Radiologie (Heidelberg, Germany)最新文献

{"title":"Comparative diagnostic accuracy of ultrasound and magnetic resonance imaging for spinal dysraphism in infants: insights from a single-center study.","authors":"Tareef Sahal Daqqaq","doi":"10.1007/s00117-025-01494-2","DOIUrl":"https://doi.org/10.1007/s00117-025-01494-2","url":null,"abstract":"<p><strong>Background: </strong>Spinal dysraphism refers to congenital abnormalities of the spine and spinal cord resulting from defective development of ectodermal, mesodermal, and neuroectodermal tissues. It is broadly classified into open (aperta) and closed (occulta) forms, presenting with conditions such as meningocele, myelomeningocele, and lipomyelomeningocele. Our study aimed to assess the diagnostic accuracy of ultrasound (US) in detecting spinal dysraphism in infants, with magnetic resonance imaging (MRI) as the reference standard.</p><p><strong>Methodology: </strong>This comparative analytical study was conducted over 12 months across two tertiary medical institutions. Based on a calculated sample size derived from expected sensitivity (82%) and specificity (95%), 106 infants were included, with 80% test power, 10% margin of error, and 95% confidence level.</p><p><strong>Results: </strong>Among the 106 infants assessed, US demonstrated a sensitivity of 86.54%, specificity of 81.48%, positive predictive value (PPV) of 81.2%, and negative predictive value (NPV) of 86.96%, yielding an overall diagnostic accuracy of 83.96%. Of the total cases, 58 infants were diagnosed with open spinal dysraphism (including myelomeningocele and myelocele), while 20 infants had closed forms (such as tethered cord, dermal sinus tracts, and others). These findings highlight the reliability of US as an initial diagnostic tool for both types of spinal dysraphism.</p><p><strong>Conclusion: </strong>Ultrasound is a practical, noninvasive screening tool for identifying spinal dysraphism in infants, with an overall high diagnostic accuracy. However, it has a diagnostic discordance rate, requiring MRI confirmation in patients with unusual presentations or high clinical suspicion. However, MRI is still necessary for a precise diagnosis and discrimination between open and closed types of spinal dysraphism.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981778","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":"A comprehensive MRI-based study on adhesive capsulitis and its correlations with tendinosis and systemic diseases.","authors":"Gizem Timoçin Yığman, Hande Özen Atalay","doi":"10.1007/s00117-025-01495-1","DOIUrl":"https://doi.org/10.1007/s00117-025-01495-1","url":null,"abstract":"<p><strong>Background: </strong>The association between adhesive capsulitis and hypothyroidism is well-known. However, its relationship with hypertension and diabetes remains debated. While, rotator cuff (RC) tendinosis is frequently observed, to our knowledge, there is no study indicating its link to adhesive capsulitis. This study aimed to assess the prevalence RC tendinosis in adhesive capsulitis and examine associations between adhesive capsulitis and hypertension, diabetes, thyroid dysfunction, and inferior glenohumeral ligament (IGHL) thickness.</p><p><strong>Methods: </strong>This retrospective study included 503 patients with adhesive capsulitis who underwent magnetic resonance imaging (MRI) of the shoulder. Patients with previous shoulder trauma, surgery, or rheumatologic disease were excluded. Clinical data on hypertension, diabetes, and thyroid dysfunction were collected. The IGHL thickness was measured, and RC tendinosis was classified according to tendon involvement. Statistical analyses included t tests, chi-square tests, logistic regression, and receiver operating characteristic analysis.</p><p><strong>Results: </strong>Rotator cuff tendinosis was observed in 76.94% of patients, with supraspinatus tendinosis being the most common (74.95%). Thyroid dysfunction was significantly more prevalent in patients with adhesive capsulitis (15.90%, p < 0.001), while hypertension was lower (21.87%, p < 0.001) compared to the general population. The prevalence of diabetes (12.52%) was not significantly different from the general population (p = 0.426). Diabetes was associated with increased IGHL thickness (p = 0.005), whereas thyroid dysfunction was linked to lower IGHL thickness (p = 0.023). The IGHL thickness did not predict tendinosis (AUC = 0.47).</p><p><strong>Conclusion: </strong>Supraspinatus tendinosis is overrepresented in patients with adhesive capsulitis, with a prevalence of 75%. Thyroid dysfunction may contribute to its pathogenesis as indicated in previous research. Additionally, IGHL thickness alone is not a reliable predictor of tendinosis. Further studies are needed to explore these associations.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981813","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":"Bosniak classification of renal cysts using large language models: a comparative study.","authors":"Ibrahim Hacibey, Esat Kaba","doi":"10.1007/s00117-025-01499-x","DOIUrl":"https://doi.org/10.1007/s00117-025-01499-x","url":null,"abstract":"<p><strong>Background: </strong>The Bosniak classification system is widely used to assess malignancy risk in renal cystic lesions, yet inter-observer variability poses significant challenges. Large language models (LLMs) may offer a standardized approach to classification when provided with textual descriptions, such as those found in radiology reports.</p><p><strong>Objective: </strong>This study evaluated the performance of five LLMs-GPT‑4 (ChatGPT), Gemini, Copilot, Perplexity, and NotebookLM-in classifying renal cysts based on synthetic textual descriptions mimicking CT report content.</p><p><strong>Methods: </strong>A synthetic dataset of 100 diagnostic scenarios (20 cases per Bosniak category) was constructed using established radiological criteria. Each LLM was evaluated using zero-shot and few-shot prompting strategies, while NotebookLM employed retrieval-augmented generation (RAG). Performance metrics included accuracy, sensitivity, and specificity. Statistical significance was assessed using McNemar's and chi-squared tests.</p><p><strong>Results: </strong>GPT‑4 achieved the highest accuracy (87% zero-shot, 99% few-shot), followed by Copilot (81-86%), Gemini (55-69%), and Perplexity (43-69%). NotebookLM, tested only under RAG conditions, reached 87% accuracy. Few-shot learning significantly improved performance (p < 0.05). Classification of Bosniak IIF lesions remained challenging across models.</p><p><strong>Conclusion: </strong>When provided with well-structured textual descriptions, LLMs can accurately classify renal cysts. Few-shot prompting significantly enhances performance. However, persistent difficulties in classifying borderline lesions such as Bosniak IIF highlight the need for further refinement and real-world validation.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981824","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":"CT evaluation of gastrointestinal system perforations: A retrospective comparative analysis between retroperitoneal and intraperitoneal perforation sites.","authors":"Ummuhan Ebru Karabulut, Huseyin Toprak, Yagmur Basak Polat, Zeynep Donmez, Ahmet Akcay, Mehmet Ali Gultekin, Temel Fatih Yilmaz","doi":"10.1007/s00117-025-01500-7","DOIUrl":"https://doi.org/10.1007/s00117-025-01500-7","url":null,"abstract":"<p><strong>Background: </strong>Correct identification of the etiology and anatomical location of perforations is paramount for ensuring optimal therapeutic intervention and surgical planning in cases of gastrointestinal tract perforation.</p><p><strong>Purpose: </strong>This study aimed to retrospectively evaluate the distinctive multidetector computed tomography (MDCT) findings of intraperitoneal and retro-/extraperitoneal perforation by comparing the locations of free air in the abdomen and other imaging findings.</p><p><strong>Material and methods: </strong>A total of 226 patients with acute abdominal pain who visited the emergency department and underwent contrast-enhanced CT between January 2016 and November 2023 were included. The study consisted of 146 male and 80 female patients with a median age of 53.5 years. Surgical findings determined the site of perforation in all cases. Two radiologists evaluated the CT images in a consensus blind to operative findings, assessing the presence of specific air distributions and strong predictors of gastrointestinal tract perforation.</p><p><strong>Results: </strong>The study included 192 intraperitoneal and 34 retro-/extraperitoneal perforation cases. Subphrenic free air and periportal free air were statistically significant in differentiating intraperitoneal gastrointestinal tract perforation among specific air distributions. Conversely, the presence of free air in the minor pelvis, right lower quadrant, left lower quadrant, and retroperitoneum was significant in differentiating retro-/extraperitoneal gastrointestinal tract perforation. Among strong imaging predictors, only ascites was statistically significant in differentiating intraperitoneal from retro-/extraperitoneal perforations.</p><p><strong>Conclusion: </strong>Findings from MDCT may serve as predictive indicators for the precise localization of gastrointestinal tract perforations, which is crucial for appropriate management and surgical planning.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981821","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":"[Thoracolumbar spine fractures : Classification and stability].","authors":"Steffen Warmann","doi":"10.1007/s00117-025-01502-5","DOIUrl":"https://doi.org/10.1007/s00117-025-01502-5","url":null,"abstract":"<p><strong>Background: </strong>Fractures of the thoracolumbar spine are among the most common spinal injuries and are associated with a high risk of instability and neurological deficits. Accurate classification is crucial to correctly assess the severity of injury and initiate the correct treatment.</p><p><strong>Objectives: </strong>Presentation and classification of current classification systems, in particular the AO Spine classification, for the structured analysis of thoracolumbar spine fractures, taking into account fracture morphology, ligament stability, and neurological status.</p><p><strong>Methods: </strong>Literature-based evaluation of epidemiological data, biomechanical principles and imaging techniques. Comparison of the Denis, Magerl, and AO Spine classifications and analysis of the role of computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosis.</p><p><strong>Results: </strong>The incidence of thoracolumbar fractures has increased significantly in recent years, especially in older patients. The Denis three-pillar model serves as a basis for assessing stability. The AO Spine classification offers a comprehensive, practical system that takes into account fracture morphology (type A-C), neurological status (N0-N4/NX), and patient-specific modifiers (M1/M2). CT is the method of choice for the detection of bony injuries, while MRI is indicated for the assessment of the spinal cord and ligaments in cases of neurological deficits.</p><p><strong>Conclusion: </strong>The AO Spine classification facilitates standardized communication and supports well-founded treatment decisions by incorporating relevant clinical parameters. CT and MRI are indispensable for precise diagnosis. Nevertheless, the individual assessment of each patient, including relevant comorbidities, remains central to choosing optimal treatment and avoiding long-term complications.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877128","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":"[Semicircular canal dehiscence syndrome].","authors":"Malvina Garner","doi":"10.1007/s00117-025-01468-4","DOIUrl":"10.1007/s00117-025-01468-4","url":null,"abstract":"<p><strong>Clinical/methodological issue: </strong>Semicircular canal dehiscence (SCD) is a rare but clinically significant cause of vertigo and auditory symptoms. The clinical presentation is relatively specific and typically includes sound- or pressure-induced rotational vertigo accompanied by nystagmus, autophony, hypersensitivity to bone-conducted sound (hyperacusis), and pseudo-conductive hearing loss. Imaging plays a central role in establishing an accurate diagnosis and in excluding differential diagnoses. High-resolution thin-slice computed tomography (CT), particularly when combined with magnetic resonance imaging (MRI), forms the cornerstone of radiologic assessment. Importantly, a substantial proportion of patients with radiologically confirmed dehiscence remain asymptomatic. While the presence of vestibular symptoms in conjunction with a bony dehiscence should raise suspicion for SCD syndrome, other etiologies must be prioritized in the differential diagnosis based on clinical history, examination, and imaging findings, given the rarity of the condition.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"595-600"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478177","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":"[Petrous bone fractures].","authors":"Armin Bachhuber","doi":"10.1007/s00117-025-01467-5","DOIUrl":"10.1007/s00117-025-01467-5","url":null,"abstract":"<p><strong>Background: </strong>The temporal bone is one of the most complex bones in the human body. Fractures require significant force and are usually associated with extensive damage to adjacent structures.</p><p><strong>Objective: </strong>Which imaging modality facilitates the assessment of petrous bone fractures, and which anatomical landmarks may be used for orientation?</p><p><strong>Methods: </strong>A literature search on PubMed.gov was conducted to determine the current state of research.</p><p><strong>Results: </strong>Injuries to the petrous part of the temporal bone often involve the facial nerve and the vestibulocochlear nerve, as well as the cochlea and the vestibular organ. This article presents strategies to facilitate correct diagnosis.</p><p><strong>Conclusion: </strong>In addition to the (often knotty) description of the fracture, it is essential to assess the cranial nerves that transverse the petrous bone and to evaluate the auditory ossicles.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"562-570"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303912","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":"[Temporal bone surgery and requirements for radiology].","authors":"Alessandro Bozzato","doi":"10.1007/s00117-025-01429-x","DOIUrl":"10.1007/s00117-025-01429-x","url":null,"abstract":"<p><strong>Background: </strong>Perioperative imaging plays a central role in otorhinolaryngology, particularly in procedures involving the complex temporal bone. Detailed understanding and precise depiction of its specialised anatomy are essential to minimise risks during surgical interventions and to optimise surgical planning.</p><p><strong>Materials and methods: </strong>This article highlights the value of cross-sectional imaging, primarily computed tomography (CT) and magnetic resonance imaging (MRI), in the context of surgical challenges, critical aspects in the assessment of inflammatory conditions, the planning of middle ear procedures, and tumour diagnostics in the temporal bone. Surgical concepts are illustrated using common pathological conditions.</p><p><strong>Conclusion: </strong>Close collaboration between radiologists and surgeons is crucial to minimise patient-specific risks and to optimise surgical outcomes in inflammatory diseases and neoplasms of the temporal bone.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"586-594"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744569","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":"[Anatomical variants of the petrous bone].","authors":"A Haußmann","doi":"10.1007/s00117-025-01465-7","DOIUrl":"10.1007/s00117-025-01465-7","url":null,"abstract":"<p><strong>Clinical issue: </strong>The anatomy of the petrous bone is very complex, particularly due to the many important nervous, vascular and muscular structures that run through it, as well as the protection of hearing and balance organs. Anatomical standard variants complicate radiological interpretation, can imitate pathologies, and present surgeons with enormous challenges during surgical procedures.</p><p><strong>Standard radiological methods: </strong>Morphological imaging-based diagnostics for detecting normal anatomical variants of the petrous bone include computed tomography (CT) and/or magnetic resonance imaging (MRI). The patient's precise history of existing symptoms or previous surgery also plays a role in the assessment of the findings. Radiologists must be aware that some anatomical standard variants can mimic pathology, and therefore there is a risk of misinterpretation. The imaging helps surgeons facilitating preoperative planning and identification of possible complications.</p><p><strong>Conclusion: </strong>Precise radiological knowledge of the complex anatomical relationships of the petrous bone is crucial in routine radiological and neuroradiological practice. A detailed description of existing anatomical standard variants enables colleagues in surgical disciplines such as otolaryngology and neurosurgery to efficiently prepare the procedures and assess possible complications.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"556-561"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188610","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":"[Inflammatory diseases of the petrous bone].","authors":"Wolfgang Reith, Michael Kettner","doi":"10.1007/s00117-025-01473-7","DOIUrl":"10.1007/s00117-025-01473-7","url":null,"abstract":"<p><p>In most cases, inflammatory diseases of the petrous bone can be diagnosed clinically. However, for certain diseases, the extent of the findings must be assessed using cross-sectional imaging, or important complications such as cerebral complications must be excluded. The petrous bone is part of the temporal bone, consisting of the pars squamosa, pars tympanica, and pars mastoidea [1]. It encompasses the inner ear, the internal auditory canal, and the petrous bone itself. Anatomically, the middle ear and mastoid already belong to the pars tympanica and pars mastoidea [1]. Imaging should ideally be carried out in conjunction with a detailed medical history, especially information about previous surgeries, chronic infections, possible anti-inflammatory medications, and the current otoscopic findings. The description should always be systematic, e.g., from outside to inside. Within the anatomical structures, different inflammatory processes can occur. Infections are one of the main causes of inflammation in the temporal bone. Important differential diagnoses must be considered. This article discusses the most important inflammatory lesions of the temporal bone and middle ear and the differential diagnoses.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"571-579"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628017","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}