Radiologie (Heidelberg, Germany)最新文献

{"title":"[Image-guided procedures for treatment of erectile dysfunction].","authors":"Hanno Hoppe, Chiara Brechbühl, Greicy Heymann, Nicolas Diehm","doi":"10.1007/s00117-026-01683-7","DOIUrl":"https://doi.org/10.1007/s00117-026-01683-7","url":null,"abstract":"<p><p>Erectile dysfunction (ED) is defined as the chronic inability to achieve and maintain erection sufficient for sexual intercourse. It is a common condition, affecting an estimated 30-50 % of men above the age of 40, and can significantly impair quality of life and interpersonal relationships. The most common vascular etiology includes arterial obstruction of the pelvic arteries and venous leakage. The goal of image-guided endovascular treatments is to restore adequate erectile function. Arterial blood flow to the penis can be achieved through endovascular revascularization and venous leakage can be treated by embolization. The studies published to date show that these minimally invasive procedures are effective and safe in carefully selected patients and treatment outcomes remain stable over the long term in most patients.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149372433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Contrast agents for liver MRI].","authors":"Guido Matthias Kukuk","doi":"10.1007/s00117-026-01678-4","DOIUrl":"https://doi.org/10.1007/s00117-026-01678-4","url":null,"abstract":"<p><strong>Background: </strong>Iron oxide-, manganese-, and gadolinium-based contrast agents (CAs) have been developed for liver magnetic resonance imaging (MRI). Gadolinium-based agents dominate clinical practice and comprise extracellular and hepatobiliary (liver-specific) compounds.</p><p><strong>Objective: </strong>To characterize the available CA classes and define criteria for choosing between extracellular and hepatobiliary agents.</p><p><strong>Materials and methods: </strong>Narrative review based on the current literature, guidelines, approval status, and the author's clinical experience.</p><p><strong>Results: </strong>Extracellular CAs provide robust dynamic imaging, unrestricted washout assessment, and shorter examination times; they are preferred for incidental lesions and prior to liver transplantation. Hepatobiliary CAs add information derived from hepatocyte uptake, particularly for differentiating focal nodular hyperplasia from hepatocellular adenoma, detecting metastases before resection, and demonstrating bile leaks. Pitfalls such as pseudo-washout, steatosis, iron overload, and impaired liver function reduce diagnostic performance and must be considered in protocol selection and interpretation.</p><p><strong>Conclusion: </strong>Extracellular and hepatobiliary CAs are complementary. The choice depends on the clinical question, liver function, and individual circumstances; selecting the appropriate agent upfront avoids additional and follow-up examinations.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149345046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Job-sharing in radiology-a model with a promising future?]","authors":"Vivien L Kratzer, Lisa Ullrich","doi":"10.1007/s00117-026-01685-5","DOIUrl":"https://doi.org/10.1007/s00117-026-01685-5","url":null,"abstract":"","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149336381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Image-guided minimally invasive treatment options for endometriosis].","authors":"Michael Kostrzewa","doi":"10.1007/s00117-026-01674-8","DOIUrl":"https://doi.org/10.1007/s00117-026-01674-8","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis affects approximately 10% of women of reproductive age with a mean diagnostic delay of 7-10 years. Image-guided procedures show increasingly promising results as minimally invasive alternatives to excision.</p><p><strong>Objective: </strong>Structured overview of image-guided minimally invasive treatment options for endometriosis with focus on percutaneous cryoablation.</p><p><strong>Results: </strong>Percutaneous cryoablation demonstrates the strongest evidence for extraperitoneal and intramuscular lesions and represents a valid minimally invasive alternative to excision. Three institutional cases illustrate technique and outcomes. Ethanol sclerotherapy is established for ovarian endometriomas. High-intensity focused ultrasound (HIFU) shows promising results for abdominal wall disease; radiofrequency ablation (RFA) and microwave ablation are investigational.</p><p><strong>Conclusion: </strong>Interventional radiology offers a growing therapeutic spectrum. Prospective randomized trials are needed for guideline integration.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149328325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Trauma-From diagnosis to intervention].","authors":"Holger Goessmann, Sebastian Ebel","doi":"10.1007/s00117-026-01669-5","DOIUrl":"https://doi.org/10.1007/s00117-026-01669-5","url":null,"abstract":"<p><p>Abdominal trauma represents a diagnostic and therapeutic challenge because the large number of potentially involved organs and the complexity of the underlying injuries are difficult to capture within a standardized diagnostic approach. Both blunt and penetrating abdominal injuries can be involved as well as falls from a great height, traffic accidents or violent encounters. In addition, patients may be polytraumatized and the abdomen represents only one component of the injuries sustained but is often clinically prioritized due to the potentially immediate life-threatening nature of injuries to abdominal organs. Such injuries represent an interdisciplinary challenge and their treatment is increasingly carried out using minimally invasive procedures, often within the involvement of interventional radiology. This article aims to present both appropriate diagnostic approaches and minimally invasive treatment options.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149328326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid CNN-transformer model with gated feature fusion and GAN-based augmentation for MRI image classification.","authors":"Sedat Orenc, Cebrail Turkeri, Yusuf Alaca","doi":"10.1007/s00117-026-01681-9","DOIUrl":"https://doi.org/10.1007/s00117-026-01681-9","url":null,"abstract":"<p><strong>Objective: </strong>Brain tumor classification based on magnetic resonance imaging (MRI) plays a critical role in clinical diagnosis, yet it remains challenging due to high intra-class variability, inter-class similarity, and limited annotated data. To address these challenges, this study proposes a gated hybrid convolutional neural network (CNN)-transformer architecture (GHCT-Net) that effectively integrates local and global feature representations for robust brain tumor classification in data-limited medical imaging scenarios.</p><p><strong>Methods: </strong>The proposed framework combines a ConvNeXt-based convolutional branch for fine-grained spatial feature extraction with a Swin Transformer branch for modeling long-range contextual dependencies. A gate-based fusion mechanism is introduced to adaptively balance the contribution of each feature stream. Additionally, a conditional deep convolutional generative adversarial network (cDCGAN) is employed to generate class-consistent synthetic MRI samples to mitigate data scarcity. The model was evaluated on a public dataset of 7023 MRI images across four classes (glioma, meningioma, pituitary tumor, and no tumor) under three training scenarios: original, traditionally augmented, and GAN-augmented datasets.</p><p><strong>Results: </strong>The results demonstrate that the GHCT-Net achieves superior performance compared to state-of-the-art CNN and Transformer architectures, reaching a classification accuracy of 98.39% on the GAN-augmented dataset. Quantitative analysis, along with confusion matrices, t‑distributed stochastic neighbor embedding (t-SNE) visualizations, and gradient-weighted class activation mapping (Grad-CAM) interpretability studies, confirms that the model successfully learns discriminative and clinically relevant features.</p><p><strong>Conclusion: </strong>Combining a gated hybrid CNN-transformer architecture with GAN-based data augmentation provides a highly effective and robust solution for brain tumor classification, particularly in scenarios constrained by limited medical imaging data.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149328327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Vascular mass lesions of the spinal cord : Cavernous malformations, spinal arteriovenous malformations and haemangioblastomas].","authors":"Frederik Fries","doi":"10.1007/s00117-026-01658-8","DOIUrl":"10.1007/s00117-026-01658-8","url":null,"abstract":"<p><p>In a narrow neuroradiological sense, vascular mass lesions of the spinal cord primarily comprise intramedullary cavernous malformations, spinal arteriovenous malformations (AVMs) with an intramedullary or pial nidus, and hemangioblastomas. Cavernous malformations typically present as small eccentric lesions with a mixed internal signal pattern and a hemosiderin rim; contrast enhancement is usually absent or only minimal. Spinal AVMs are characterized by a nidus with intra- and perimedullary flow voids; hemorrhagic stigmata may be present, and angiography demonstrates early venous drainage. Hemangioblastomas typically appear as avidly enhancing nodules, usually located superficially or subpially, often with a syrinx that is disproportionately large relative to tumor size. Magnetic resonance imaging (MRI) is the first-line imaging modality; when a shunt lesion is suspected, digital subtraction angiography (DSA) remains indispensable. The spinal dural arteriovenous fistula (SDAVF) is presented as the most important differential diagnosis; its appearance of a venous congestive myelopathy distinguishes it from the aforementioned mass lesions.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"858-863"},"PeriodicalIF":0.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Spinal tumors in childhood and adolescence].","authors":"Alena Haußmann","doi":"10.1007/s00117-026-01663-x","DOIUrl":"10.1007/s00117-026-01663-x","url":null,"abstract":"<p><p>Spinal tumors are a rare tumor entity in children and adolescents, accounting for approximately 4-10% of all central nervous system (CNS) tumors. Based on their anatomical location, they are classified as intradural or extradural and intradural tumors are further subdivided into intramedullary and extramedullary lesions. The clinical symptoms are often nonspecific, with persistent back pain being the most common initial symptom. Neurological manifestations, including sensory and motor deficits, typically develop later in the course of the disease. The imaging modality of choice is magnetic resonance imaging (MRI) of the entire spinal axis and when indicated the head. The various tumor entities exhibit characteristic imaging features that should be recognized as they are essential for accurate diagnosis and appropriate treatment planning.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"850-857"},"PeriodicalIF":0.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intramedullary spinal cord tumors : MRI diagnosis and differential diagnosis].","authors":"Umut Yilmaz","doi":"10.1007/s00117-026-01657-9","DOIUrl":"10.1007/s00117-026-01657-9","url":null,"abstract":"<p><strong>Background: </strong>Intramedullary spinal cord tumors are rare neoplasms but frequently cause significant neurological deficits because of the limited compensatory capacity of the spinal cord. Magnetic resonance imaging (MRI) is the imaging modality of choice and often allows a reliable differential diagnosis based on characteristic imaging findings.</p><p><strong>Objectives: </strong>To provide a practical neuroradiological approach to the diagnosis of intramedullary spinal cord tumors, including recent developments in the World Health Organization (WHO) classification.</p><p><strong>Materials and methods: </strong>Narrative review of the current literature regarding epidemiology, imaging characteristics, WHO classification, and differential diagnosis of intramedullary spinal cord tumors.</p><p><strong>Results: </strong>Ependymomas, astrocytomas, and hemangioblastomas account for the majority of intramedullary tumors. Tumor location, longitudinal extent, enhancement pattern, hemorrhagic components, syringomyelia, and flow voids substantially narrow the differential diagnosis. Recent WHO classifications increasingly incorporate molecular markers, including MYCN-amplified spinal ependymoma and H3 K27-altered diffuse midline glioma.</p><p><strong>Conclusion: </strong>Structured MRI assessment frequently enables a reliable preoperative diagnosis. Inflammatory, vascular, and ischemic disorders must always be considered as important differential diagnoses.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"842-849"},"PeriodicalIF":0.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[It looks like a spinal tumor-Differential diagnosis].","authors":"Armin Bachhuber","doi":"10.1007/s00117-026-01664-w","DOIUrl":"10.1007/s00117-026-01664-w","url":null,"abstract":"<p><strong>Background: </strong>Spinal space-occupying lesions frequently pose a diagnostic challenge, particularly when distinguishing malignant from nonmalignant abnormalities. The challenge for the radiologist is to reliably differentiate malignant from benign entities.</p><p><strong>Objective: </strong>To identify imaging features that argue against a neoplastic disease and provide clues to relevant differential diagnoses.</p><p><strong>Material and methods: </strong>A literature search was conducted in pubmed.gov to identify and characterize tumor-like spinal conditions.</p><p><strong>Results: </strong>A total of 11 differential diagnoses were selected that can mimic a neoplastic disease, although their etiology fundamentally differs from that of a neoplasm. The key characteristics of each entity are briefly summarized.</p><p><strong>Conclusion: </strong>As tumor-like spinal lesions comprise a broad spectrum of entities, their differential diagnosis remains challenging.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"864-870"},"PeriodicalIF":0.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}