American Journal of Roentgenology最新文献

{"title":"Use of a Template-Matching Clavicle Fracture Atlas for Surrogate Dating of Humeral and Femoral Fractures in Young Infants: A Six-Reader Study.","authors":"Jade Iwasaka-Neder, Shaoju Wu, Sila Kurugol, Sarah D Bixby, Eric L Tung, Jordan Forte, Atsuhiko Handa, Patrick Duffy, Chantal Akkari, Enju Liu, Paul K Kleinman, Andy Tsai","doi":"10.2214/AJR.25.33184","DOIUrl":"10.2214/AJR.25.33184","url":null,"abstract":"<p><p><b>BACKGROUND</b>. Fracture dating is important in suspected infant abuse. Birth-related clavicle fractures are common and may provide surrogates to aid long bone fracture dating in infants. <b>OBJECTIVE</b>. The purpose of this study was to assess the impact of a template-matching clavicle fracture timeline atlas on radiologists' performance in dating birth-related fractures of the clavicle, humerus, and femur in young infants. <b>METHODS</b>. This retrospective study included infants 90 days old or younger who underwent radiography of a birth-related clavicle fracture from April 1, 2021, to July 31, 2024 or a birth-related fracture of the humerus or femur from December 1, 2011, to July 31, 2024. All eligible radiographs of each fracture were identified, representing distinct observations for the purposes of analysis. Patient age (expressed as days) at the time of radiograph acquisition served as the reference standard for fracture ages. A nonrigid image registration technique was applied to a nonoverlapping preassembled database of radiographs of birth-related clavicle fracture, to create a fracture dating atlas. Six readers (three trainees and three pediatric radiologists) independently reviewed the radiographs in separate sessions without and with use of the atlas to estimate fracture ages. Interreader agreement was assessed using intraclass correlation coefficients (ICCs). Fracture aging performance was assessed using mean absolute errors (MAEs). <b>RESULTS</b>. The analysis included 145 infants (87 male and 58 female infants) with 269 fracture radiographs (104 of the clavicle, 128 of the humerus, and 37 of the femur). The mean fracture age was 26 ± 19 [SD], 22 ± 14, and 21 ± 13 days for clavicle, humerus, and femur fractures, respectively. Interreader agreement for estimating fracture ages improved from moderate (ICC = 0.69) without use of the atlas to excellent (ICC = 0.91) with use of the atlas. The MAE in fracture dating was significantly lower (<i>p</i> < .05) with than without use of the atlas for all six readers for clavicle fractures (range, 4.8-5.5 vs 5.8-10.1 days), for all six readers for humeral fractures (range, 6.0-12.1 vs 3.0-3.8 days), and for five of six readers for femur fractures (range, 7.4-17.2 vs 3.3-4.8 days). MAE without and with use of the atlas was 8.8 versus 4.3 days, respectively, across trainee readers and 8.4 versus 4.0 days, respectively, across attending physician readers. <b>CONCLUSION</b>. The fracture dating atlas yielded significant improvements in radiologists' performance for dating infant clavicle, humerus, and femur fractures. <b>CLINICAL IMPACT</b>. Clavicle fracture healing patterns can serve as surrogates for dating long bone fractures commonly encountered in infant abuse.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":"1-13"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Lower MRI Field Strength May Be an Option for IPMN Surveillance, But Questions Remain.","authors":"Edward M Lawrence","doi":"10.2214/AJR.25.33934","DOIUrl":"https://doi.org/10.2214/AJR.25.33934","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of Microvascular Obstruction From Early to Late Gadolinium Enhancement Images on Cardiac MRI: Prognostic Utility After STEMI-Analysis of EARLY-MYO-CMR Registry Data.","authors":"Jin-Yi Xiang, Jin-Yu Zheng, Wei-Hui Xie, Ruo-Yang Shi, Rui Wu, Bing-Hua Chen, Dong-Aolei An, Yan Zhou, Jun Pu, Lian-Ming Wu","doi":"10.2214/AJR.25.33747","DOIUrl":"10.2214/AJR.25.33747","url":null,"abstract":"<p><p><b>Background:</b> In patients undergoing cardiac MRI after ST-elevation myocardial infarction (STEMI), microvascular obstruction (MVO) often decreases in size between early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE) images. Persistence of MVO between these images may indicate greater microvascular injury. <b>Objective:</b> To evaluate the prognostic utility of measures of MVO persistence between EGE and LGE images in patients undergoing cardiac MRI after STEMI <b>Methods:</b> This retrospective study included 584 patients (mean age, 60±11 years; 507 male, 77 female) enrolled in the multicenter EARLY-MYO-CMR registry from June 2017 to March 2023 who underwent cardiac MRI, including EGE and LGE images, within 1 week after percutaneous intervention for STEMI. Using semiautomated software, a radiologist measured MVO volumes (i.e., hypointense cores within hyperenhancing territories) on EGE and LGE images. The MVO persistence index was calculated as the ratio of MVO volume between LGE and EGE images. Patients were assigned to one of four MVO patterns (none [absent on EGE and LGE]; reversible [present on EGE, absent on LGE]; partially reversible [present on both, persistence index <40%]; persistent [present on both, persistence index ≥40%]). Cox regression models were performed to predict major adverse cardiovascular events (MACE: all-cause death, heart failure hospitalization, reinfarction), adjusted for established clinical and MRI risk factors including static EGE and LGE MVO volumes. Propensity-score matching (PSM) analysis was performed between partially reversible and persistent MVO patterns. <b>Results:</b> No MVO, reversible MVO, partially reversible MVO, and persistent MVO patterns were observed in 157, 133, 195, and 99 patients, respectively. In separate models, increased risk of MACE (n=103) showed independent associations with MVO persistence index (HR per 10% increase=1.36; P<.001) and persistent MVO pattern (HR vs no MVO pattern=5.14; p<.001). Heart failure hospitalizations and reinfarctions also showed significant independent associations with MVO persistence index (HR=1.26-1.45) and persistent MVO pattern (HR=7.06-11.16). In PSM analysis (99 patients per group), MACE was independently associated with the persistent relative to partially reversible MVO pattern (HR=3.33; P=.004). <b>Conclusion:</b> MVO persistence between EGE and LGE images was a significant independent predictor of MACE. <b>Clinical Impact:</b> Measures of MVO dynamics provide prognostic information beyond standard static MVO measures.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologists and Artificial Intelligence in Breast Screening: Are We Ready?","authors":"Louise S Wilkinson","doi":"10.2214/AJR.25.33944","DOIUrl":"https://doi.org/10.2214/AJR.25.33944","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echogenic Rind Improves Prediction of Malignancy and Tumor Size.","authors":"Reni S Butler","doi":"10.2214/AJR.25.33927","DOIUrl":"https://doi.org/10.2214/AJR.25.33927","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lateral Meniscal Oblique Radial Tear: MRI Identification of a Biomechanically Important Tear Pattern Associated With Anterior Cruciate Ligament Injury.","authors":"Erin F Alaia, Mohammad Samim, Michael R Moore, William R Walter, Christopher J Burke, Zachary L LaPorte, Alexander J Egol, Alexander Golant, Michael J Alaia","doi":"10.2214/AJR.25.33466","DOIUrl":"https://doi.org/10.2214/AJR.25.33466","url":null,"abstract":"<p><p><b>Background:</b> Lateral meniscal oblique radial tears (LMORTs) are a recently described, biomechanically important tear pattern associated with anterior cruciate ligament (ACL) injury. <b>Objective:</b> The purposes of this study were to assess the utility of MRI for distinguishing LMORT lesions from other posterior lateral meniscal tears in patients undergoing primary ACL reconstruction, utilizing an arthroscopic reference standard, and to assess potential independent predictors of LMORT lesions on MRI. <b>Methods:</b> An arthroscopic database of 568 ACL reconstructions (12/2022-12/2023) included 140 lateral meniscal posterior horn or posterior root tears meeting inclusion criteria. An orthopedic surgeon, blinded to the original arthroscopic report, reviewed the arthroscopic images for LMORT presence and type. Three musculoskeletal radiologists, also blinded to the original arthroscopic report, independently reviewed posterior lateral meniscal tears for LMORT presence, lesion type based on treatment, meniscofemoral ligament tear, meniscal extrusion, and presence of the \"meniscal sail\" sign. Sensitivity and specificity were calculated for each reader, and the kappa coefficient assessed interreader agreement. Univariate regression analysis assessed for independent imaging predictors of LMORT lesions using a p value of < .05. <b>Results:</b> Arthroscopic review identified 51 LMORT lesions (9.0% of ACL reconstructions, 36.4% of lateral meniscal posterior tears; 19 female patients, 32 male patients; mean age, 28.1 years; age range, 14-50 years). MRI had a sensitivity of 76.5-80.4% and specificity of 54.9-88.2% for all LMORT lesions, with moderate to substantial interreader agreement (0.443-0.747). MRI showed a higher sensitivity for classification of LMORT Type 3 and 4 lesions (82.6-91.3%) than of Type 1 (12.5-25.0%) or Type 2 (0-27.3%) lesions. Lateral meniscal extrusion was an independent predictor of LMORT presence (p = .049). <b>Conclusion:</b> MRI can be used to distinguish LMORT lesions from other posterior lateral meniscal tears, and lateral meniscal extrusion may serve as a useful feature in the identification of LMORT lesions on MRI. <b>Clinical Impact:</b> LMORT lesions are a biomechanically important meniscal tear pattern that should be included in the MRI search pattern of patients with ACL tears.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teleradiology Leader to Chief Medical Officer-Career Pivots, an <i>AJR</i> Podcast Series (Episode 3).","authors":"Siddhant Dogra, Samir Shah","doi":"10.2214/AJR.25.33909","DOIUrl":"https://doi.org/10.2214/AJR.25.33909","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Promise of General-Purpose Artificial Intelligence to Support Timely Critical Results Communication.","authors":"Alexander J Towbin","doi":"10.2214/AJR.25.33921","DOIUrl":"https://doi.org/10.2214/AJR.25.33921","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero-Shot Large Language Model-Powered Data Curation for Pancreatic Cyst Surveillance: Promise, Progress, and the Path to Practice.","authors":"Zheren Zhu, Kang Wang","doi":"10.2214/AJR.25.33928","DOIUrl":"https://doi.org/10.2214/AJR.25.33928","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Notebook: September 2025.","authors":"Andrew B Rosenkrantz","doi":"10.2214/AJR.25.33314","DOIUrl":"https://doi.org/10.2214/AJR.25.33314","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":"1"},"PeriodicalIF":6.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}