To evaluate whether temporal AI-assisted compressed sensing (tACS) enables high-resolution, motion-robust magnetic resonance enterography (MRE) without antiperistaltic agents and improves acquisition efficiency and motility visualization. This prospective single-center study enrolled consecutive patients who underwent both routine and tACS MRE on a 3.0-T scanner between October 2024 and June 2025, without antiperistaltic agents. The tACS protocol acquired axial and coronal T2-weighted images (T2WI); the routine protocol included a coronal Cine sequence. Acquisition time and total temporal frames for non-fat-saturated T2WI (routine and tACS) and Cine were recorded to calculate imaging efficiency (frames/min). Primary outcomes included total temporal frames, scan time, efficiency, subjective image-quality scores, apparent signal-to-noise ratio (aSNR), contrast-to-noise ratio (aCNR), maximum local variation sharpness, peri-enteric fat-plane clarity, and ileocecal-valve (ICV) motility. Paired statistical tests compared within-subject differences; Kendall’s W assessed inter-reader agreement. Thirty patients completed both protocols. tACS acquired 504 frames in 287 s vs 107 frames in 241 s for the routine protocol, improving efficiency 4.0-fold (105.4 vs 26.6 frames/min; p < 0.001). Subjective image quality favored tACS (median 5.0 vs ≤ 4.0; p < 0.01) with perfect agreement (W = 1.00). Quantitative analysis demonstrated significantly improved sharpness (all p < 0.001) and increased aSNR/aCNR. Fat-plane clarity reached perfect scores in 93

Background: Transmural healing (TH) is an emerging therapeutic target in Crohn’s disease (CD); however, reliable baseline biomarkers for predicting TH after ustekinumab (UST) therapy remain lacking. We aimed to investigate whether a baseline computed tomography enterography (CTE)-based mesenteric fat radiomics signature could predict TH at week 52 of UST treatment and to compare its predictive performance with an intestinal radiomics signature. Methods: This retrospective study consecutively enrolled patients with CD from two tertiary centers in China between August 2020 and March 2023. The training set consisted of patients from center 1, and the multi-center test set comprised patients from both centers. Radiomics features were extracted from the most severely inflamed intestinal segment and the corresponding mesenteric fat. Mesenteric, intestinal, and integrated radiomics models were developed to predict TH at week 52 of UST treatment. Findings: A total of 142 patients were included (training, n = 75; test, n = 67). The AUCs for the mesenteric and intestinal radiomics models were 0.855 and 0.793 in the training set, and 0.757 and 0.656 in the multi-center test set, respectively. Integrating mesenteric and intestinal features significantly improved the predictive performance compared with the intestinal model alone (AUC training: 0.905 vs. 0.793, p = 0.039; test AUC: 0.821 vs. 0.656, p = 0.043). Interpretation: A baseline mesenteric fat radiomics signature derived from CTE enables precise stratification of TH in patients with CD receiving UST non-invasively. Integrating mesenteric and intestinal imaging information may facilitate early treatment optimization and support treat-to-target decision-making in clinical practice.

ABSTRACT As the management of Crohn's disease (CD) shifts from symptom control toward objective healing targets, the limitations of conventional assessments underscore the need for imaging to transcend detection and guide personalized therapy. Although endoscopy remains central for the evaluation of CD, its limitations in the assessment of submucosal lesions and penetrating complications necessitate advanced imaging solutions. Noninvasive multimodal imaging techniques, including computed tomography enterography, magnetic resonance enterography, and intestinal ultrasound, have emerged as indispensable tools in the management of CD. These modalities enable a comprehensive evaluation of transmural inflammation and extramural complications while also providing prognostic information to guide therapeutic decisions. This review focuses on the transformative role of multimodal imaging in the modern management landscape for CD. We discuss how imaging facilitates baseline risk stratification, quantification of transmural healing as a deep therapeutic endpoint, and differentiation of inflammatory from fibrotic strictures to guide medical versus surgical decision‐making. Furthermore, we examine the integration of artificial intelligence and body composition analysis, providing tools enabling personalized prognostication. By aligning imaging innovations with evolving clinical goals, we propose a clinically oriented framework for integrating imaging‐defined transmural healing into precision‐based CD management.

BACKGROUND:Sarcopenia is prevalent in Crohn's disease (CD) patients, but the prognostic value of skeletal muscle-to-intermuscular adipose tissue (IMAT) balance in penetrating CD remains unexplored. OBJECTIVE:To determine whether skeletal muscle-IMAT imbalance predicts non-surgical treatment failure in CD. METHODS:This retrospective study included CD patients undergoing computed tomography enterography (CTE, 2013-2022), stratified by disease behavior (penetrating vs. non-penetrating). Automated CTE segmentation algorithm quantified skeletal muscle and IMAT volumes at baseline. Skeletal muscle ratio was calculated as skeletal muscle/(skeletal muscle + IMAT). Sarcopenia was defined by the skeletal muscle area at the third lumbar vertebra. Patients received ≥1 year of non-surgical therapy, with outcomes categorized as 'maintenance therapy' or 'treatment escalation'. Cox proportional hazards analysis identified predictors of escalation; mediation analysis evaluated inflammatory-nutritional pathways. RESULTS:Among 157 patients (penetrating: n = 42; non-penetrating: n = 115), treatment escalation rates were 64.3% (27/42) and 53.0% (61/115) respectively, without significant intergroup difference (p = 0.21). Skeletal muscle ratio predicted escalation in both cohorts (penetrating: AUC = 0.822 [0.673, 0.923], non-penetrating: AUC = 0.922 [0.857, 0.964]), outperforming conventional sarcopenia metrics (p = 0.002 and p < 0.001). Cox regression confirmed skeletal muscle ratio as an independent protective factor (penetrating: HR = 0.098 [0.014 - 0.680], p = 0.02; non-penetrating: HR = 0.597 [0.442 - 0.804], p = 0.001; combined: HR = 0.637 [0.493 - 0.823], p = 0.001), while penetrating disease as risk factor (HR = 3.778 [1.281 - 11.14], p = 0.02). Body mass index mediated 6.9% of the skeletal muscle ratio-treatment escalation relationship in non-penetrating CD. CONCLUSIONS:Skeletal muscle-IMAT imbalance independently predicts treatment escalation in CD, offering superior prognostic utility to traditional sarcopenia measures.

ObjectivesTo analyze the differences in clinical manifestations between children and adults with intestinal involvement in IgAV and to identify the specific subtypes requiring particular attention.MethodsA systematic review of the HIS system was conducted on patient data from four centers at Tongji Hospital between January 2015 and October 2022. Patients with a diagnosis of IgAV with intestinal involvement were further analyzed. Clinical manifestations, laboratory data, and CT findings at the time of initial hospitalization were recorded. The differences in clinical manifestations between children and adults were analyzed. The extent of intestinal involvement, linked to disease severity, was quantitatively assessed by evaluating the number of affected intestinal segments on CT imaging. Laboratory markers that could reflect severe intestinal involvement were explored. Furthermore, patients were classified based on the sites of involved intestinal segments: L1 type (duodenum and/or jejunum), L2 type (ileum), L3 type (duodenum and/or jejunum and ileum), and L4 type (limited to the colorectum). A comparison of the first three types was performed.ResultsA total of 148 patients were enrolled (67 children and 81 adults). The proportion of joint pain and renal involvement was higher in adults. D-dimer level was an independent risk factor for severe intestinal involvement (OR = 1.104, p = .016). In the first three types patients based on the sites of involved intestinal segments, it found that L3 type patients had a longer hospital stay.ConclusionWith the exception of joint pain and renal involvement, there were no significant differences in clinical symptoms between children and adults. CT imaging provided objective insights into the extent of intestinal involvement, which correlated with disease severity. Patients with widespread small bowel involvement displayed a more severe disease state.

PURPOSE:Median Arcuate Ligament Syndrome (MALS) is often underdiagnosed due to nonspecific symptoms. This study proposes a CT-based grading system that evaluate the association between grade and the incidence of celiac or superior mesenteric artery aneurysms. METHODS:From January 2021 to July 2023, patients exhibiting the characteristic hooked appearance on sagittal contrast-enhanced CT, indicative of MALS, were included in the study. An age- and sex-matched hypertension screening cohort was also recruited as a control group for comparison. They were classified into mild-to-moderate and severe stenosis groups based on a 50% stenosis threshold. Clinical data (biochemical markers, etc), and imaging parameters (SMA and CA diameters) were analyzed to assess their association with MALS severity and related complications. RESULTS:A total of 427 MALS patients and 427 age- and sex-matched controls were included (69.1% male; median age 59 years). Radiological assessments showed increased abdominal aorta and distal SMA diameters in the MALS group. Higher age (p = 0.002), alcohol consumption (p = 0.022), lower triglycerides (p = 0.004), and larger SMA diameter (p = 0.001) were associated with MALS severity. Our study revealed that while the incidence of severe complications in MALS patients does not correlate significantly with age(p = 0.064), it peaks in those aged 60-69 years(50.8%). CONCLUSION:Contrast-enhanced CT serves as a valuable tool for classifying the severity of MALS and assessing associated complications. MALS severity correlates with older age, alcohol consumption, lower triglyceride levels, and larger SMA diameter. These findings underscore the importance of integrated clinical, biochemical, and imaging assessment in improving diagnostic accuracy, risk stratification, and management of MALS.

Delayed diagnosis of inflammatory bowel disease (IBD) is common, there is still no effective imaging system to distinguish Crohn's Disease (CD) and Ulcerative Colitis (UC) patients. This multicenter retrospective study included IBD patients at three centers between January 2012 and May 2022. The intestinal and perianal imaging signs were evaluated. Visceral fat information from CT images was extracted, including the ratio of visceral to subcutaneous fat volume (VSR), fat distribution, and attenuation values. The valuable indicators were screened out in the derivation cohort by binary logistic regression and receiver working curve (ROC) analysis to construct an imaging report and data system for IBD (IBD-RADS), which was tested in the validation cohort. The derivation cohort included 606 patients (365 CD, 241 UC), and the validation cohort included 155 patients (97 CD, 58 UC). Asymmetric enhancement (AE) (OR = 87.75 [28.69, 268.4]; P < 0.001), perianal fistula (OR = 4.968 [1.807, 13.66]; P = 0.002) and VSR (OR = 1.571 [1.087, 2.280]; P = 0.04) were independent predictors of CD. VSR improved the efficiency of imaging signs (AUC: 0.929 vs. 0.901; P < 0.001), with a threshold greater than 0.97 defined as visceral fat predominance (VFP). In IBD-RADS, AE was the major criterion, VFP and perianal fistula were auxiliary criteria, and intestinal fistula, limited small bowel disease, and skip distribution were special favoring items as their 100

Abstract Objectives The purpose of this study is to assess the diagnostic efficacy of contrast-enhanced CT scans for small bowel bleeding. Methods This retrospective study evaluated patients diagnosed with non-neoplastic small intestinal bleeding (including duodenum) who underwent abdominal CT at our institution from December 2013 to March 2023. Patients were categorized into diverticulum and non-diverticulum groups based on the cause of bleeding. Active bleeding was defined on the CT images as extravasation of contrast material in the intestinal lumen during the arterial phase and/or progressive accumulation of contrast material during the venous phase. We have documented the original report (extracted from the medical record system and additional consultation opinions from senior radiologists), including the presence of active bleeding and its potential bleeding location. Furthermore, two radiologists reassessed the CT images, seeking consensus on the diagnosis between them. Results The study included 165 patients, predominantly male, with a median age of 30 years. Active bleeding was identified in 48.3% of patients. Notably, all identified bleeding diverticula in the diverticulum group exhibited cul-de-sac termination. Among the identified causes of bleeding, Crohn’s disease was most prevalent (46.7%, N of causes = 64). Significant differences were observed in the diagnostic methods between the diverticulum and non-diverticulum groups, with surgery predominantly applied in the diverticulum group, and endoscopy in the non-diverticulum group (n = 49 vs n = 15, p = 0.001). Contrast agent extravasation was significantly higher in the diverticulum group (n = 54 vs n = 16, p = 0.001), and Meckel’s diverticulum cases appearing tubular were significantly higher than in other diverticulum cases (n = 25 vs n = 3, p < 0.001). Conclusion CT allows for a higher detection rate of diverticular bleeding, even if asymptomatic, guiding classification into multiple potentially clinically relevant categories. Critical relevance statement Contrast-enhanced CT imaging is effective in determining the location and cause of non-neoplastic small bowel bleeding, especially diverticular bleeding. Therefore, the use of enhanced CT should be prioritized in the diagnosis and management of small bowel bleeding. Key Points CT has potential value in the diagnosis of small bowel bleeding. CT imaging suggests possible surgical intervention for active bleeding detection. CT diagnoses and localizes small bowel bleeding, aiding in treatment and prioritizing in guidelines. Graphical Abstract

Abstract Objectives To achieve automated quantification of visceral adipose tissue (VAT) distribution in CT images and screen out parameters with discriminative value for inflammatory bowel disease (IBD) subtypes. Methods This retrospective multicenter study included Crohn’s disease (CD) and ulcerative colitis (UC) patients from three institutions between 2012 and 2021, with patients with acute appendicitis as controls. An automatic VAT segmentation algorithm was developed using abdominal CT scans. The VAT volume, as well as the coefficient of variation (CV) of areas within the lumbar region, was calculated. Binary logistic regression and receiver operating characteristic analysis was performed to evaluate the potential of indicators to distinguish between IBD subtypes. Results The study included 772 patients (365 CDs, median age [inter-quartile range] = 31.0. (25.0, 42.0) years, 255 males; 241 UCs, 46.0 (34.0, 55.5) years, 138 males; 166 controls, 40.0 (29.0, 53.0) years, 80 males). CD patients had lower VAT volume (CD = 1584.95 ± 1128.31 cm3, UC = 1855.30 ± 1326.12 cm3, controls = 2470.91 ± 1646.42 cm3) but a higher CV (CD = 29.42 ± 15.54 %, p = 0.006 and p ˂ 0.001) compared to UC and controls (25.69 ± 12.61 % vs. 23.42 ± 15.62 %, p = 0.11). Multivariate analysis showed CV was a significant predictor for CD (odds ratio = 6.05 (1.17, 31.12), p = 0.03). The inclusion of CV improved diagnostic efficiency (AUC = 0.811 (0.774, 0.844) vs. 0.803 (0.766, 0.836), p = 0.08). Conclusion CT-based VAT distribution can serve as a potential biomarker for distinguishing IBD subtypes. Critical relevance statement Visceral fat distribution features extracted from CT images using an automated segmentation algorithm (1.14 min) show differences between Crohn’s disease and ulcerative colitis and are promising for practical radiological screening. Key points • Radiological parameters reflecting visceral fat distribution were extracted for the discrimination of Crohn’s disease (CD) and ulcerative colitis (UC). • In CD, visceral fat was concentrated in the lower lumbar vertebrae, and the coefficient of variation was a significant predictor (OR = 6.05 (1.17, 31.12), p = 0.03). • The differences between CD, UC, and controls are promising for practical radiological screening. Graphical Abstract

(1) Background: pathological changes in hepatic Langerhans cell histiocytosis (LCH) have been observed; however, corresponding imaging findings can appear vague to physicians and radiologists. The present study aimed to comprehensively illustrate the imaging findings of hepatic LCH and to investigate the evolution of LCH-associated lesions. (2) Methods: LCH patients with liver involvement treated at our institution were retrospectively reviewed along with prior studies in PubMed. Initial and follow-up computed tomography (CT) and magnetic resonance imaging (MRI) were systematically reviewed, and three imaging phenotypes were created based on the lesion distribution pattern. Clinical features and prognoses were compared among the three phenotypes. Liver fibrosis was evaluated visually on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) values of the fibrotic areas were measured. Descriptive statistics and a comparative analysis were used to analyze the data. (3) Results: based on the lesion distribution pattern on CT/MRI scans, patients with liver involvement were categorized as the disseminated lesion phenotype, scattered lesion phenotype, and central periportal lesion phenotype. Patients with scattered lesion phenotype were typically adults, and only a few of them had hepatomegaly (npresent = 1, 1/6, 16.7%) and liver biochemical abnormalities (npresent = 2, 2/6, 33.3%); patients with central periportal lesion phenotype were typically young children, and hepatomegaly and biochemical abnormalities were more apparent in these patients than those with another phenotype; and those with the disseminated lesion phenotype were found in all age groups, and the lesions evolved rapidly on medical imaging. Follow-up MRI scans show more details and can better document the evolution of lesions than CT. T2-hypointense fibrotic changes, including the periportal halo sign (npresent = 2, 2/9, 22.2%), patchy liver parenchyma changes (npresent = 6, 6/9, 66.7%), and giant hepatic nodules close to the central portal vein (npresent = 1, 1/9, 11.1%), were found, while fibrotic changes were not observed in patients with the scattered lesion phenotype. The mean ADC value for the area of liver fibrosis in each patient was lower than the optimal cutoff for significant fibrosis (METAVIR Fibrosis Stage ≥ 2) in a previous study that assessed liver fibrosis in chronic viral hepatitis. (4) Conclusions: The infiltrative lesions and liver fibrosis of hepatic LCH can be well characterized on MRI scans with DWI. The evolution of these lesions was well demonstrated on follow-up MRI scans.

Behçet’s disease (BD) behaves similarly to Crohn’s disease (CD) when the bowel is involved. Computed tomography enterography (CTE) can accurately show intestinal involvement and obtain body composition data. The objective of this study was to evaluate whether CTE could improve the ability to distinguish between intestinal BD and CD. This study evaluated clinical, laboratory, endoscopic, and CTE features on first admission. Body composition analysis was based on the CTE arterial phase. The middle layers of the L1–L5 vertebral body were selected. The indicators assessed included: the area ratio of visceral adipose tissue (VAT)/subcutaneous adipose tissue (SAT) (VSR) in each layer, the total volume ratio of VAT/SAT, the quartile of VAT attenuation in each layer and the coefficient of variation (CV) of the VAT area for each patient was also calculated. Two models were developed based on the above indicators: one was a traditional model (age, gender, ulcer distribution) and the other was a comprehensive model (age, gender, ulcer distribution, proximal ileum involvement, asymmetrical thickening of bowel wall, intestinal stenosis, VSRL4, and CV). The areas under the receiver operating characteristic (ROC) curve of the traditional (sensitivity: 80.0%, specificity: 81.0%) and comprehensive (sensitivity: 95.0%, specificity: 87.2%) models were 0.862 and 0.941, respectively (p = 0.005).

Parasitic co-infection is commonly observed in natural populations, yet rare in the laboratory. Multiparasitism can have negative effects on the host, ranging from the atypical manifestations to increased mortality, consequently, it may be misdiagnosed and treated with unsuitable anthelmintic medicines. Therefore, reliable diagnosis is critical for appropriate treatment of parasitic co-infection. Herein, we report a case of a 31-year-old woman with persistent eosinophilia and hypoechoic liver lesion on ultrasound. The microscopic examination of multiple stool specimens did not find any pathogens. The patient had serum specific anti-Trichinella IgG antibody by Dot enzyme-linked immunosorbent assay (Dot-ELISA). After treatment with albendazole, contrast-enhanced magnetic resonance imaging (MRI) revealed more lesions in the liver. Subsequently, liver biopsy was performed in this patient and Fasciola hepatica was identified using metagenomic next-generation sequencing (mNGS) as well as polymerase chain reaction. After treatment with triclabendazole, which is the only anthelmintic drug specifically available against this fluke, her eosinophil count returned normal, and the liver lesions were significantly regressed. This case highlights the diagnostic challenge posed by parasitic co-infection, which merits more in-depth evaluation to confirm the diagnosis.

To investigate whether volumetric visceral adipose tissue (VAT) features extracted using radiomics and three-dimensional convolutional neural network (3D-CNN) approach are effective in differentiating Crohn’s disease (CD) and ulcerative colitis (UC). This retrospective study enrolled 316 patients (mean age, 36.25 ± 13.58 [standard deviation]; 219 men) with confirmed diagnosis of CD and UC who underwent CT enterography between 2012 and 2021. Volumetric VAT was semi-automatically segmented on the arterial phase images. Radiomics analysis was performed using principal component analysis (PCA) and the least absolute shrinkage and selection operator (LASSO) logistic regression algorithm. We developed a 3D-CNN model using VAT imaging data from the training cohort. Clinical covariates including age, sex, modified body mass index, and disease duration that impact VAT were added to the machine learning model for adjustment. The model’s performance was evaluated on the testing cohort separating from the model’s development process by its discrimination and clinical utility. Volumetric VAT radiomics analysis with LASSO had the highest AUC value of 0.717 (95% CI, 0.614–0.820), though difference of diagnostic performance among the 3D-CNN model (AUC = 0.693; 95% CI, 0.587–0.798) and radiomics analysis with PCA (AUC = 0.662; 95% CI, 0.548–0.776) and LASSO have not reached statistical significance (all p > 0.05). The radiomics score was higher in UC than in CD on the testing cohort (mean ± SD, UC 0.29 ± 1.05 versus CD −0.60 ± 1.25; p < 0.001). The LASSO model with adjustment of clinical covariates reached an AUC of 0.775 (95%CI, 0.683–0.868). The developed volumetric VAT–based radiomics and 3D-CNN models provided comparable and effective performance for the characterization of CD from UC. • High-output feature data extracted from volumetric visceral adipose tissue on CT enterography had an effective diagnostic performance for differentiating Crohn’s disease from ulcerative colitis. • With adjustment of clinical covariates that cause difference in volumetric visceral adipose tissue, adjusted clinical machine learning model reached stronger performance when distinguishing Crohn’s disease patients from ulcerative colitis patients.

Objective The aim of this study was to analyze the relationship between abdominal adipose tissue and perianal fistula activity in patients with Crohn's disease (CD) using cross-sectional imaging. Methods Patients with perianal fistulizing CD who underwent pelvic magnetic resonance imaging (MRI) and abdominal computed tomography (CT) were retrospectively enrolled. We scored the fistulas in each patient's MRI images based on Van Assche's classification. The area and density of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) (at the third, fourth, and fifth lumbar (L3, L4, and L5) levels were measured by averaging five slices of measurements at each vertebral level in CT images, and areas were further standardized by the lumbar height 2 (height L1-5 ). The VAT/SAT ratio (VSR) and VAT/Total adipose tissue (VA/TA) index were calculated. Based on MRI scores, patients were divided into two groups with low and high activity, and their clinical, MRI features, and CT parameters were compared. We evaluated patients with follow-up MRI and compared the differences in clinical and radiological indicators among patients with different outcomes. Results Overall, 136 patients were included, 77 in the low-activity group and 59 in the high-activity group. Patients in the high activity group had lower subcutaneous adipose index (all levels, p < 0.05) and visceral adipose index (L3 level, p < 0.01), but higher SAT and VAT density (all levels, p < 0.01), VSR (L5 level, p = 0.07) and VA/TA index (L5 level, p < 0.05). Conclusion There were differences in adipose tissue composition among CD patients with different active perianal fistulas.

RSNA2020腹部影像学对腹部多个脏器(肝脏、胆囊、胰腺、肾脏、前列腺、结直肠)从诊断及治疗方面进行研究,其中基于机器学习的影像学研究为肿瘤治疗相关的影像学组学及肿瘤预后等热门研究领域的有力分析工具.

Background The efficacy of computed tomography-based multiple body composition parameters in assessing disease behavior and prognosis has not been comprehensively evaluated in Crohn’s disease. This study aimed to assess the association of body composition parameters with disease behavior and outcomes in Crohn’s disease and to compare the efficacies of indexes derived from body and lumbar spinal heights in body composition analysis. Results One hundred twenty-two patients with confirmed Crohn’s disease diagnoses and abdominal computed tomography scans were retrospectively included in this study. Skeletal muscle, visceral, and subcutaneous fat indexes were calculated by dividing each type of tissue area by height 2 and lumbar spinal height 2 . Parameters reflecting the distribution of adiposity were also assessed. Principal component analysis was used to deal with parameters with multicollinearity. Patients were grouped according to their disease behavior (inflammatory vs. structuring/penetrating) and outcomes. Adverse outcome included need for intestinal surgery or anti-TNF therapy. Predictors of disease course from multiple parameters were evaluated using multivariate analysis. Indexes derived from body and lumbar spinal heights were strongly correlated ( r , 0.934–0.995; p < 0.001). Low skeletal muscle-related parameters were significantly associated with complicated disease behavior in multivariate analysis ( p = 0.048). Complicated disease behavior ( p < 0.001) and adipose tissue parameters-related first principal component ( p = 0.029) were independent biomarkers for predicting adverse outcomes. Conclusions Skeletal muscle and adipose tissue principle component were associated with complicated Crohn’s disease behavior and adverse outcome, respectively. Indexes derived from body and lumbar spinal heights have similar efficacies in body composition analysis.

Objective To evaluate the changes in magnetic resonance imaging-based body composition parameters during follow-ups in patients with Crohn's disease (CD). Methods Between November 1, 2017, and June 30, 2021, patients diagnosed with CD, who underwent two or more magnetic resonance enterography (MRE) scans at our institution were retrospectively reviewed. The baseline and one subsequent follow-up scan for each patient were paired to form longitudinal comparisons. Skeletal muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) indexes were calculated from tissue areas measured at the third lumbar vertebra level per scan, standardized by dividing the height 2 and lumbar height 2 (height L1–L5 ). We also assessed the correlation between changes in VAT to total adipose tissue ratio (VA/TA index) and CD activity scores (5-point MRE classification) using Spearman’s correlation analysis. A multivariate linear regression model was used to adjust for the follow-up duration and treatment type. Results Overall, 49 patients (with 49 paired scans) were enrolled. VA/TA index changes were negatively correlated with changes in skeletal muscle index (SMI; r = − 0.339, p < 0.05). The VA/TA index (52.69 ± 10.66% vs. 49.18 ± 10.80%, p < 0.001) and the total MRE score (8.0 ± 3.9 vs. 5.7 ± 3.4, p < 0.001) decreased significantly during follow-up, regardless of follow-up duration and treatment type (both p > 0.05). Changes in total MRE score were negatively correlated with SMI changes ( r = − 0.408, p < 0.01) but positively correlated with VA/TA index changes ( r = 0.479, p < 0.01). Conclusion An increase in SMI and a decrease in VA/TA index could reflect improved nutritional and inflammatory status.

Objective To classify adult intestinal malrotation by CT. Methods This retrospective study enrolled adults diagnosed with intestinal malrotation who underwent abdominal CT at our institution between June 1, 2013, and August 30, 2020. All patients’ clinical information was recorded. Patients were divided into groups undergoing surgical and conservative management. The duodenum (nonrotation, partial rotation, and malrotation), jejunum, cecum, and the superior mesenteric artery/superior mesenteric vein relationship were reviewed on the CT images of each patient, and classification criteria developed based on the first three items. For each patient, each item was assessed separately by three radiologists. Consensus was required from at least two of them. Results A total of 332 eligible patients (218 men and 114 women; mean age 51.0 ± 15.3 years) were ultimately included and classified into ten types of malrotation. Duodenal partial rotation was present in most (73.2%, 243/332) with only 25% (83/332) demonstrating nonrotation. The jejunum was located in the right abdomen in 98.2% (326/332) of cases, and an ectopic cecum was found in only 12% (40/332, 29 cases with a left cecum, 7 pelvic, and 4 at midline). Asymptomatic patients comprised 56.6% (188/332) of cases, much higher than that in previous studies (17%, n = 82, p < .001), comprised mainly of patients with duodenal partial rotation (80.3%, 151/188). In 91 patients with detailed clinical data available (12 managed surgically and 79 conservatively), a significant difference in malrotation CT categorization was identified ( p = .016). Conclusions CT enables greater detection of asymptomatic intestinal malrotation, enabling classification into multiple potentially clinically relevant subtypes.

To summarize the clinical and radiological features of hepatic trichinellosis. Patients diagnosed with trichinellosis and liver involvement in our institution since 2011 were included retrospectively. Then, qualified patients were divided into a seropositive group and a clinically diagnosed group. Preoperative liver CT and/or MRI images were evaluated independently by two radiologists. The correlations between the radiological and pathological features were evaluated by a radiologist and a pathologist. Independent t-tests were carried out to assess clinical data between groups and those reported in the previous literature. Values of P less than 0.05 were considered statistically significant. Eventually, ten patients were enrolled, five in each group. All patients recovered successfully after surgical (n = 8) or conservative treatment (n = 2). The clinical, radiological, and pathological features were highly consistent between the two groups. All patients were under 60 years of age (48.0 ± 7.9 years in the seropositive group, 48.6 ± 10.1 years in the clinically diagnosed group), and they were older than those previously reported in the literature (30.5 ± 17 years, n  =  31; P = 0.032 and 0.028). Eosinophilia was found in four patients, and all were mildly increased (˂ 1.5 × 109/L). Lesions in all patients were in the right lobe of the liver, and nine of them showed a characteristic ‘curved tunnel’ sign on DCE-MRI images. None of the patients had signs or evidence of extrahepatic infection. The ‘curved tunnel’ sign on MRI is a typical radiological feature in hepatic trichinellosis.