Search Results (607)

Background/Objectives: The possibilities of endovascular and minimally invasive treatment of visceral and renal artery aneurysms require precise procedure planning. Accurate visualization of vascular pathologies is crucial in this regard. Expanding diagnostic imaging with real 3D models is one of these methods. The objective of our study was to evaluate the utility of 3D printing and virtual 3D models in visualizing visceral and renal artery aneurysms. Methods: A group of 30 patients with true aneurysms of the visceral and renal arteries was selected based on computed tomography angiography (CTA). Aneurysm morphology, diameters, arterial diameters, and anatomical vessel variants were analyzed. Imaging data were processed and 3D-printed using Fused Filament Fabrication (FFF) technology. The resulting 3D models were measured, and dimensional deviations were compared to radiological images. Results: The cohort included 51 aneurysms across arteries supplying abdominal organs, with splenic artery aneurysms (49%) and renal artery aneurysms (25.5%) predominating. Half of the patient group had multiple aneurysms, and 36.7% exhibited anatomical arterial variants. Forty-three 3D models of visceral and renal artery aneurysms were generated, accurately depicting isolated vascular pathologies and the course of visceral arteries in regions of interest. Measurement analysis confirmed that the 3D-printed models showed a mean dimensional deviation of 0.24 mm compared to radiological images. Conclusions: 3D-printed and virtual models enhance the analysis of vascular pathologies, significantly improving the assessment of pathological changes and visualization of anatomical details, especially in hilar aneurysms and aneurysm branches. Full article

Congenital umbilicobiliary fistula is a rare disease reported in humans and dogs. A 2-month-old, intact, male French Bulldog presented with a greenish-yellow discharge dripping from the umbilicus since birth. Complete blood count and serum biochemistry were within normal limits, but serum alkaline phosphatase activity was mildly elevated. A positive contrast cystogram was performed to rule out a patent urachus and confirmed the presence of a vesicourachal diverticula, a type of urachal anomalies. An abdominal ultrasound and computed tomography fistulogram demonstrated a communication between the umbilicus and common bile duct, which suggested an umbilicobiliary fistula. Surgical correction of the umbilicobiliary fistula and vesicourachal diverticula was successfully performed with an uneventful recovery. Histological analysis of the fistulous tract demonstrated a cuboidal/columnar lining epithelium that transitioned to squamous epithelium near the umbilicus. Agenesis of the gallbladder was noted. The application of multiple imaging techniques in the diagnosis and surgical correction of these congenital abnormalities (umbilicobiliary fistula, gallbladder agenesis, and vesicourachal diverticula) was beneficial for treatment planning and outcome. Full article

Background: Hemoglobin Rothschild (Hb Rothschild), NM_000518.5(HBB):c.112T>C, is an ultra-rare low-oxygen-affinity hemoglobin variant that persistently causes reduced peripheral oxygen saturation on pulse oximetry despite normal arterial oxygenation. Fewer than ten cases have been reported worldwide, and only one involved a child—an asymptomatic carrier identified incidentally. Methods: The patient underwent clinical examination, growth assessment, blood tests, hemoglobin electrophoresis, chest CT, abdominal ultrasound, echocardiography, and pulmonary perfusion scintigraphy. Whole genome sequencing (WGS) of the proband and parents was performed, followed by bioinformatic analysis and ACMG-based variant interpretation. A PRISMA-guided PubMed literature review was conducted. Results: We report on the first pediatric case exhibiting a symptomatic clinical course. A 4-year-old boy was referred for chronically low peripheral oxygen saturation (SpO₂), 78–86%, on pulse oximetry and recurrent lower respiratory tract infections. Early developmental history revealed episodes of apnea in infancy, perioral cyanosis, poor exercise tolerance, and low weight gain. Repeated cardiopulmonary assessments, chest computed tomography (CT), echocardiography, and pulmonary perfusion scintigraphy yielded unremarkable findings. Arterial blood gas analysis consistently showed normal arterial partial pressure of oxygen (PaO₂), excluding true hypoxemia. Hemoglobin electrophoresis revealed an abnormal HbD fraction; WGS identified a heterozygous variant NM_000518.5(HBB):c.112T>C inherited from the patient’s asymptomatic father. This variant increases the partial pressure of oxygen at which hemoglobin is 50% saturated (p50), thereby decreasing hemoglobin’s oxygen affinity and shifting the oxyhemoglobin dissociation curve to the right. These alterations explain the discordance between low peripheral oxygen saturation (SpO₂) and preserved oxygen delivery to tissues. Conclusions: This case expands the clinical spectrum of Hb Rothschild and demonstrates that symptomatic presentation may occur in early childhood. Awareness of low-affinity hemoglobin variants is essential to avoid misdiagnosis and unnecessary cardiopulmonary interventions. Early genetic testing facilitates accurate diagnosis and appropriate counseling. Full article

Accurate segmentation of the pancreas in Computed Tomography (CT) scans is a challenging task, which may be crucial for the diagnosis and treatment planning of pancreatic cancer. The irregular shape of the pancreas, its low contrast relative to surrounding tissues, and its close proximity to other complex anatomical structures make it difficult to accurately delineate its contours. Furthermore, a significant class imbalance between foreground (pancreas) and background voxels in an abdominal CT series represents an additional challenge for deep-learning-based approaches. In this study, we developed a deep learning model for automated pancreas segmentation based on a 3D U-Net architecture enhanced with an attention mechanism to improve the model capability to focus on relevant anatomical features of the pancreas. The model was trained and evaluated on two widely used benchmark datasets for volumetric segmentation, the NIH Healthy Pancreas-dataset and the Medical Segmentation Decathlon (MSD) pancreas dataset. The proposed attention-guided 3D U-Net achieved a Dice score of 80.8 ± 2.1%, ASSD of 2.1 ± 0.3 mm, and HD₉₅ of 8.1 ± 1.6 mm on the NIH dataset, and the values of 78.1 ± 1.1%, 3.3 ± 0.3 mm, and 12.3 ± 1.5 mm for the same metrics on the MSD dataset, demonstrating the value of attention mechanisms in improving segmentation performance in complex and low-contrast anatomical regions. Full article

Background: Vascular calcification is a frequent consequence of ageing and is associated with an increased risk of cardiovascular disease. This study aimed to compare two rapid scoring systems for quantifying calcification of the distal abdominal aorta and iliac arteries and to investigate correlations with increasing age. Methods: Patients aged ≥65 years who sustained pelvic trauma between 2003 and 2023 and underwent computed tomography (CT) were included in this retrospective study. Patients were categorised into three age groups (65–74, 75–84, ≥85). The abdominal aorta calcification score (AACS) and the common, external, and total iliac artery calcification scores (CIACS, EIACS, TIACS) were assessed on cross-sectional images and classified into three severity grades (mild, moderate, severe). Results: A total of 224 patients (mean age 78.8 ± 8.5 years; 62% female) were included. Significant differences between age groups were identified for hypertension (p < 0.001), osteoporosis (p < 0.001), atrial fibrillation (p = 0.015), chronic heart failure (p = 0.004), chronic kidney disease (p < 0.001), neurocognitive disorders (p < 0.001), and anticoagulant therapy (p = 0.002). Calcification severity increased with age across all vascular territories (EIACS p = 0.006; others p < 0.001). In multivariable linear regression, age remained the strongest adjusted predictor of calcification across all vascular regions (β = 0.323–0.376, all p < 0.001). Significant positive correlations were found between aortic and iliac calcifications (all p < 0.001), strongest between AACS and CIACS (ρ = 0.78, CI 0.719–0.835) and TIACS (ρ = 0.745, CI 0.676–0.807). Corresponding categorical associations were most pronounced between AACS and CIACS. Conclusions: The evaluated calcification scores were strongly correlated and demonstrated clear age-dependent trends. Given their simplicity and applicability to routine CT imaging, these methods may provide practical tools for assessing vascular ageing. Full article

Leveraging the complementary strengths of handcrafted radiomics and data-driven deep learning, this work develops and rigorously benchmarks three modeling streams (Models A, B and C) for pancreatic ductal adenocarcinoma (PDAC) detection on multiphase abdominal Computed Tomography (CT) scans. Model A distills hundreds of PyRadiomics descriptors to sixteen interpretable features that feed a gradient-boosted machine learning model, achieving discrimination (external AUC ≈ 0.99) with excellent calibration. Model B adopts a 3-D CBAM-ResNet-18 trained under weighted cross-entropy and mixed precision; although less accurate in isolation, it yields volumetric Grad-CAM maps that localize the tumor and provide explainability. Model C explores two fusion strategies that merge radiomics and deep embeddings: (i) a two-stage “frozen-stream” variant that locks both feature extractors and learns only a lightweight gating block plus classifier, and (ii) a full end-to-end version that allows the CNN’s adaptor layer to co-train with the fusion head. The frozen approach surpasses the single stream, whereas the end-to-end model reports external AUC of 0.987, balanced sensitivity/specificity above 0.93, and a Brier score below 0.05, while preserving clear Grad-CAM alignment with radiologist-drawn masks. Results demonstrate that a carefully engineered deep-radiomic fusion pipeline can deliver accurate, well-calibrated and interpretable PDAC triage directly from routine CT. Our contributions include a stability-verified 16-feature radiomic signature, a novel deep-radiomic fusion design that improves robustness and interpretability across vendors and a fully guideline-aligned, openly released pipeline for reproducible PDAC detection on routine CT. Full article

Femtosecond laser-ablated gold nanoparticles (AuNPs) offer a unique platform for developing novel cost-effective contrast agents due to their ultraclean, surfactant-free synthesis and precisely tunable surface properties. This study developed three computed tomography (CT) contrast agents from a single stock solution of laser-ablated AuNPs, functionalized with polyethylene glycol (PEG-2kDa, PEG-4kDa), or lipoic acid with bovine serum albumin (BSA). The primary objective was to evaluate the safety and functional efficacy of these coated AuNPs in healthy and tumor-bearing mice. After a single intravenous injection (690 ± 30 mg Au/kg), all formulations were well tolerated with no acute toxicity observed. PEGylated AuNPs demonstrated long blood half-life (18 ± 2 h for PEG-2kDa; 37 ± 2 h for PEG-4kDa), making them suitable for cardiovascular imaging up to 24 h post-injection. BSA-AuNPs had a rapid blood clearance (T_1/2 = 2.8 ± 0.9 h), permitting cardiovascular assessment during the first 3 h, and provided intense, persistent contrast in abdominal organs, enabling liver imaging from 5 min and spleen imaging from 1 h post-injection. In a Ca755 mammary adenocarcinoma model, PEGylated AuNPs selectively accumulated in the tumor stroma and fibrous septa, allowing for precise tumor margin delineation and analysis of internal architecture. The findings establish that a single AuNP stock can be used to produce specialized contrast agents for specific imaging applications. Full article

Cecal volvulus is a rare cause of acute abdominal pain, resulting from torsion of the cecum and ascending colon due to abnormal mobility caused by inadequate peritoneal fixation. Clinical presentation is often vague and nonspecific, which can delay diagnosis and treatment. Computed tomography (CT) is the imaging modality of choice, as it not only confirms the presence and location of the volvulus but also identifies serious complications such as ischemia or perforation. Abdominal radiographs may be inconclusive, especially when the twisted bowel loop is fluid-filled, aligned antero-posteriorly, or obscured by adjacent gas-filled loops. We present the case of a 65-year-old woman who arrived at the emergency department with sudden-onset abdominal pain. Abdominal CT revealed classic signs of cecal volvulus, including the rarely reported ‘embryo sign,’ which proved crucial for swift diagnosis and intervention. Recognizing both common and less common CT features, such as the embryo sign, is paramount for rapid diagnosis and appropriate management in emergency situations. Familiarity with the full radiologic spectrum of this condition can significantly improve patient outcomes. Full article

Mammary gland tumors (MGT) are the most common neoplasms in intact female dogs and represent the third most frequent tumor type in female cats. Imaging plays a central role in the diagnosis, staging, and follow-up of these neoplasms. This review summarizes the diagnostic imaging features of canine and feline MGT and the advantages and limitations of each modality. Radiography and computed tomography (CT) are mainly used to detect pulmonary and abdominal metastases, while ultrasonography provides key information about primary tumor size, margins, echogenicity, vascularization, and elasticity. Advanced ultrasound techniques, such as Doppler, contrast-enhanced ultrasonography (CEUS), and elastography, improve differentiation between benign and malignant lesions. Magnetic resonance imaging (MRI) offers excellent soft-tissue detail and can assist in preoperative planning, whereas nuclear medicine techniques, including scintigraphy and positron emission tomography (PET), allow functional assessment and the early detection of micrometastases. Although histopathology remains the diagnostic gold standard, imaging is indispensable for characterizing primary lesions, evaluating metastatic spread, guiding sampling, and monitoring therapeutic outcomes in small animal oncology. By integrating and comparing the main imaging modalities applied to canine and feline mammary tumors, this review underscores their complementary roles in improving diagnosis, staging, and therapeutic decision-making in small animal oncology. Full article

Objective: This study systematically evaluates the association between breast arterial calcifications (BACs) on mammography and systemic vascular calcifications detected by computed tomography (CT) in female lung transplant recipients, representing the first investigation of this relationship in this population. Methods: This retrospective single-center study included 78 female LTX recipients who underwent both digital mammography and thoracoabdominal CT. BACs were graded on a four-point scale. Calcifications in seven arterial territories were visually assessed on CT with a binary scale (“present”, “not present”) and graded on a severity scale of systemic calcifications ranging from no involvement (0) and minor vascular calcification (1–4 vessels) to major vascular calcification (5–10 vessels). Associations between BACs and systemic vascular calcifications were analyzed using correlation, logistic regression, and ROC analysis. Results: BACs were present in 31 of 78 patients (40%). Vascular calcifications were frequent, most often affecting the thoracic aorta (82%), abdominal aorta (76%), and iliac arteries (72–73%). Coronary calcifications were more common in BAC-positive than BAC-negative patients (77% vs. 40%, p = 0.002). BAC grade correlated with the cumulative vascular calcification (ρ = 0.35, p = 0.0017). In ROC analysis, BACs discriminated patients with vascular calcification with fair accuracy (AUC 0.73, 95% CI 0.67–0.79). In multivariable logistic regression adjusted for age, diabetes, chronic kidney disease, and hypertension, BACs remained independently associated with systemic calcification, with an adjusted odds ratio of approximately 2.0 for ≥1 affected vascular territory. Interreader agreement for the 4-level BAC score was excellent with a quadratic-weighted κ of 0.91 and a linear-weighted κ of 0.88. Conclusions: BACs are common in female LTX recipients and independently predict systemic vascular calcifications. Their detection in routine mammography may provide a simple, opportunistic marker to support cardiovascular risk stratification in this high-risk population. Full article

Objectives: This review aims to review the application of deep learning (DL) techniques in the imaging analysis of abdominal aortic aneurysm (AAA), with a specific focus on the segmentation of intraluminal thrombus (ILT). Methods: A comprehensive literature review was conducted through searches of PUBMED and Web of Science up to September 2025. Only English-language studies applying DL-based networks for ILT segmentation in patients with AAA on computed tomography angiography were included. After screening 664 articles, 22 met the eligibility criteria and were included. The reported methodological frameworks and segmentation performance metrics were extracted for comparison and analysis. Results: Among the studies included, the reported Dice similarity coefficients ranged from 0.81 to 0.93 for 2D networks and from 0.804 to 0.9868 for 3D networks. Notably, 2D Multiview fusion models outperform other 2D approaches, while 3D U-Net remains a strong baseline. Methods using preoperative images demonstrated great applicability for surgical planning, while postoperative segmentation faced challenges related to imaging artifacts caused by stent. Conclusions: This review provides a comprehensive overview of recent DL-based ILT segmentation methods for AAA patients on CTA, offering perspectives for applications in advanced preoperative planning and postoperative surveillance. Despite the promising results, the lack of standardized datasets limits model development and external validation. Future research should address these limitations by focusing on multicenter standardized datasets and seamless integration into clinical workflows. Full article

Background: Early identification of patients requiring operative management (OM) after blunt abdominal trauma is critical, yet initial physiological signs may be nonspecific. We sought to develop and internally validate an admission-based prediction model for early emergency department (ED) triage, prior to computed tomography (CT), using routinely available physiological and biochemical parameters. Methods: We conducted a retrospective observational study including adult patients with blunt abdominal trauma who underwent FAST and lactate testing at admission. OM was defined as any abdominal surgical intervention within 24 h to control hemorrhage or repair injury. A multivariable logistic regression model incorporating lactate, heart rate, leukocyte count, and FAST positivity was developed using complete-case data. Lactate diagnostic accuracy was assessed using ROC analysis. Internal validation was performed with 1000 bootstrap resamples. Results: In 81 patients with lactate results, lactate showed good discrimination for OM (AUC 0.815). At ≥3.5 mmol/L, sensitivity was 0.737 (95% CI 0.569–0.866), specificity 0.744 (0.588–0.865), LR⁺ 2.88, and LR⁻ 0.35. The final logistic model demonstrated an apparent AUC of 0.904 and an optimism-corrected AUC of 0.882. The full model equation and coefficients are provided for reproducibility. Conclusions: Admission lactate, combined with FAST and physiologic measurements, provides useful early-triage information before CT and warrants external validation in larger cohorts. Full article

Gossypiboma is a retained surgical item, most commonly gauze or sponge, inadvertently left inside a patient’s body after surgery. Although preventable, it can cause severe complications and is often underreported due to medicolegal concerns. We present a case of a 61-year-old woman who experienced left lower abdominal pain for three days. Her history included lumbar disc surgery via the lower left abdomen a decade earlier. Physical examination revealed a non-tender pelvic mass, and abdominal computed tomography (CT) showed a 4.5 × 4.7 × 6.1 cm high-attenuation lesion with internal low-attenuation areas in the left retroperitoneal space. The mass was surgically removed, and gauze material was identified inside, confirming the diagnosis of gossypiboma. The patient recovered uneventfully postoperatively. Gossypiboma can present with subacute or chronic symptoms, making diagnosis challenging. While uncommon, gossypiboma should be considered in differential diagnoses of patients with unexplained abdominal masses and prior surgical history. Prompt surgical management is essential to prevent complications. This case highlights the importance of meticulous surgical counts and awareness of this rare but serious condition. Full article

Background/Objectives: Despite the increasing use of ultrasound (US) as a tool for assessing muscle mass and diagnosing sarcopenia, its application remains limited because few studies have validated cut-off points for specific populations. This study aimed to propose US cut-off points for diagnosing sarcopenia in Brazilian individuals aged 60 years and older. Methods: Patients schedule for elective abdominal computed tomography (CT) were also evaluated with musculoskeletal US of the thigh. CT images were obtained at the level of the third lumbar vertebra. US measurements included the thickness of the rectus femoris (RF) muscle and the rectus femoris combined with the vastus intermedius (RF + VI). Receiver Operating Characteristic (ROC) curves determine the sensitivity and specificity of the US cut-off points. The area under the curve (AUC) and 95% confidence intervals (CI) were calculated. Results: The study sample (n = 88) had a mean age of 71.8 ± 8.7 years, and 64% were women. The proposed cut-off points for diagnosing sarcopenia using US, based on the mean ± SD, were ≤19.1 mm and ≤15.9 mm for RF thickness and ≤31.9 mm and ≤29.2 mm for RF + VI thickness in men and women, respectively. These cut-off points demonstrated good accuracy and significant AUC values. Conclusions: This study proposes US-based cut-off points with good accuracy for suggesting sarcopenia diagnosis, particularly when assessing RF thickness. Full article

Background: The diagnosis of abdominal tuberculous lymphadenopathy (ATBL) remains challenging in clinical practice. Patients with ATBL and HIV infection may have atypical clinical and computed tomography (CT) features. The aim of this study was to investigate the impact of HIV infection on the clinical and CT features of ATBL patients. Methods: From January 2012 to March 2023, 178 patients with untreated ATBL were retrospectively analyzed. Patients with ATBL were classified into HIV-negative group (n = 152) and HIV-positive group (n = 26). In addition to the clinical characteristics of the patients, the features of ATBL (e.g., size and location) were evaluated via CT. The Mann–Whitney U test (for continuous variables) and Fisher’s exact test (for categorical variables) were used to compare clinical data and CT imaging features between the two groups. Missing values were handled using multiple imputation, and the Benjamini–Hochberg procedure was applied to control the false discovery rate (FDR) in multiple comparisons. Post hoc power analysis for key variables was performed. Results: Compared with the HIV-negative group, the HIV-positive group had older age, lower CD4⁺ T-cell counts, and larger ATBL diameter. The HIV-positive group also showed a stronger tendency for disease dissemination, with significantly higher rates of smear positivity, miliary pulmonary tuberculosis (PTB), and disseminated tuberculosis (TB). On CT imaging, the HIV-positive group had a higher frequency of ATBL involvement in the upper para-aortic region, portacaval space, and hepatogastric ligament. In contrast, abdominal distension was more common in the HIV-negative group. post hoc power analysis confirmed that most key variables had adequate statistical power (≥0.8), except for age (power = 0.597) and ATBL diameter (Power = 0.769). Conclusions: The clinical and CT features of ATBL differ significantly between HIV-negative and HIV-positive patients. Full article