Radiographics最新文献

Complications of CT- and US-guided Thoracic Interventional Procedures. CT 和 US 引导下的胸腔介入手术并发症。

IF 5.2 1区医学

Radiographics Pub Date : 2025-02-01 DOI: 10.1148/rg.240146

Valèria Richart, Llúria Cornellas, Blanca Domenech-Ximenos, Judit Mestres, Mariana Benegas, Marcelo Sánchez, Ivan Vollmer

引用次数: 0

Image-guided Interventions for Core Muscle Injury and Other Disorders in the Pubic Symphysis.

IF 5.2 1区医学

Radiographics Pub Date : 2025-02-01 DOI: 10.1148/rg.240148

Dyan V Flores, Juvel Lee, Timothy Murray

{"title":"Image-guided Interventions for Core Muscle Injury and Other Disorders in the Pubic Symphysis.","authors":"Dyan V Flores, Juvel Lee, Timothy Murray","doi":"10.1148/rg.240148","DOIUrl":"https://doi.org/10.1148/rg.240148","url":null,"abstract":"Formerly termed sports hernia or athletic pubalgia, core muscle injury (CMI) encompasses abnormality of structures within the so-called core, which is essentially the hip, abdomen, and pubis. Compared with data on image-guided procedures of other joints, information regarding procedures performed to address CMI and other disorders of the pubic symphysis is lacking. These procedures can be daunting given the joint's small size, surrounding critical neurovascular structures, and three-dimensional anatomy. Nonetheless, various diagnostic and therapeutic image-guided interventions in this region can be successfully performed by the astute radiologist. Diagnostic symphyseography provides a contrast agent map that allows detection of symphyseal cleft injuries. Although largely supplanted with MRI, which can help depict additional findings such as bone marrow edema and atypical cleft injuries, symphyseography performed alongside local anesthetic and steroid injection remains a valuable conservative therapeutic strategy in the treatment of CMI. US-guided percutaneous dry needling (tenotomy) is thought to promote tendon healing by using repeated needle passage to convert chronic degeneration of tendinosis into an acute inflammatory condition; the distal rectus abdominis and/or proximal adductor longus may be targeted. Other perisymphyseal procedures include joint aspiration, biopsy, and osteoplasty. Fluoroscopic- or US-guided joint aspiration aids in evaluation of arthropathies. While bone and soft-tissue biopsies are best performed under CT guidance, fluoroscopy and US are viable alternatives in the evaluation of lesions with significant extraosseous components. Percutaneous osteoplasty is a minimally invasive palliative procedure that stabilizes pubic metastases by injecting bone cement; it can be performed under fluoroscopic or CT guidance by itself or with thermal ablation to maximize pain relief. ©RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 2","pages":"e240148"},"PeriodicalIF":5.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypointense Findings on Hepatobiliary Phase MR Images.

IF 5.2 1区医学

Radiographics Pub Date : 2025-02-01 DOI: 10.1148/rg.240090

Kelly C Harper, Maxime Ronot, Michael L Wells, Antonio Luna, Ahmed Ba-Ssalamah, Jin Wang, Christopher L Welle, Alvin C Silva, Jeff Fidler, Sudhakar K Venkatesh

{"title":"Hypointense Findings on Hepatobiliary Phase MR Images.","authors":"Kelly C Harper, Maxime Ronot, Michael L Wells, Antonio Luna, Ahmed Ba-Ssalamah, Jin Wang, Christopher L Welle, Alvin C Silva, Jeff Fidler, Sudhakar K Venkatesh","doi":"10.1148/rg.240090","DOIUrl":"https://doi.org/10.1148/rg.240090","url":null,"abstract":"Hepatobiliary (HB) contrast agents are increasingly valuable diagnostic tools in MRI, offering a wider range of applications as their clinical use expands. Normal hepatocytes take up HB contrast agents, which are subsequently excreted in bile. This property creates a distinct HB phase providing valuable insights into liver function and biliary anatomy. HB contrast agents can assist in diagnosing a broad spectrum of HB diseases ranging from diffuse liver disease to focal hepatic lesions and can delineate anatomic details of the biliary tree. Understanding the pharmacodynamics of HB contrast agents is paramount to their appropriate clinical application and troubleshooting. HB phase hypointensity can arise from various diffuse and focal abnormalities that may or may not be associated with biliary excretion. Hypointensity during the HB phase can be broadly grouped into diffuse hypointensity, regional hypointensity, and focal lesions for better evaluation of the underlying cause. Abnormalities may arise from hepatic parenchymal, biliary, or vascular causes, or a combination thereof in each of the broad groups. Recognition of a suboptimal hypointense HB phase is important in the evaluation of focal lesions in patients with cirrhosis of the liver and particularly in those with hepatocellular carcinoma. Furthermore, hypointensity can also suggest the aggressiveness of malignancies such as hepatocellular carcinoma or colorectal metastases, which may affect the prognosis. It is essential to consider all imaging findings relative to the clinical context and the complete set of the MRI sequences performed for diagnosis of liver abnormalities. This comprehensive approach minimizes the risk of misinterpretation or pitfalls. The authors aim to equip radiologists with key insights for accurately understanding hypointensity in the HB phase, ultimately leading to more accurate diagnoses. ©RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 2","pages":"e240090"},"PeriodicalIF":5.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac MRI in Heart Transplantation: Approaches and Clinical Insights. 心脏移植中的心脏磁共振成像：方法和临床启示。

IF 5.2 1区医学

Radiographics Pub Date : 2025-02-01 DOI: 10.1148/rg.240142

Sandra Quinn, Roberta Catania, Vinesh Appadurai, Jane E Wilcox, Richard L Weinberg, Daniel C Lee, James C Carr, Michael Markl, Bradley D Allen, Ryan Avery

{"title":"Cardiac MRI in Heart Transplantation: Approaches and Clinical Insights.","authors":"Sandra Quinn, Roberta Catania, Vinesh Appadurai, Jane E Wilcox, Richard L Weinberg, Daniel C Lee, James C Carr, Michael Markl, Bradley D Allen, Ryan Avery","doi":"10.1148/rg.240142","DOIUrl":"https://doi.org/10.1148/rg.240142","url":null,"abstract":"Orthotopic heart transplant (OHT) is a well-established therapy for end-stage heart failure that leads to improved long-term survival rates, with careful allograft surveillance essential for optimizing clinical outcomes after OHT. Unfortunately, complications can arise after OHT that can compromise the success of the OHT. Cardiac MRI is continually evolving, with a range of advanced techniques that can be applied to evaluate allograft structure and function. Understanding the unique features of cardiac MRI in OHT recipients, identifying findings suggestive of acute or chronic complications, and recognizing the limitations of this imaging modality are essential for accurate interpretation of cardiac MRI findings and subsequent clinical reporting. The authors address the anticipated postsurgical anatomy and functionality of the OHT. Emphasis is placed on the advanced functional and tissue characterization features that can be seen in the stable OHT recipient, including global longitudinal strain, late gadolinium enhancement, native T1 and T2 mapping, and extracellular volume fraction. Subsequently, the evidence for detection of acute cardiac allograft rejection with cardiac MRI comprehensive tissue characterization techniques and the role of quantitative myocardial perfusion for cardiac allograft vasculopathy screening are discussed, with reference to their comparative standard of reference screening tests, including endomyocardial biopsy, invasive coronary angiography, and myocardial rest and stress perfusion PET/CT. Cardiac MRI has been included in contemporary OHT management guidelines and therefore can be considered a complementary tool for allograft evaluation. The authors demonstrate the complementary role cardiac MRI can play in cardiac allograft surveillance, with clinical examples. ©RSNA, 2025 Supplemental material is available for this article. See the invited commentary by Agarwal in this issue.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 2","pages":"e240142"},"PeriodicalIF":5.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Invited Commentary: Cardiac MRI in Orthotopic Heart Transplantation: A New Frontier?

IF 5.2 1区医学

Radiographics Pub Date : 2025-02-01 DOI: 10.1148/rg.250005

Saurabh Agarwal

引用次数: 0

Valentine's Day Wishes.

IF 5.2 1区医学

Radiographics Pub Date : 2025-02-01 DOI: 10.1148/rg.259001

David J DiSantis

引用次数: 0

Erratum for: Quality Improvement Report: The Sliding Sign Initiative-Facilitating Earlier Detection of Deep Endometriosis in an Academic US Department. 质量改进报告的勘误：滑动标志倡议-促进早期发现深子宫内膜异位症在美国学术部门。

IF 5.2 1区医学

Radiographics Pub Date : 2025-01-01 DOI: 10.1148/rg.249013

Emily H T Pang, Caroline E Lee, Abigail Lee, Esraa A Khalifa

引用次数: 0

CT Angiography of the Upper Extremities: Review of Acute Arterial Entities. 上肢的CT血管造影：急性动脉实体的回顾。

IF 5.2 1区医学

Radiographics Pub Date : 2025-01-01 DOI: 10.1148/rg.240077

Daniel D Friedman, Michael J Ponkowski, Anup Shashindra Shetty, Mark Jeffrey Hoegger, Malak Itani, Mohamed Z Rajput, Vincent M Mellnick, Constantine Apostolos Raptis, Benjamin E Northrup, David Ballard, Jorge A Cabrera Lebron, Richard Tsai

{"title":"CT Angiography of the Upper Extremities: Review of Acute Arterial Entities.","authors":"Daniel D Friedman, Michael J Ponkowski, Anup Shashindra Shetty, Mark Jeffrey Hoegger, Malak Itani, Mohamed Z Rajput, Vincent M Mellnick, Constantine Apostolos Raptis, Benjamin E Northrup, David Ballard, Jorge A Cabrera Lebron, Richard Tsai","doi":"10.1148/rg.240077","DOIUrl":"10.1148/rg.240077","url":null,"abstract":"Historically, evaluation of the upper extremity vasculature was performed using digital subtraction angiography. With the advancement of cross-sectional imaging and submillimeter isotropic data acquisition, CT angiography (CTA) has become an excellent noninvasive diagnostic tool for evaluation of the vasculature of the upper extremities. CTA allows quick evaluation of vessel patency and irregularity and achievement of the anatomic detail needed in preoperative planning. When interpreting CTA of the upper extremities, radiologists must be familiar with the normal vascular anatomy, common vascular anomalies, and pitfalls or artifacts that may mimic or mask abnormality. In this review, the authors provide an overview of the utility of CTA of the upper extremities. Also discussed are CTA techniques and the use of several newer technologies including dual-energy and photon-counting detector CT. The utility of CTA in patients with upper extremity trauma is explored, with a focus on assessing vascular injury. Other vascular abnormalities including infection, acute limb ischemia, and vasculitis are discussed. It is imperative for radiologists to be accustomed to CTA of the upper extremities in diagnosing acute vascular abnormalities and to recognize common pitfalls and mimics of these abnormalities. ©RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 1","pages":"e240077"},"PeriodicalIF":5.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artifacts at Cardiac MRI: Imaging Appearances and Solutions. 心脏MRI伪影：影像学表现及解决方法。

IF 5.2 1区医学

Radiographics Pub Date : 2025-01-01 DOI: 10.1148/rg.230200

Prabhakar Shantha Rajiah, Baskaran Sundaram, Ming Yen Ng, Praveen Ranganath, Philip A Araoz, Michael A Bolen

{"title":"Artifacts at Cardiac MRI: Imaging Appearances and Solutions.","authors":"Prabhakar Shantha Rajiah, Baskaran Sundaram, Ming Yen Ng, Praveen Ranganath, Philip A Araoz, Michael A Bolen","doi":"10.1148/rg.230200","DOIUrl":"https://doi.org/10.1148/rg.230200","url":null,"abstract":"Cardiac MRI (CMR) is an important imaging modality in the evaluation of cardiovascular diseases. CMR image acquisition is technically challenging, which in some circumstances is associated with artifacts, both general as well as sequence specific. Recognizing imaging artifacts, understanding their causes, and applying effective approaches for artifact mitigation are critical for successful CMR. Balanced steady-state free precession (bSSFP), the most common CMR sequence, is associated with band and flow artifacts, which are amplified at 3-T imaging. This can be mitigated by targeted shimming, by short repetition time, or by using a frequency-scout sequence. In patients with cardiac arrhythmias or poor breath hold, the quality of cine imaging can be improved with a non-electrocardiographically gated free-breathing real-time sequence. Motion artifacts on late gadolinium enhancement (LGE) images can be mitigated by using single-shot technique with motion compensation and signal averaging. LGE images are also prone to partial-volume averaging and incomplete myocardial nulling. In phase-contrast imaging, aliasing artifact is seen when the velocity of blood is higher than the encoded velocity. Aliasing can be mitigated by increasing the encoded velocity or using postprocessing software. In first-pass perfusion imaging, a dark rim artifact due to Gibbs ringing can be distinguished from a true perfusion defect based on earlier appearance and fading after a few cardiac cycles. With implanted cardiac devices, artifactual high signal intensity mimicking scar is seen on LGE images, which can be mitigated using a wide-band sequence. With devices and metallic artifacts, traditional gradient-recalled echo sequence has fewer artifacts than bSSFP. CMR at 3 T requires adaptation of sequences to minimize artifacts. ©RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 1","pages":"e230200"},"PeriodicalIF":5.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nuclear Medicine Imaging in Epilepsy. 癫痫的核医学成像。

IF 5.2 1区医学

Radiographics Pub Date : 2025-01-01 DOI: 10.1148/rg.240062

Aakanksha Sriwastwa, Andrew Timothy Trout, Bruce Wayne Mahoney, Lily L Wang, Jennifer L Scheler

{"title":"Nuclear Medicine Imaging in Epilepsy.","authors":"Aakanksha Sriwastwa, Andrew Timothy Trout, Bruce Wayne Mahoney, Lily L Wang, Jennifer L Scheler","doi":"10.1148/rg.240062","DOIUrl":"https://doi.org/10.1148/rg.240062","url":null,"abstract":"Approximately one-third of patients with focal epilepsy have medically refractory focal epilepsy (MRFE), which significantly impacts their quality of life. Once a seizure focus is identified and determined to be in the noneloquent cortex, it can be surgically resected with the goal of freedom from seizures and minimal neurocognitive deficit. During noninvasive (phase I) presurgical planning, functional (nuclear) imaging and structural imaging are complementary in the accurate localization of the epileptogenic zone (EZ). PET and SPECT are complementary functional imaging modalities. Fluorine 18-fluorodeoxyglucose PET shows hypometabolism in the EZ, while SPECT radiotracers are used to assess regional cerebral perfusion. Functional imaging plays a more important role in patients with nonlesional epilepsy (approximately one-third of patients with MRFE), in patients with multiple lesions, or in the setting of electrophysiologic-structural discordance. Nuclear medicine imaging also helps in evaluating the functional integrity of the rest of the brain and unmasking abnormalities that are not apparent at structural imaging before surgery. During invasive (phase II) evaluation, the EZ seen at functional imaging helps in guiding intracranial electrode placement. This review of nuclear medicine imaging of epilepsy is focused on the radiotracers used, imaging acquisition and postprocessing, commonly encountered causes of MRFE in adults and children, radiologic appearances of MRFE, imaging artifacts, and interpretation pitfalls. The goal is to guide radiologists in optimally performing and interpreting these studies for effective multidisciplinary discussions of these complex patient cases. ©RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 1","pages":"e240062"},"PeriodicalIF":5.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0