Radiographics最新文献

{"title":"Ultrahigh-Field 7-T MRI in Neuroradiology: A Comprehensive Clinical Review.","authors":"Seyed Mohammad Seyedsaadat, Seyedeh Nazanin Seyed Saadat, Vishal Patel, Sukhwinder Johnny Singh Sandhu, Daniel Paech, Amit Desai, Xiangzhi Zhou, Shengzhen Tao, Vivek Gupta, Erik H Middlebrooks","doi":"10.1148/rg.250194","DOIUrl":"10.1148/rg.250194","url":null,"abstract":"<p><p>Recent advances in ultrahigh-field MRI have led to accelerated adoption in clinical applications, especially after regulatory approval for 7-T MRI systems. The substantial gains in signal-to-noise ratio, tissue contrast, chemical shift, and susceptibility effects enable unprecedented image resolution and quality, resulting in more accurate diagnoses and improved treatment planning. Despite these inherent advantages of 7-T MRI, several challenges have historically limited its clinical adoption. The authors review recent technical advancements that have further enabled routine clinical implementation of 7-T MRI and highlight its applications across a diverse range of neurologic disorders. They outline key physical principles underpinning 7-T imaging, including susceptibility and chemical shift effects, and describes how innovations such as dynamic parallel transmission and deep-learning reconstructions stand to impact clinical translation by mitigating previous technical barriers. Next, the most common clinical indications are addressed, encompassing epilepsy, multiple sclerosis, pituitary microadenomas, unruptured aneurysms, cerebrovascular disease, brain tumors, neurodegenerative diseases, and applications in planning deep brain stimulation. In each of these conditions, 7-T MRI demonstrates superior lesion detection, enhanced anatomic delineation, and increased diagnostic specificity compared with MRI at lower field strengths. With an expanding body of evidence supporting its utility in both diagnosis and treatment planning, 7-T MRI is poised to play an increasingly pivotal role in clinical neuroradiology. ^©RSNA, 2025 Supplemental material is available for this article.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"46 1","pages":"e250194"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783662","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}

{"title":"Mastocytosis: Imaging Spectrum and Diagnostic Insights.","authors":"Rachita Khot, Mahmoud Diab, James M Jing, Mamie Gao, Ahmed Elbanna, Eric S Rupe, Hagar Samir Mahmoud, Albert R Klekers, Ayman Gaballah, Khaled M Elsayes","doi":"10.1148/rg.250075","DOIUrl":"10.1148/rg.250075","url":null,"abstract":"<p><p>Mastocytosis is a rare clonal disorder marked by the excessive proliferation and accumulation of mast cells in different tissues, with the skin and bone marrow being the most commonly affected sites. Mastocytosis is primarily driven by somatic mutations that most commonly affect the c-KIT proto-oncogene. The World Health Organization classifies mastocytosis into three main categories. Cutaneous mastocytosis involves infiltration limited to the skin and is more prevalent in children than in adults. Systemic mastocytosis involves infiltration of extracutaneous organs, including the liver, spleen, lymph nodes, and gastrointestinal tract, and is the most common form of mastocytosis in adults. Mast cell sarcoma is rare and highly aggressive. Skeletal involvement is the most frequently observed radiologic feature of mastocytosis, ranging from diffuse osteosclerosis to osteolytic lesions, and is best visualized on radiographs and CT images. MRI is essential in evaluating bone marrow infiltration. Advanced disease may manifest with hepatosplenomegaly, lymphadenopathy, and gastrointestinal wall thickening. PET/CT allows functional assessment, helping to differentiate between indolent and aggressive subtypes. The differential diagnosis of mastocytosis includes metastatic disease, myeloproliferative disorders, and metabolic bone conditions. Thus, correlation of imaging findings with clinical and laboratory markers, including serum tryptase levels and findings at bone marrow biopsy, is necessary. While histopathologic confirmation remains the reference standard, characteristic imaging findings can prompt early suspicion and guide appropriate workup. The authors review the pathogenesis, classification, and imaging features of mastocytosis, highlighting multiorgan involvement and potential diagnostic mimics of mastocytosis. ^©RSNA, 2025.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"46 1","pages":"e250075"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822176","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}

{"title":"Quality Improvement Report: Decreasing Incorrectly Scheduled Screening US for Hip Dysplasia in Premature Infants.","authors":"Daniella Asch, Gowthaman Gunabushanam, Janelle van Luling, Lauren J Ehrlich, Landra Knoth, Jay K Pahade","doi":"10.1148/rg.250072","DOIUrl":"10.1148/rg.250072","url":null,"abstract":"<p><p>Screening US for developmental dysplasia of the hip in infants with risk factors should optimally be performed after 6 weeks corrected gestational age (CGA). Scanning before this age leads to higher false-positive rates and the potential need for repeat examination, which creates waste and undue stress on the child and family. Pediatric radiologists at the authors' institution observed that many premature infants were being scheduled too early for their screening US. This quality improvement project aimed to decrease incorrectly scheduled screening examinations from a baseline rate of 50% to less than 25% within 6 months. Key drivers and interventions addressed the lack of clarity regarding whether the examination was screening or diagnostic (physical examination finding), poor visibility and manual calculation of CGA by schedulers, and lack of automated scheduling guidance. Ordering clinicians were educated, and an electronic health record (EHR) report was created to prospectively identify examinations that may need rescheduling. Next, a mandatory order question was added in the EHR to clearly identify which examinations were ordered for screening, with embedded guidance for schedulers to time these examinations after 6 weeks CGA. Finally, a special work queue was created to leverage the expertise of certain schedulers assigned to this task. After the final plan-do-study-act cycle, incorrectly scheduled examinations decreased from 50% to 10%. By using people- (specialized scheduling team), process- (dedicated work queue), and system-related (EHR order question with scheduling guidance) interventions, the group was able to create and sustain change and decreased incorrectly scheduled pediatric hip US examinations by 80%. ^©RSNA, 2025.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"46 1","pages":"e250072"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679615","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}

{"title":"Gynecologic Manifestations of Hereditary Syndromes: Clinical and Imaging Spectrum.","authors":"Ekta Maheshwari, Shaun A Wahab, Ashish P Wasnik, Katherine E Maturen, Phuong L Mai, Biatta Sholosh, Atul B Shinagare, Paniti Sukumvanich, Aradhana M Venkatesan","doi":"10.1148/rg.240223","DOIUrl":"10.1148/rg.240223","url":null,"abstract":"<p><p>Gynecologic manifestations often serve as key diagnostic clues associated with a broad spectrum of hereditary syndromes. The authors summarize the spectrum of gynecologic abnormalities observed with these syndromes, emphasizing their implications for radiologic practice. Hereditary cancer predisposition syndromes such as Lynch syndrome, <i>BRCA</i> and <i>BRCA2</i> mutations, and Cowden syndrome are associated with distinct gynecologic features, including increased risks of cancers and structural anomalies, which can be effectively assessed with imaging. The authors synthesize current knowledge on the imaging characteristics of gynecologic abnormalities linked to these syndromes and highlight the diagnostic challenges in image interpretation. Current syndrome-specific imaging recommendations, including screening and surveillance guidelines, are also summarized herein. The authors emphasize the importance of integrating radiologic findings with clinical context, with the aim enhancing awareness and expertise in the detection and characterization of gynecologic manifestations associated with hereditary syndromes, thereby contributing to optimal patient management. ^©RSNA, 2025.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"46 1","pages":"e240223"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744438","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}

{"title":"<i>RadioGraphics</i> 2026: Editorial Reflections at 5 Years.","authors":"Christine Cooky Menias","doi":"10.1148/rg.259013","DOIUrl":"https://doi.org/10.1148/rg.259013","url":null,"abstract":"","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"46 1","pages":"e259013"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919119","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}

{"title":"Current Update on Nomenclature, Diagnosis, and Management of Metabolic Dysfunction-associated Steatotic Liver Disease: Radiologists' Perspective.","authors":"Eri G Osta, Florentino Saenz, Sriram Jaganathan, Courtney Thomas, Eugenia Tsai, Venkateswar Surabhi, Srinivasa R Prasad, Venkata S Katabathina","doi":"10.1148/rg.240221","DOIUrl":"10.1148/rg.240221","url":null,"abstract":"<p><p><i>Metabolic dysfunction-associated steatotic liver disease</i> (MASLD) is the new name for <i>nonalcoholic fatty liver disease</i> (NAFLD). MASLD continues to be a significant global health care problem, commensurate with the increased prevalence of obesity and metabolic syndrome. The study of MASLD has intensified over the past 5 years, with major breakthroughs in understanding the pathogenesis and natural history. The American Association for the Study of Liver Diseases (AASLD) published practice guidance in 2023 to incorporate changes in diagnosis and management. A new nomenclature for MASLD, with updated definitions, has been approved through a global multisociety-led Delphi consensus to replace <i>NAFLD</i> with <i>MASLD</i> and <i>nonalcoholic steatohepatitis</i> (NASH) with <i>metabolic dysfunction-associated steatohepatitis</i> (MASH). AASLD practice guidelines on blood-based and imaging-based noninvasive liver disease assessments of hepatic fibrosis and steatosis have also been recently published. The latest advances in US and MRI techniques have allowed radiologists to play a pivotal role in early detection, accurate assessment, and monitoring of diseases, thus enabling timely intervention and lifestyle changes. Resmetirom has recently been approved for treating noncirrhotic adult patients with MASLD and moderate to severe hepatic fibrosis, along with diet and exercise. The authors review the role of imaging in the new guidelines as the current evaluation of MASLD transitions from invasive tests to advanced imaging-based diagnostics. The article will serve as a reference for radiologists, who play a critical role in managing and prognosticating MASLD. ^©RSNA, 2025 Supplemental material is available for this article.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 12","pages":"e240221"},"PeriodicalIF":5.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514963","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}

{"title":"Permanent Prostate Brachytherapy Placement: Imaging Assessment of Seed Positioning, Spacer Use, and Complications.","authors":"Koichiro Muraki, Makoto Nakiri, Andrei S Purysko, Chikayuki Hattori, Hiroaki Suefuji, Hiroki Suekane, Tsukasa Igawa, Etsuyo Ogo, Shuichi Tanoue","doi":"10.1148/rg.250051","DOIUrl":"10.1148/rg.250051","url":null,"abstract":"<p><p>Low-dose-rate (LDR) brachytherapy with iodine 125 (¹²⁵I) seeds is an effective treatment of localized prostate cancer, delivering targeted doses to the prostate while minimizing radiation exposure to adjacent tissues. ¹²⁵I seeds implanted under transrectal US guidance provide tailored radiation distribution through loose or stranded configurations. Loose seeds allow flexible placement but carry a higher migration risk than stranded seeds. Optimal placement strategies involve targeting the peripheral zone near the prostate capsule to achieve adequate dose coverage for potential extracapsular extensions, with careful consideration to minimize toxicity to adjacent organs. Seed migration, primarily to the lungs, typically occurs through venous pathways due to the extensive periprostatic venous plexus. Less common migration sites include the heart, vertebral venous plexus, kidneys, liver, and testicular veins. Migration mechanisms involve retrograde venous flow and, in rare cases, arterial pathways through pulmonary arteriovenous malformations or intracardiac shunts. These seed migrations are typically incidental findings at imaging and rarely necessitate intervention because of the gradual radioactive decay of the seeds. Hydrogel spacers composed of polyethylene glycol are increasingly used during brachytherapy to reduce rectal toxicity by creating a separation between the prostate and rectum. Although these spacers are generally effective, complications such as asymmetric distribution, intraprostatic or intrarectal injection, and fistula formation can compromise radiation safety and efficacy. These complications can be identified at postprocedural imaging. Accurate imaging assessment is crucial for evaluating seed placement, detecting seed migration, and identifying complications related to hydrogel spacers, ultimately contributing to improved patient outcomes in prostate cancer treated with LDR brachytherapy. ^©RSNA, 2025 Supplemental material is available for this article.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 12","pages":"e250051"},"PeriodicalIF":5.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643021","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}

{"title":"Imaging in Renovascular Hypertension: State of the Art.","authors":"Tomas V Gonzalez, Candice Bookwalter, Ashish Khandelwal, Christopher J François, Edwin A Takahashi, Prabhakar Shantha Rajiah","doi":"10.1148/rg.240211","DOIUrl":"10.1148/rg.240211","url":null,"abstract":"<p><p>Renovascular hypertension (RVH) results from activation of the renin-angiotensin system by renal arterial stenosis (RAS). RAS can result from either intrinsic narrowing or extrinsic compression. Intrinsic narrowing may be caused by atherosclerosis, fibromuscular dysplasia, vasculitis, dissection, thrombus, aneurysm, arteriovenous fistula, neurofibromatosis type 1, or midaortic syndrome. Extrinsic compression can be from retroperitoneal fibrosis, neoplasm, or subcapsular hematoma or fluid. Diagnostic evaluation for RVH is triggered by either a high index of suspicion in a patient with hypertension or incidental detection of RAS at noninvasive imaging. Renal US, primarily with Doppler, is a common modality used for initial screening of RVH, especially when renal function is decreased. US can be used to evaluate hemodynamically significant RAS, including in stents, and also for parenchymal evaluation. MR angiography (MRA) is an excellent modality for RVH evaluation, typically used following US. In patients with decreased renal function, MRA can be performed without contrast material or with ferumoxytol, but group 2 gadolinium-based contrast agents are safe. CT angiography offers excellent spatial resolution that is ideal for the evaluation of distal small renal arterial branches and for assessment of in-stent stenosis following intervention. Conventional angiography is the reference standard, now reserved only for interventional procedures. Imaging also plays an important role in excluding other causes of secondary hypertension and evaluating complications of RVH. The management of RVH depends on the cause and involves a combination of medical treatment and surgical or interventional procedures. Interventional options include angioplasty, stent placement, and embolization. ^©RSNA, 2025 Supplemental material is available for this article.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 12","pages":"e240211"},"PeriodicalIF":5.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514987","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}

{"title":"Budd-Chiari Syndrome: Update on Classification and Intravascular US.","authors":"Anne Sailer, Nariman Nezami, Parham Tabeli Bouroujeni, Kara Fitzgerald, Riddhi Borse, Nadia Solomon, Irene Dixe de Oliveira Santo, Margarita V Revzin, Meghan G Lubner, Rachita Khot, Angelo G Marino, Jeffrey Pollak, Todd Schlachter","doi":"10.1148/rg.240240","DOIUrl":"10.1148/rg.240240","url":null,"abstract":"<p><p>Budd-Chiari syndrome (BCS) results from the obstruction of hepatic venous outflow and can occur anywhere from the level of the small hepatic veins (HVs) to the junction of the inferior vena cava (IVC) and the right atrium. The obstruction of the HVs can be global or segmental. This results in sinusoidal congestion, which leads to portal hypertension and subsequent centrilobular fibrosis, nodular regenerative hyperplasia, and ultimately cirrhosis. Treatment is aimed at restoring HV or IVC outflow by angioplasty, stent placement, or creating a portosystemic shunt, which in turn drastically reduces hepatic sinusoidal pressure. Thus, treatment strategies should be based on detailed knowledge of the underlying causal factors, lesion classification, clinical presentation, and baseline liver function. The BCS classification system is divided into types and subtypes that can guide interventional therapy, with the aim of standardizing the imaging diagnosis and interventional therapy of BCS. Intravascular US (IVUS) aids in BCS lesion characterization as described by the BCS classification system. It can help determine the need for stent placement following angioplasty and is helpful in portosystemic shunt creation. Additionally, IVUS can reduce radiation dose, contrast agent volume, and procedure time and increase the technical success rate of procedures. It is essential for the radiologist to understand the BCS classification system as a useful tool to guide interventional therapy. ^©RSNA, 2025 <i>Supplemental material is available for this article.</i></p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 12","pages":"e240240"},"PeriodicalIF":5.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566271","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}

{"title":"Patient-centered Radiology: Implementing a Trauma-informed Care Framework.","authors":"Sydney J Torres, Angelica N Alexopoulos, Colleen H Neal, Janet E Bailey, Katherine A Klein","doi":"10.1148/rg.250032","DOIUrl":"10.1148/rg.250032","url":null,"abstract":"<p><p>The authors present a framework for integrating trauma-informed care principles into radiologic procedures. Trauma-informed care is an approach that acknowledges the widespread impact of psychological trauma, incorporating this understanding into health care practices to prioritize patient safety, trust, and support while minimizing the risk of retraumatization. Given the high prevalence of psychological trauma among patients, radiologic procedures-some of which can be physically and emotionally distressing, such as breast biopsies, hysterosalpingography, and fluoroscopic enemas-must be approached with sensitivity. However, despite the growing awareness of trauma-informed care in health care, there is limited literature specifically addressing its application in the field of radiology. Without established frameworks, radiologists and imaging staff may unintentionally overlook critical aspects of patient-centered care, increasing the risk of psychological retraumatization. The authors aim to bridge that gap by providing a structured approach to implementing trauma-informed care in radiology. They outline key principles, including clear communication, patient autonomy, environmental modifications, and procedural adjustments, to foster a sense of safety and control. Additionally, they offer actionable recommendations for before, during, and after imaging examinations-the START, CARES, and FOLLOW framework-to enhance patient comfort and trust. By incorporating trauma-informed strategies and considering barriers to implementation, radiologists and imaging teams can improve patient experiences, foster stronger provider-patient relationships, and ultimately contribute to more compassionate, patient-centered care. Given the integral role of radiology in modern medicine, these considerations are crucial to ensuring equitable and supportive health care for all patients, particularly those with a history of psychological trauma. ^©RSNA, 2025 Supplemental material is available for this article.</p>","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 12","pages":"e250032"},"PeriodicalIF":5.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642912","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}