Abdominal Radiology最新文献

{"title":"Radiomics derived from MRI T2-weighted imaging combined with clinical variables for predicting disease severity in hypertriglyceridemic acute pancreatitis","authors":"Yanting Li,&nbsp;Yuan Wang,&nbsp;Xiyao Wan,&nbsp;Xiaohua Huang","doi":"10.1007/s00261-026-05487-0","DOIUrl":"10.1007/s00261-026-05487-0","url":null,"abstract":"<div><h3>Objectives</h3><p>Hypertriglyceridemic acute pancreatitis (HTG-AP) carries a high risk of severe disease (HTG-SAP). Early recognition of patients likely to progress to HTG-SAP is crucial for timely intervention. This study aimed to develop and validate a combined T2-weighted MRI (magnetic resonance imaging) radiomics-clinical model for accurate, noninvasive early prediction of SAP in HTG-AP and to compare its performance with established clinical scores.</p><h3>Methods</h3><p>This retrospective analysis incorporated a derivation cohort of 207 patients with HTG-AP, who were classified as non-SAP (<i>n</i>=159) or SAP (<i>n</i>=48) based on the 2012 revised Atlanta criteria. These patients were randomly assigned to internal training and internal test sets at a 7:3 ratio. An additional 55 patients from an independent hospital campus within the same medical group were collected as an external validation cohort. The pancreas was manually delineated on T2-weighted images using 3D Slicer, while extraction of radiomic features was undertaken using PyRadiomics. After testing reproducibility and performing multistep feature selection, including LASSO regression, a random-forest model based on clinical and radiomic features was constructed. Predictive performance was evaluated using AUC values from ROC curves, DeLong’s test, calibration curves, and decision curve analysis. For further robust assessment in the imbalanced dataset, Precision-Recall (PR) curves and their corresponding PR-AUC were also computed. The model, trained on the internal training set of the derivation cohort, was then applied to predict outcomes in the external validation cohort, with performance assessed using the same metrics.</p><h3>Results</h3><p>The integrated radiomics-clinical model, which included six radiomic descriptors and four clinical indicators, yielded AUCs of 0.955 (95% CI: 0.914–0.997) in the training set and 0.954 (95% CI: 0.907–0.996) in the internal test set, and 0.930 (95% CI: 0.865–0.995) in the external validation cohort. These values were substantially higher than those obtained with radiomics-only, clinical-only, BISAP, or MRSI models. Additionally, the model demonstrated robust performance on PR analysis, with PR-AUCs of 0.906 (95% CI: 0.820–0.971) in the internal training set and 0.868 (95% CI: 0.685–0.977) in the internal test set. The model also demonstrated good calibration and achieved the highest net benefit over a wide range of decision thresholds.</p><h3>Conclusions</h3><p>A model combining MRI T2-weighted radiomics with clinical variables enables highly accurate early prediction of SAP in HTG-AP. This noninvasive approach holds promise for facilitating early risk stratification and supporting personalized treatment strategies in clinical practice.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5070 - 5083"},"PeriodicalIF":2.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hepatic steatosis and MOLLI acquisition parameters on liver T1 estimates","authors":"Amol S. Pednekar,&nbsp;Anandh Kilpattu Ramaniharan,&nbsp;Joshua S. Greer,&nbsp;Pradipta Debnath,&nbsp;Andrew T. Trout,&nbsp;Jonathan R. Dillman,&nbsp;Mary Kate Manhard","doi":"10.1007/s00261-026-05473-6","DOIUrl":"10.1007/s00261-026-05473-6","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the influence of hepatic fat content and sequence acquisition parameters on Modified Look-Locker Inversion Recovery (MOLLI)-based liver T1 estimates, comparing balanced steady-state free precession (bSSFP) and spoiled gradient recalled echo (SPGR) readouts under in-phase (IP), opposed-phase (OP), and fat-suppressed (FS) conditions.</p><h3>Methods</h3><p>Twenty participants (5 controls, 11 with hepatic steatosis, 4 with other chronic liver diseases; median age 15 years, range 10–28) underwent abdominal MRI at 1.5T. Six single-slice MOLLI acquisitions (bSSFP and SPGR; IP, OP, FS) were performed to obtain hepatic T1 maps. A 3D multi-echo confounder-corrected chemical shift encoded (mDIXON Quant^®) sequence was performed to obtain proton density fat fraction (PDFF), and T2* maps. ROI-based measurements were made by three blinded readers. Agreement and mean difference among MOLLI protocols were assessed using intraclass correlation coefficients (ICC), Bland-Altman analysis, and repeated-measures ANOVA. Correlations between PDFF and T1 differences were evaluated using weighted linear regression. Numerical simulations were implemented to model fat-related effects on MOLLI T1 estimates.</p><h3>Results</h3><p>Liver PDFF ranged from 1 to 43% (median 4.6%). Agreement between bSSFP and SPGR T1 estimates was excellent (ICC ≥ 0.90), though SPGR estimated higher T1 values than bSSFP by 30–60 ms, with greater variability. T1-OP differed significantly from T1-IP and T1-FS (both <i>p</i> &lt; 0.0001) and showed significant PDFF-related mean difference, in line with simulation results, while T1-FS and T1-IP estimates showed excellent agreement (ICC ≥ 0.89). Regression analysis showed that bSSFP T1-OP correlated very strongly with PDFF (<i>r</i> = 0.81; +7.8 ms/%PDFF), whereas T1-IP showed a strong negative correlation (<i>r</i> = − 0.79; − 5.0 ms/%PDFF), and T1-FS demonstrated only a moderate negative correlation (<i>r</i>=-0.48; -3.1ms/%PDFF). SPGR based T1 estimates exhibited similar correlations with PDFF. In participants without steatosis, T1 values were consistent across all acquisitions.</p><h3>Conclusion</h3><p>Liver MOLLI T1 estimates are strongly influenced by hepatic fat content and acquisition parameters, particularly for OP acquisitions. IP and FS MOLLI acquisitions provide more reliable estimates across fat fractions. These findings support prioritization of IP or FS strategies in clinical and research liver T1 mapping protocols and underscore the need for fat-corrected or water-specific approaches.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4920 - 4930"},"PeriodicalIF":2.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05473-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging in scrub typhus – a pictorial review","authors":"Shravan Reddy Kankara,&nbsp;Shreyas Reddy Kankara,&nbsp;Dhanush Jayanna,&nbsp;Galib Mirza Nasirul Islam,&nbsp;Nishant Aswani,&nbsp;Simmi Kumari,&nbsp;Yashant Aswani","doi":"10.1007/s00261-026-05474-5","DOIUrl":"10.1007/s00261-026-05474-5","url":null,"abstract":"<div><p>Scrub typhus (STy) is a common yet underrecognized and life-threatening rickettsial zoonosis endemic to the Asia-Pacific region. It is transmitted by the bite of chigger mites infected with <i>Orientia tsutsugamushi</i>. In the US, it is primarily encountered among recent travellers. STy presents as an acute febrile illness with non-specific features. Eschar at the site of a mite bite and positive serology clinch the diagnosis. However, the classic eschar may not be seen in all cases, and serology may be negative in early cases. Multisystemic involvement is the rule in STy, and the underlying pathology is vasculitis &amp; perivasculitis across multiple organs. Imaging features are nonspecific. However, awareness about common radiological features such as a combination of gallbladder wall edema, hepatosplenomegaly, and reticulonodular lung opacities is crucial to raise suspicion of STy in those at risk and thus prompt specific diagnostic testing. Imaging features are particularly useful in flagging cases of early disease with negative serology or those without the characteristic eschar. STy responds promptly to antirickettsial antibiotics. Delayed institution of antibiotics carries an adverse prognosis. Hence, early diagnosis is important. Further, imaging also helps with prognostication and early detection of complications.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5299 - 5318"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05474-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiplanar versus axial measurement of prostate lesion size: agreement and impact on PI-RADS v2.1 categorization and histopathologic correlation","authors":"Thitinan Chulroek,&nbsp;Ratchaya Ariyasaksakul","doi":"10.1007/s00261-026-05484-3","DOIUrl":"10.1007/s00261-026-05484-3","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether measurement of prostate lesion size on sagittal or coronal imaging planes influences PI-RADS v2.1 categorization and histopathologic correlation compared with axial measurement.</p><h3>Methods</h3><p>In this single-center retrospective study, 261 prostate lesions categorized as PI-RADS 4 or 5 underwent subsequent targeted MRI/TRUS fusion biopsy or prostatectomy. Lesion size was measured as maximal axial diameter (MAD) and maximal coronal or sagittal diameter (MCSD). Lesions were subsequently categorized according to PI-RADS v2.1 using these measurements. The agreement between MAD and MCSD was assessed using a Bland–Altman analysis. Measurement reliability and interobserver agreement were evaluated using intraclass correlation coefficients (ICC). Kappa statistics were used to assess agreement in PI-RADS categorization for clinically significant prostate cancer.</p><h3>Result</h3><p>Bland–Altman analysis demonstrated minimal bias and strong agreement between MAD and MCSD measurements for the whole prostate (mean difference 0.28 mm; 95% limits of agreement − 2.62 to 3.19 mm), with similar results in both the peripheral and transition zones. Intraclass correlation analysis showed excellent reliability between measurements (ICC = 0.93). Agreement in PI-RADS categorization between MAD and MCSD was almost perfect (κ = 0.931). Reclassification from PI-RADS 4 to 5 occurred in 1.74% of lesions when using MCSD, and all reclassified lesions demonstrated clinically significant prostate cancer on histopathology.</p><h3>Conclusion</h3><p>MAD and MCSD measurements of prostate lesion size demonstrate excellent agreement and highly concordant PI-RADS categorization. Although reclassification is uncommon, evaluation of the sagittal or coronal planes may provide additional value for selected lesions with craniocaudal elongation, where the maximal tumor extent may not be fully represented on axial images.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5127 - 5135"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From signal-intensity ratio to decision-grade triage in prostate MRI","authors":"M. Vijayasimha,&nbsp;M. Srikanth","doi":"10.1007/s00261-026-05488-z","DOIUrl":"10.1007/s00261-026-05488-z","url":null,"abstract":"","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5124 - 5126"},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality assessment of fluoroscopic imaging obtained during neonatal contrast enema exams","authors":"Shyam Sunder B. Venkatakrishna,&nbsp;Levy C. Onyango,&nbsp;Carmen Rosa Cerron-Vela,&nbsp;Devyn C. Rigsby,&nbsp;Mohammad Jalloul,&nbsp;Dana Alkhulaifat,&nbsp;Hansel J. Otero,&nbsp;Savvas Andronikou","doi":"10.1007/s00261-026-05400-9","DOIUrl":"10.1007/s00261-026-05400-9","url":null,"abstract":"<div><h3>Purpose</h3><p>The American College of Radiology (ACR) and Society for Pediatric Radiology (SPR) have published practice parameters for pediatric fluoroscopic contrast enema (CE) exams. The purpose of our quality assurance (QA) study was to assess adherence to neonatal (&lt; 2 days of age) CE practice parameters at a large tertiary care pediatric hospital.</p><h3>Methods</h3><p>Image database review identified all CE exams performed on children ≤ 2 days old at our institution between February 2019 and August 2022. Two pediatric radiologists conducted independent review of CE imaging and reports for six subjective quality criteria. One radiologist assessed six objective quality metrics. Data were summarized as counts and percentages and inter-reviewer agreement <i>p</i>_o was calculated for the subjective metrics.</p><h3>Results</h3><p>70 neonatal CEs met inclusion criteria and were reviewed. For subjective criteria: A small-caliber rectal catheter was used in 93% (R1) to 94% (R2) of cases. 96–97% of exams included a true lateral rectal view; this view was obtained at early filling in 83–86% of cases. The rectosigmoid index was readily assessed in nearly all studies (100% R1; 97% R2). The entirety of the colon was visualized through to the cecum in 87% of studies. In 74–76% of cases, the appendix and/or terminal ileum were visualized. Observed inter-reader agreement was substantial for all metrics, ranging from 83% to 97%. For the objective quality metrics: 83% of CEs included a scout image. Lateral rectal imaging included visualization of the sacrum in 91% of cases. Radiation dose and fluoroscopy time were documented in 90% of cases. 63% of cases were performed without direct exposures. All 70 CEs were performed without documented complications.</p><h3>Conclusion</h3><p>Although the majority of studies included a scout image, radiation dose and fluoroscopy time, operators should be reminded to collect and store these basic components for every exam. Similarly, while most cases used an appropriately small rectal catheter, staff should be aware to do so in every exam. Approximately one-fourth of studies did not include visualization of the appendix and/or terminal ileum, which may reflect the difficulty of obtaining these views for certain pathologic entities in neonatal practice. Our study demonstrates the importance of continuous quality assessment even in expert centers and we recommend that a Quality Standards checklist be used for all neonatal CE studies, possibly incorporated as part of a template report.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4813 - 4819"},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05400-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia and postoperative outcomes in patients with peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy","authors":"Manuela Gallo,&nbsp;Sergio Valencia,&nbsp;Laura Manuela Olarte-Bermúdez,&nbsp;Fernando Arias-Amézquita,&nbsp;Eduardo Londoño-Schimmer,&nbsp;Jorge Otero,&nbsp;Camilo Cétares,&nbsp;Diego Andrés Aguirre","doi":"10.1007/s00261-026-05393-5","DOIUrl":"10.1007/s00261-026-05393-5","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the association between preoperative computed tomography (CT)-measured sarcopenia and short-term postoperative outcomes in patients with peritoneal carcinomatosis (PC) undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). In addition, specific objectives included determining the prevalence of sarcopenia, evaluating the association of postoperative prognosis and outcomes, and assessing the prevalence of postoperative complications in this population undergoing CRS-HIPEC.</p><h3>Materials and methods</h3><p>Retrospective observational study included patients with PC undergoing CRS + HIPEC at a specialized center. Sarcopenia was assessed on preoperative CT using the skeletal muscle index (SMI) at the L3 level. Postoperative outcomes and survival were analyzed using standard univariable and multivariable statistical methods.</p><h3>Results</h3><p>No significant differences in short-term postoperative outcomes were observed between sarcopenic and non-sarcopenic patients. Overall survival did not differ significantly between groups. However, sarcopenia was independently associated with shorter disease-free survival (DFS) and a higher risk of recurrence.</p><h3>Conclusion</h3><p>Sarcopenia was independently associated with shorter DFS and a higher risk of recurrence, supporting its role as a prognostic marker rather than a driver of perioperative morbidity. Preoperative identification may improve risk stratification and guide long-term follow-up, while prospective studies are needed to determine whether targeted interventions can improve outcomes.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5290 - 5298"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical applications of vascular and non-vascular interventional procedures for various urologic diseases: a pictorial essay","authors":"Euntaek Hwang,&nbsp;Doo Ri Kim,&nbsp;Young Hwan Kim,&nbsp;Jung Hee Hong,&nbsp;Byoungje Kim,&nbsp;Mu Sook Lee","doi":"10.1007/s00261-026-05485-2","DOIUrl":"10.1007/s00261-026-05485-2","url":null,"abstract":"<div><p>Owing to the recent aging of the population and the increasing number of patients at high surgical risk, the role of interventional radiology in diagnosing and treating urologic diseases has continually expanded in scope and importance. It has evolved from a simple complementary diagnostic tool to a first-line treatment strategy, encompassing applications ranging from basic image-guided biopsy to urinary drainage procedures, double-J stent placement, endovascular management, and tumor ablation. This pictorial essay presents representative clinical cases to illustrate the core concepts and characteristic imaging findings of these procedures. This approach is intended to provide practical insights for physicians in the urology and radiology departments, thereby guiding appropriate interdisciplinary treatment strategies in clinical settings.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5113 - 5123"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05485-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI findings of ovarian microcystic stromal tumor with pathologic correlation: a case report and literature review","authors":"Mayumi Takeuchi,&nbsp;Kenji Matsuzaki,&nbsp;Yoshimi Bando,&nbsp;Masato Nishimura,&nbsp;Masafumi Harada","doi":"10.1007/s00261-026-05482-5","DOIUrl":"10.1007/s00261-026-05482-5","url":null,"abstract":"<div><p>Ovarian microcystic stromal tumor (MCST) is a rare benign sex cord-stromal tumor that commonly occurs in women of reproductive age, associated with aberrant Wnt/β-catenin signaling pathway. We report a case of a 49-year-old woman with a right ovarian MCST presenting as a cystic mass with an irregularly thickened cyst wall corresponding to the solid component, and differentiation from malignancy was challenging. MRI revealed a hemorrhagic cystic mass with an irregularly thickened, T2-hyperintense wall, lobulated by thin hypointense septa. It showed inhomogeneous, rapid, intense contrast-enhancement but heterogeneous apparent diffusion coefficients (ADC) without marked diffusion restriction. Histopathology demonstrated lobulated proliferation of stromal cell nests with fibrous septa exhibiting microcystic and hemorrhagic changes. Immunohistochemistry showed nuclear and cytoplasmic β-catenin positivity, confirming MCST. While the hemorrhagic changes may suggest malignancy, these features and the heterogeneous ADC actually reflect varying degrees of intercellular loosening and microcyst formation resulting from decreased cell-cell adhesion due to loss of E-cadherin expression. Characteristic findings of this rare tumor include T2-hypointense thin septations reflecting fibrous stroma interposed between lobulated proliferative foci, a capsule-like compressed cortex reflecting slow tumor growth, and cystic changes (often hemorrhagic) resulting from tumor cell dissociation. This is the first paper to conduct a detailed comparative analysis of MRI and pathological findings in MCST and to examine findings considered characteristic. Recognition of these imaging features is crucial for correct diagnosis to avoid extensive surgery for preserving ovarian function.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5235 - 5239"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiological predictors of surgical or endovascular intervention and adverse outcomes in spontaneous rectus sheath hematoma patients","authors":"Om Biju Panta,&nbsp;Hadiseh Kavandi,&nbsp;Yasir Andrabi,&nbsp;Natasha Larocque,&nbsp;Francesca Rigiroli,&nbsp;Alexander Brook,&nbsp;Olga R. Brook","doi":"10.1007/s00261-026-05464-7","DOIUrl":"10.1007/s00261-026-05464-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine clinical and radiographic parameters predictive of interventions and adverse outcomes in patients with spontaneous rectus sheath hematoma.</p><h3>Methods</h3><p>This retrospective, institutional review board approved study identified 261 patients with spontaneous rectus sheath hematoma from January 2000 to August 2021 through CT report searches. Demographics, clinical presentation, comorbidities, medications, and laboratory values were collected. CT scans were reviewed for hematoma characteristics including size, location, density, and active contrast extravasation. The primary outcome was the invasive intervention; and the secondary outcomes included transfusion requirements, length of hospital stay, acute kidney injury, readmission, and mortality. Categorical variables were compared using Fisher’s exact test, while continuous variables were analyzed using Student’s t-test or Mann-Whitney U test as appropriate based on normality assessment.</p><h3>Results</h3><p>The cohort comprised 261 patients (median age 71 (IQR, 60–78) years, 59% female). Invasive treatments were performed in 41 patients (15.7%): 35 underwent angiography with embolization; 6 had surgical exploration. Invasive treatment was significantly more frequent among patients with trans-umbilical extension (25.7% vs 9.4%; <i>p</i> &lt; 0.001), active contrast extravasation (46.7% vs 33.0%, <i>p</i> &lt; 0.001), and hematoma volume &gt; 443.5 cc (31.8% vs 9.6%, <i>p</i> &lt; 0.001).” These patients had higher red blood cell transfusion requirements (85.4% vs. 47.7%, <i>p</i> &lt; 0.001) and longer hospital stays (7 vs. 4 days, <i>p</i> &lt; 0.001). The overall in-hospital mortality was 6.9%, with 1.9% attributable to rectus sheath hematoma.</p><h3>Conclusion</h3><p>While most rectus sheath hematomas are managed conservatively, specific CT findings—trans-umbilical extension, larger volume, and active contrast extravasation—predict invasive intervention and guide clinical decision-making.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5279 - 5289"},"PeriodicalIF":2.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}