Current Issue : July-September Volume : 2026 Issue Number : 3 Articles : 5 Articles
Background: Cardiac computed tomographic angiography (CTA) detects patent foramen ovale (PFO) with variable accuracy. This study investigated factors affecting CTA detectability for PFO in patients with suspected PFO-associated stroke. Methods: Consecutive patients with cryptogenic stroke and positive findings on contrast transcranial Doppler (cTCD) examinations were enrolled between November 2020 and April 2023 in this retrospective study. Each participant underwent transesophageal echocardiography (TEE) and cardiac CTA. Patients with confirmed PFO on TEE were categorized into two groups based on CTA detectability: the CTA-positive group (PFO identified by CTA) and the CTA-negative group (PFO missed by CTA). Univariate and multivariate logistic regression analyses were performed to identify predictors of CTA false-negative results. Results: Among 108 patients (mean age 46.7 ± 14.9 years, 47.2% male), the prevalence of PFO by TEE was 94.4% (102/108). Compared to TEE, cardiac CTA had a sensitivity of 70% (95%CI 61–79%), a specificity of 100% (95%CI 54–100%), a positive predictive value of 100% (95%CI 95–100%), and a negative predictive value of 16% (95%CI 6–32%). Among patients with PFO confirmed by TEE (n = 102), the incidence of moderate to large right-to-left shunts (RLS) was significantly higher in the CTA-positive group than in the CTA-negative (77.5% vs. 22.5%, p < 0.001). After adjusting for confounders, patients with moderate to large shunts showed a significantly lower likelihood of a CTA false-negative result compared to those with small shunts (OR 0.113, 95%CI 0.035–0.365, p < 0.001). In patients with moderate to large RLS, the sensitivity of cardiac CTA for diagnosing PFO increased to 90.16% (95% CI 82.69–97.64%). Conclusion: Cardiac CTA could be an effective complementary modality for selected patients with suspected PFO-associated stroke. Its diagnostic performance appears more reliable for identifying PFO in patients with moderate-tolarge RLS than in those with small RLS....
Reoperation for papillary thyroid carcinoma (PTC) requires precise lymph node metastasis assessment, yet ultrasound (US) alone may be insufficient in complex or high-risk cases. This study evaluated whether supplementing US with magnetic resonance imaging (MRI) improves surgical guidance and outcomes in reoperation. We retrospectively analyzed 375 patients who underwent reoperation between 2014 and 2022. Propensity score matching yielded 101 patients in the USUS-only group and 62 in the US+MRI group. Pathological and imaging data were compared to assess diagnostic performance, surgical outcomes, biochemical responses, and recurrence-free survival. The combined approach significantly increased sensitivity for detecting central lymph node metastasis from 52.5% to 90.9% and resulted in higher rates of central neck dissections (65.1% versus 45.5%) with greater lymph node yield (median: 29 versus 20) but lower lymph node ratios. More patients in the combined group achieved excellent biochemical responses (50.0% versus 27.7%). While overall recurrence-free survival (RFS) was not significantly different, the US+MRI group showed improved RFS among patients with ≥2 positive central nodes (HR = 0.24, p = 0.032). Importantly, complication rates were comparable, suggesting that improved outcomes were achieved without added surgical risk. Combined US and MRI assessment enhances diagnostic performance and may improve surgical and oncological outcomes in select high-risk patients undergoing PTC reoperation....
Introduction: Degenerative lumbar spondylolisthesis (LS) is a common condition in older people, often causing lumbar spinal stenosis and neurogenic claudication. Objectives: This study aimed to determine the epidemiological, clinical and radiological profile of LS in elderly patients (≥60 years) attending the Bouaké University Hospital. Methods: A prospective cross-sectional descriptive and analytical study was conducted from 2019 to 2024 at Bouake University Hospital, including 113 patients aged 60 years and older with lumbar SL. Results: SL in elderly subjects accounted for 41.2% of all SL cases. There was a clear female predominance (88.5%), with a male-to-female sex ratio of 0.13. The mean BMI was 24.1 ± 4.7 kg/m2. The mean age was 66.9 ± 6.1 years. The most common occupation was housewife (72.6%). Lumbosacral radiculopathy was the most common reason for consultation (87.6%), dominated by neurogenic claudication (observed in 85.8% of patients concerned). The course was predominantly chronic (85.8%) and progressive (91.2%). Radiologically, all cases (100%) involved antelisthesis. Degenerative spondylolisthesis (DS) was the main aetiology (80.5%), always associated with spondylotic and posterior interapophyseal osteoarthritis. Spondylolisthesis due to isthmic lysis (19.5%) was also observed, always associated with degenerative lesions in this elderly population. Being elderly in our study was a risk factor: it increased the risk of degenerative spondylolisthesis by approximately 2 times (OR = 1.97) compared to younger subjects. Conclusion: Lumbar SL in elderly subjects in our context is a common condition, predominantly affecting women and of a degenerative nature, mainly manifesting as a narrow lumbar canal and chronic lumbosacral radiculopathy....
Objectives: Artificial intelligence (AI) is a transformative development in the field of medicine. In the field of musculoskeletal radiology, agentic AI is a technology that could flourish, but currently, the limited evidence base is fragmented and sparse, and we present a scoping review of it. Methods: Parallel searches were conducted in four databases: PubMed, Embase, Scopus, andWeb of Science. Search terms included all agentic AI and autonomous AI agents, as well as radiology. All papers underwent screening by two independent reviewers, with conflicts resolved through consensus. Initially, inclusion criteria involved all papers on general radiology, which were later stratified for musculoskeletal radiology and applicable papers to ensure inclusion of all suitable studies. A thematic analysis was undertaken by two independent reviewers. Results: Eleven studies met the inclusion criteria, comprising two MSK (musculoskeletal)-specific and nine general radiology papers applicable to MSK workflows. Four key themes emerged. Agentic decision support was demonstrated across five studies, showing improved diagnostic coordination, pathway navigation, and reduced clinician workload. Workflow optimisation was highlighted in four studies, with agentic systems enhancing administrative efficiency, modality selection, and overall radiology throughput. Image analysis and reconstruction were improved in three studies, with multi-agent systems enabling enhanced image quality and automated interpretation. Finally, four studies addressed conceptual, ethical, and governance considerations, emphasising the need for transparency, safety frameworks, and clinician oversight. Conclusion: Agentic AI shows considerable promise for enhancing MSK radiology through improved decision support, image analysis, and workflow efficiency; however, the current evidence remains limited and largely theoretical....
Background/Objectives: Tissue conductivity reflects ionic composition (e.g., sodium), providing critical insights into various diseases. Ultrashort echo time quantitative conductivity mapping (UTE-QCM) offers a method to obtain this information, which is particularly effective for musculoskeletal (MSK) tissues with short T2 relaxation times. The aim of this study is to develop a UTE-QCM framework using ultrashort echo time double echo steadystate (UTE-DESS) and validate its feasibility in the knee. Methods: An ultrashort echo time double echo steady-state (UTE-DESS) sequence was used to acquire S+ and S− images and estimate the transmit radiofrequency field (B1+) phase at 3T. The B1+ phase was derived by canceling the phase evolution in the free induction decay using these images. This phase data was then processed using two widely used QCM reconstruction methods for comparison: parabolic fitting and an integral-based method. The proposed UTE-QCM framework was validated using a phantom containing three different concentrations of sodium chloride (0%, 0.5%, and 1%). Additionally, three healthy volunteers were recruited to validate UTE-QCM in knee imaging. Results: In both phantom and in vivo experiments, the integral-based QCM demonstrated improved robustness to noise compared to parabolic fitting. In the sodium phantom, the estimated conductivity showed high linearity with sodium concentrations. In the in vivo knee, the generated conductivity maps successfully visualized both long and short T2 tissues. Conclusions: We demonstrated the feasibility of UTE-QCM as a novel quantitative imaging tool targeting short T2 tissues in the MSK system. This technique may facilitate the diagnosis and prognosis of joint disorders....
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