The petrous portion of the temporal bone is a complex pyramidal-shaped structure of the central skull base, which contains osseous, air cell, vascular, and neural structures in close proximity, making imaging interpretation challenging. A broad spectrum of lesions may involve this region, including inflammatory, neoplastic (benign or malignant), vascular, and osseous lesions. In the pediatric population, ongoing skull base maturation and normal anatomical variability further complicate imaging assessment and may mimic pathology. Cross-sectional imaging plays a central role, with CT providing detailed assessment of osseous structures and MRI offering superior soft tissue characterization. Familiarity with the normal developmental anatomy, common anatomical variants, imaging pitfalls, and characteristic imaging features of pediatric bone lesions is essential for accurate diagnosis and appropriate patient management. This review provides a structured overview of pediatric petrous apex lesions, emphasizing imaging protocols, normal developmental variants, and key imaging features across inflammatory, neoplastic, vascular, and miscellaneous entities.
To evaluate the predictive efficacy and risk stratification potential of coronary computed tomography angiography (CCTA)-derived pericoronary adipose tissue (PCAT) radiomics for major adverse cardiovascular events (MACEs). We retrospectively enrolled patients with suspected coronary artery disease (CAD) who underwent CCTA at our hospital between June 2017 and June 2020, with 5-year follow-up for MACE occurrence. Patients were grouped by MACE status. Machine learning was applied to construct and compare three models: PCAT radiomics model, fat attenuation index (FAI) model, and clinical model. Prospective validation was conducted in 578 patients with suspected CAD undergoing CCTA, who were stratified into high- and low-risk groups by the optimal cutoff of the PCAT radiomics model. The predictive and risk stratification performance of all models was assessed. Fourteen PCAT radiomics features (5 first-order and 9 texture features) were finally screened. The PCAT radiomics model showed significantly superior MACE predictive performance over the FAI and clinical models (P < 0.001). Only the PCAT radiomics model identified significantly higher MACE risk in the high-risk versus low-risk group (HR=2.611, 95
We investigated whether the cerebral blood volume (CBV) index and pretreatment systemic inflammatory indices (SIIs) provide complementary prognostic information for 90-day functional outcomes after successful endovascular therapy (EVT) for anterior circulation large vessel occlusion and evaluated the advantages of machine learning models in terms of prognostic outcomes and quantified adverse outcomes using the population attributable fraction (PAF). This retrospective analysis of a prospective registry included 474 patients who were treated between November 2020 and June 2024. An independent 53-patient multicenter cohort was used for external validation. SIIs were calculated from the first venous sample obtained at presentation, before intravenous thrombolysis, and before arterial puncture for EVT. Multivariate logistic regression and eight predictive algorithms were evaluated. PAF estimates were considered exploratory. Among 474 patients, 41.6
Survivors of ST-segment elevation myocardial infarction (STEMI) face a substantial residual risk of major adverse cardiovascular and cerebrovascular events (MACCEs). Cardiac magnetic resonance (CMR) excellently delineates structural injury but does not assess the concomitant systemic prothrombotic state. We investigated whether fibrinogen, a key mediator of thrombosis, provides incremental prognostic value beyond CMR for risk stratification. In a prospective multicenter cohort of 532 STEMI patients undergoing primary percutaneous coronary intervention (PCI), plasma fibrinogen was measured post-procedure. CMR was performed within 7 days to assess left ventricular thrombus (LVT) and aneurysm (LVA). The primary endpoint was MACCEs over a median follow-up of 55.5 months. A novel risk score (the Fibrinogen and Cardiac Magnetic Resonance Score, or FIBR-CMR score) was derived from a multivariable Cox model, and its performance was assessed through internal validation using bootstrap resampling (optimism-corrected C-index = 0.73). Elevated fibrinogen independently predicted LVT (adjusted OR 1.46, 95
Over the past four decades, the management of thyroid nodules and selected thyroid malignancies has progressively shifted from surgery-centered approaches toward image-guided minimally invasive treatments (MITT). What began in 1985 with ultrasound-guided percutaneous ethanol injection evolved into a range of energy-based techniques, including laser ablation (LA), radiofrequency ablation (RFA), microwave ablation (MWA), and high-intensity focused ultrasound (HIFU). This historical review aimed to reconstruct the major milestones in the development of image-guided thyroid ablation. A systematic PubMed literature search and predefined selection criteria were used to identify seminal studies, first clinical applications, major technological innovations, comparative studies, guideline-defining publications, and landmark long-term follow-up studies. Overall, 43 milestone papers were included for qualitative historical analysis. The evolution of thyroid ablation can be divided into five phases: conceptual origins (1985–1999), birth of the thermal procedures’ era (2000–2006), methodological standardization (2007–2012), oncologic consolidation and comparative evidence (2013–2018), and final codification by means of international guideline endorsement and long-term validation (2019–2025). Recent 10-year follow-up studies have confirmed the durable efficacy of MITT for benign nodule management and their sustained oncologic control in low-risk papillary thyroid microcarcinoma. Image-guided thyroid ablation has transitioned from experimental innovation to an evidence-based, guideline-supported therapeutic domain, representing a paradigm shift toward precision medicine, organ preservation, and minimally invasive endocrine oncology.
