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ObjectiveTo evaluate the image quality and diagnostic performance of AI-assisted iterative algorithm protocols (AIIA) in accelerated fast spin-echo magnetic resonance imaging (MRI) versus standard (SD) fast spin-echo MRI for clinical 3.0 T rapid knee scans.Materials and methodsThe accelerated sequence, which includes fat-suppression proton density-weighted imaging (FS-PDWI), T2-weighted imaging (T2WI), and T1-weighted imaging (T1WI), was used in conjunction with the SD sequence in 61 patients who underwent MRI scans. SD images were processed using standard reconstruction techniques, while accelerated images utilized AIIA reconstruction. Quantitative assessments of image quality were conducted, measuring noise levels, signal-to-noise ratio (SNR) and contrast signal-to-noise ratio (CNR). Additionally, subjective evaluations were performed using a Likert five-point scale to assess image quality.ResultsThe SD group completed the entire knee scan in 466 s, while the AIIA group completed the scan in 312 s. Compared to the SD group, the AIIA group had a noticeably higher SNR of T1WI in the femur and subpatellar fat pad (p = 0.04, 0.001). On the other hand, T2WI femur SNR was noticeably higher in the SD group (p = 0.004). Measurements of SNR, CNR and other noise levels showed no statistically significant changes. Compared to the SD group, the AIIA group had significantly higher subjective image quality scores for every sequence (p 0.05).ConclusionImages processed using AIIA reconstruction were acquired faster while maintaining comparable image quality and diagnostic capability, meeting the requirements for clinical diagnosis.

Key points 1. ULD-CT qualified the requirements for diagnosis of non-displaced fractures. 2. ULD-CT for limb joint fractures is a useful alternative to digital radiography. 3. ULD-CT protocol for limb joint imaging effectively reduces the dose of radiation.

Abstract Purpose This study aims to examine the use of 3D printing technology to treat clavicular fractures by skilled and inexperienced surgeons. Methods A total of 80 patients with clavicle fractures (from February 2017 to May 2021) were enrolled in this study. Patients were divided randomly into four groups: group A: Patients underwent low-dose CT scans, and 3D models were printed before inexperienced surgeons performed surgeries; group B: Standard-dose CT were taken, and 3D models were printed before experienced surgeons performed surgeries; group C and D: Standard-dose CT scans were taken in both groups, and the operations were performed differently by inexperienced (group C) and experienced (group D) surgeons. This study documented the operation time, blood loss, incision length, and the number of intraoperative fluoroscopies. Results No statistically significant differences were found in age, gender, fracture site, and fracture type (P value: 0.23–0.88). Group A showed shorter incision length and fewer intraoperative fluoroscopy times than groups C and D (P

Abstract Objective To explore the feasibility of the three-dimensional printing (3DP) knee model using the ultra-low-dose computed tomography (CT) scan for preoperative planning and simulated surgery. Methods Thirty-six patients were divided into the standard-dose protocol group (A) and ultra-low-dose protocol group (B). The anteroposterior diameter, left and right diameter of femur, anteroposterior diameter of tibial plateau (APTP), left and right diameter, distance from the intercondylar ridge to tibial tuberosity, lower femur angle, and upper tibial angle were measured on CT images. On the 3D printed knee joint model, Vernier calipers were used to measure: anteroposterior diameter, left and right diameter of the internal and external condyles of femur; left and right diameters, anteroposterior diameters of tibial plateau; upper and lower meridian, left and right diameters of patella. Results With group A as reference, the effective radiation dose in group B was significantly reduced to 97.0% (36.4 ± 3.7 uSv and 1.1 ± 0.2 uSv, respectively). There was no difference in objective parameters for 3DP model (p = 0.31–0.84). None of the quantitative parameters of image quality showed significant difference (p = 0.11–0.96). Despite lower score of image quality and 3DP model in group B (3.0 ± 0.0 vs. 2.1 ± 0.2, 2.9 ± 0.3 vs. 2.2 ± 0.4; p

Abstract Background Ciliated Muconodular Papillary Tumor (CMPT) was first reported in 2002, and fewer than 100 cases have since been reported. The prognosis after surgical resection is good, and recurrence has not been reported. However, it is easily misdiagnosed as adenocarcinoma. Summarizing the CT features of CMPT will help doctors better understand the disease. Case presentation Here, we report a rare and interesting case of ciliated muconodular papillary tumor. A 6-mm diameter solid nodule with slight lobulation, short spines, and subpleural indentation. Patients with clinical diagnosis of high-risk subpleural nodule in the left lung underwent thoracoscopic surgery. Most CMPT cases lack specific clinical manifestations and were found incidentally on physical examination or during a workup for other diseases. The disease was diagnosed through CT and biopsy, and it responded well to surgery. Conclusions This paper presents the detailed computed tomography features of CMPT to help prevent misdiagnosis. The typical manifestations of CMPT imaging as solid and partial nodules, nodules in subpleural or peripheral zones, and nodules contain cavities.

Abstract Background Lymphangioma is a multi-systemic disease mostly affecting the mesentery, omentum, mesocolon and retroperitoneum and rarely involving bone, with fewer than 30 cases reported so far. Lymphangioma usually has no specific clinical manifestation and could be easily misdiagnosed. Lymphangioma with myxoid degeneration was not reported. We report a histopathologically proved case of lymphangioma of 6th and 7th cervical vertebra (C6–7) with myxoid degeneration. Case presentation A 45-year-old male who suffered from pain in the right shoulder for 1 month, aggravated with numbness in the right little finger and ring finger and radiating pain for half a month. CT showed multiple cystic bone destruction areas in C6–7 vertebral right part and appendage with marginal osteosclerosis and surrounded by soft tissue density. The size of the lesion was about 36 mm × 41 mm . MRI: the margin of the lesion appears lobulated. Lesion showed slightly hypointense on T1WI, slightly hyperintense on T2WI and STIR. Multiple patchy T1WI hypointense and T2WI hyperintense shadows were seen within the lesion. No enhancement was observed in the lesion after injection of contrast, and there was no abnormal signal in surrounding soft tissue and bone. The histopathological examination confirmed the diagnosis of lymphangioma with myxoid degeneration after surgical resection. After over 2 years of follow-up, there were no signs of disease recurrence and progression. Conclusions To the best of our knowledge, this is the first case reported in English language literature of lymphangioma with myxoid degeneration.

Abstract Background Tumor-induced osteomalacia (TIO) is a rare condition with fewer than 500 cases reported in the literature although described. Phosphaturic mesenchymal tumor (PMT) is often unrecognized cause of hypophosphatemia. This case report aims to highlight such a rare association which warrants clinical and radiologist attention. Case A 51-year-old man had pain in his feet 2 years prior to the most recent presentation in our clinic. The patient experienced increasingly severe body aches and pain, which affected the feet, hips, knees, ribs, waist, and shoulders. MRI and CT led to the diagnosis of multiple insufficiency fractures. Laboratory tests showed that inorganic phosphate (IP) levels had decreased to 0.52 mmol/L(0.81–1.45 mmol/L), while alkaline phosphatase (ALP) had increased to 216 U/L(38.0–126.0 U/L). Positron emission tomography computed tomography showed tumor-derived hypophosphate osteomalacia of the right iliac wing; surgical resection was performed. markers of bone metabolism and bone density returned normal postoperative, after 9 months follow-up. Conclusion The possibility of tumor-induced osteomalacia should be considered if unexplained joint pain, decreased bone mineral density, increased ALP and insufficiency fractures, and no similar family history are found in adult patients. Surgical resection of the tumor is the key to the treatment.

Objective. To assess the use of CT with oblique axis rib stretch (OARS) and curved planar reformats (CPRs) for rib fracture detection and characterization. Methods. A total of 108 forensically diagnosed patients with rib fractures were evaluated retrospectively. OARS and CPRs were independently used during the diagnosis in two groups. In each group, the final diagnosis was made after a junior radiologist’s initial diagnosis was reviewed by a senior radiologist. The images were evaluated for the presence and characterization of rib fractures. Results. A total of 2,592 ribs were analyzed, and 326 fractured ribs and 345 fracture sites were diagnosed using reference standard. Two groups of radiologists identified 331 and 333 fracture sites using the OARS method, 291 and 288 fracture sites using the CPRs method, and 274 fracture sites in forensically diagnosed patients (CR: conventional reconstruction), respectively; and all missed diagnoses were nondisplaced rib fractures. The ROC Az value of OARS1,2 was 0.98, which is higher than CPRs1,2 0.91, and CR 0.90 (all p

Objectives Evaluation of the clinical performance of ultra-low-dose computed tomography (CT) images of the shoulder joint on image-based diagnosis and three-dimensional (3D) printing surgical planning. Materials and methods A total of 93 patients with displaced shoulder fractures were randomly divided into standard-dose, low-dose, and ultra-low-dose groups. Three-dimensional printing models of all patients’ shoulder joints were fabricated. The subjective image quality and 3D-printing model were evaluated by two senior orthopedic surgeons who were blinded to any scanning setting. A 3-point scale system was used to quantitatively assess the image quality and 3D printing model, where more than 2 points meant adequate level for clinical application. Results Compared with the standard dose protocol, ultra-low-dose technique reduced the radiation dose by 99.29% without loss of key image quality of fracture pattern. Regarding the subjective image quality, the assessment scores for groups of standard, low, and ultra-low doses were 3.00, 2.76, 2.00 points on scapula and humerus, and 3.00, 2.73, 2.44 points on clavicle. Scores of the three groups for the assessment of 3D printing models were 3.00, 2.80, 1.34 on scapula and humerus, and 3.00, 2.90, 2.06 on clavicle. In the ultra-low-dose group, 24 out of 33 (72.7%) 3D printing models of scapula and humerus received lower than 2 points of the evaluation score, while nearly 94% of the clavicle models reached the adequate level. Conclusion An ultra-low-dose protocol is adequate for the diagnosis of either displaced or non-displaced fractures of the shoulder joint even though minor flaws of images are present. Three-dimensional printing models of shoulder joints created from ultra-low-dose CT scans can be used for surgical planning at specific bone like the clavicle but perform insufficiently in the overall surgical planning for shoulder injuries due to the significant geometric flaws.