls, characterized by decreased mLVs wash-in rates (P<0.05) and prolonged time-to-peak (TTP, P<0.01). Significant metabolic correlations emerged specifically in CSVD: In the S-CSVD group, the parameters of DCE-MRI [wash-in rate, TTP, incremental area under the curve (IAUC), transfer rate constant (Ktrans), extravascular extracellular volume fraction (Ve)] correlated with total cholesterol (TC, TTP, r=-0.38), low-density lipoprotein cholesterol (LDL-C, TTP, r=-0.41), serum creatinine (SCr, Ktrans, r=0.34), uric acid (UA, Ve, r=0.34), homocysteine (Hcy, wash-in, r=-0.31, both P<0.05), and hemoglobin A1c (HbA1c, wash-in; r=-0.32, P<0.01, IAUC; r=-0.47, P<0.01). In the CADASIL group, the parameter of DCE-MRI correlated with folic acid (FA, TTP, r=-0.57, P=0.03), SCr (IAUC; r=0.54, P=0.04, Ktrans; r=0.45, P=0.01, Ve; r=0.61, P<0.01), and UA (Ktrans; r=0.45, Ve; r=0.71, both P<0.05). Additionally, we identified several critical risk factors for diagnosing CADASIL and developed a nomogram to differentiate CADASIL from S-CSVD (area under the curve 0.870, 95% confidence interval: 0.767-0.973).</p><p><strong>Conclusions: </strong>This study confirmed that mLVs were dysfunctional in both S-CSVD patients and CADASIL patients. IAUC was identified as a key risk factor, and a nomogram was generated. This research enhances our understanding of the role of mLVs in CSVD and contributes to distinguishing between these S-CSVD and CADASIL.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"6692-6704"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalous origin of the left coronary artery from the pulmonary artery in an adult: a case description and literature analysis.","authors":"Wei Cai, Yanhong Fang, Hongbing Ma","doi":"10.21037/qims-2024-2845","DOIUrl":"10.21037/qims-2024-2845","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7624-7633"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional three-tube method for the management of duodenal perforation after endoscopic retrograde cholangiopancreatography for choledocholithiasis: a case series.","authors":"Yishu Ma, Yonghua Bi, Chenke Wei, Xiaolong Ding, Gang Zhou, Meipan Yin, Jiajia Zhang, Yaozhen Ma, Suli Zhang, Chunxia Li, Gang Wu","doi":"10.21037/qims-2024-2650","DOIUrl":"10.21037/qims-2024-2650","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure for biliary and pancreatic diseases. Although duodenal perforation is a rare complication of ERCP (incidence, <1%), it is associated with a significant mortality rate (4.2-37%). The existing evidence for the management of retroperitoneal abscess or sepsis is limited, since conservative treatments are often ineffective and surgical outcomes are poor. Endoscopic repair is particularly challenging for large perforations, with failure rates of up to 78%. This study reviews seven cases of post-ERCP duodenal perforation treated with an interventional three-tube method.</p><p><strong>Case description: </strong>This retrospective study reviewed seven cases showing duodenal perforation after ERCP for choledocholithiasis between 2019 and 2024. The patients showed clinical symptoms such as fever, abdominal pain, and abdominal distension within 1-3 days after ERCP, and were managed with the interventional three-tube method (insertion of a nasointestinal feeding tube for enteral nutrition, a gastrointestinal decompression tube, and a percutaneous drainage tube for drainage of pus and air). After 5-7 days of hospitalization, the patients were discharged upon stabilization. All patients showed successful healing of duodenal perforation during follow-up.</p><p><strong>Conclusions: </strong>The interventional three-tube method is an effective method for treating duodenal perforations following ERCP, offering a less invasive alternative for this type of complication.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7563-7571"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the computed tomography radiologic features of cytokeratin 19-positive hepatocellular carcinoma to those of conventional hepatocellular carcinoma and intrahepatic cholangiocarcinoma.","authors":"Hongbin Zhang, Lintao Chen, Jing Zhang, Ziqian Li, Yifan Wang, Fangyu Sun, Wenting Du, Xiuming Zhang, Wenjie Liang","doi":"10.21037/qims-24-914","DOIUrl":"10.21037/qims-24-914","url":null,"abstract":"<p><strong>Background: </strong>Cytokeratin 19-positive hepatocellular carcinoma (CK19⁺ HCC) is an uncommon subtype of hepatocellular carcinoma (HCC). The purpose of this study was to identify radiological characteristics with diagnostic value for CK19⁺ HCC.</p><p><strong>Methods: </strong>This was a case-control study. A retrospective analysis of 104 patients with surgically resected, pathologically confirmed CK19⁺ HCC was conducted. The contrast-enhanced computed tomography characteristics of the enrolled patients were assessed, and differences in characteristics between groups were identified by statistical analysis. A multivariate logistic regression model was established to identify CK19⁺ HCC, and receiver operating characteristic curves were plotted to evaluate the diagnostic performance of the model.</p><p><strong>Results: </strong>The univariate analysis revealed that the frequency of regular morphology (55.8% <i>vs.</i> 35.6%, P<0.001), hypodensity (99.0% <i>vs.</i> 91.8%, P=0.010), intratumoral necrosis (61.5% <i>vs.</i> 25.0%, P<0.001), heterogeneous enhancement (96.2% <i>vs.</i> 86.5%, P=0.008), peripheral washout (5.8% <i>vs.</i> 1.4%, P=0.031), non-peripheral washout (88.5% <i>vs.</i> 45.7%, P<0.001), Liver Imaging Reporting and Data System category 5 (67.3% <i>vs.</i> 40.4%, P<0.001), and Liver Imaging Reporting and Data System - Category tumor in vein (LR-TIV) (16.3% <i>vs.</i> 2.4%, P<0.001) were significantly higher in CK19⁺ HCC than the non-CK19+ hepatic tumor patients. Conversely, the incidence of rim enhancement in the arterial phase (7.7% <i>vs.</i> 22.6%, P=0.001), transient hepatic attenuation difference (THAD; 4.8% <i>vs.</i> 23.1%, P<0.001), pseudocapsule formation (12.5% <i>vs.</i> 23.6%, P=0.021), progressive enhancement (5.8% <i>vs.</i> 50.5%, P<0.001), and lymphadenopathy (9.6% <i>vs.</i> 24.5%, P=0.002) was significantly lower in the CK19⁺ HCC than the non-CK19⁺ hepatic tumor patients. The multivariate analysis identified intratumoral necrosis, THAD, pseudocapsule formation, progressive enhancement, and LR-TIV as independent predictors of CK19+ HCC (P<0.05). The joint prediction model had an area under the curve of 0.867 in terms of its ability to detect CK19⁺ HCC, and a sensitivity of 88.46% and a specificity of 69.71%.</p><p><strong>Conclusions: </strong>CK19⁺ HCC is characterized by an increased prevalence of intratumoral necrosis and LR-TIV, as well as a lower incidence of THAD, pseudocapsule formation, and progressive enhancement, which collectively contribute to the identification of this HCC variant.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7470-7482"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between computed tomography imaging features of mesenteric fat and inflammatory activity in Crohn's disease.","authors":"Xiao Hu, Jie-Jie Ding, Nian-Xia Qian, Xiao-Dong Liu","doi":"10.21037/qims-2024-2606","DOIUrl":"10.21037/qims-2024-2606","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Creeping fat (CF), a characteristic structure of Crohn's disease (CD), is closely associated with surgery and prognosis but lacks a unified imaging assessment standard, and endoscopic and serological indicators have limitations in evaluating extra-intestinal lesions. The study aimed to explore the correlation between computed tomography (CT) value distribution changes of mesenteric-surrounding fat in CD and disease activity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, we retrospectively analyzed CT enterography (CTE) images from 47 pathologically confirmed CD patients and 25 randomly selected controls with suspected inflammatory bowel disease (IBD). Quantitative measurements were obtained for mesenteric adipose tissue density (mean of CT values) along key anatomical landmarks including the mesenteric root, superior mesenteric artery, inferior mesenteric artery, perilesional regions, intestinal stricture, and adjacent branching vascular spaces. Other evaluated parameters included bowel wall thickness, CT attenuation, enhancement patterns, and CF grading. Qualitative evaluations were made by comparing with endoscopic, serological, and histopathological results and simplified CD activity index (CDAI) scores. A patient with concurrent anal fistula underwent magnetic resonance imaging (MRI) examination to compare its detection efficiency of fistula with that of CT examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant inter-group differences were found in non-contrast mesenteric fat attenuation, mean ΔCT (difference in Hounsfield units between contrast-enhanced CT and non-contrast CT scans) enhancement, bowel wall thickening, mucosal enhancement, CF grading, intestinal stricture, and serological parameters (P&lt;0.05). The moderate-to-severe activity group had the highest mesenteric fat density in the venous phase [mean ΔCT &gt;20 Hounsfield units (HU), P&lt;0.05], especially around lesions. There was a positive correlation between mesenteric fat CT values and images of diseased bowel segments. The mean value of the venous phase ΔCT of the lesion and the mean of the intestinal wall venous phase ΔCT value and intestinal wall stratification were positively correlated (&gt;0.6, P&lt;0.05). ROC analysis showed that the venous-phase ΔCT of perilesional adipose tissue had excellent diagnostic performance [area under the curve (AUC) =0.964] for moderate-to-severe activity CD, with 95.8% sensitivity and 87.5% specificity. The diagnostic efficacy of the venous phase in the vascular space around the lesion ranked second (AUC =0.943). MRI showed superior detection of the anal fistula to that of CT in one patient. Multivariate analysis confirmed it as an independent predictor for moderate-to-severe active CD (P&lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Changes in mesenteric adipose tissue CT values and CF classification can distinguish CD from other IBD, suggesting their utility as another noninvasive diagnostic method for predicting the in","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"6910-6922"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}