Roxana Elena Coroiu

Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogenous clinical syndrome in which aetiologies range from “true” ischemic mechanisms to non-ischemic mimics (e.g., myocarditis and Takotsubo syndrome). Cardiac magnetic resonance (CMR) plays a central role in the diagnostic pathway. Recent advances in parametric mapping (native T1, T2, and extracellular volume ECV) and evolving AI/radiomic methods promise to further improve diagnostic accuracy and prognostic stratification. This review aims to evaluate the current CMR evidence in MINOCA, while highlighting parametric mapping advances and future directions in the sphere of AI and radiomics. Methods: A systematic literature search of PubMed and the Directory of Open Access Journals (DOAJ) was performed. We included original prospective and retrospective CMR studies of MINOCA and MINOCA-like presentations in adults. Data were extracted into a master dataset and synthetised thematically into five subsections: (1) diagnostic yield, (2) reclassification rate), (3) timing of CMR, (4) prognosis, and (5) future directions. Results: Twenty-two studies met the inclusion criteria. CMR diagnostic yield varied by protocol and timing but was consistently substantial. CMR consistently reclassified initial MINOCA diagnoses (ischemia or alternative non-ischemic diagnoses). Parametric mapping provided incremental diagnostic and prognostic information. Across studies, early imaging (ideally within the first 1–2 weeks) increased diagnostic yield, while delayed CMR reduced detectability of transient lesions. Early AI and radiomics work show promise for LGE-based classification and for predicting post-contrast findings from non-contrast data, but current models require larger, multicentre training and robust external validation. Conclusions: CMR increases diagnostic yield and reclassification rates in MINOCA, particularly when performed early and with standardised T1/T2/ECV mapping. Mapping not only improves detection of inflammatory and diffuse injuries but also contributes to prognostic stratification. High-resolution LGE, OCT, and AI/radiomics are promising future refinements but need prospective validation in large, early, mapping-inclusive cohorts.

Background: CT perfusion (CTP) is increasingly used in the evaluation of acute ischemic stroke (AIS) and may complement non-contrast CT (NCCT) and CT angiography (CTA). This review aimed to assess the role of CTP in patient selection for reperfusion therapy, its prognostic value, and the influence of technical factors, collateral assessment, and post-processing software. Methods: A literature search of PubMed, DOAJ, and Google Scholar (2014–2025) identified 119 articles; after screening, 39 met inclusion criteria. Only studies on adult AIS patients investigated with CTP were included. Data were synthesized across eight thematic categories: core/penumbra estimation, prognosis, treatment selection, collateral assessment, software validation, technical parameters, reliability, and safety. Results: CTP improved identification of infarct core, penumbra, and collateral status, aiding patient selection for endovascular therapy, particularly beyond 6 h. Limitations included variability in tissue thresholds, “ghost infarct core,” and differences across software. Technical advances, such as “one-stop-shop” protocols and low-kV acquisition, reduced treatment delays and radiation. Reliability studies showed CTP to be less accurate than diffusion-weighted MRI, while safety analyses confirmed a low risk of contrast-induced nephropathy. Conclusions: CTP enhances patient stratification and outcome prediction, supporting individualized treatment strategies. Standardization of protocols and validation of software remain necessary before CTP can serve as a reliable alternative to MRI-DWI.

Renal cysts have become more commonly recognized in asymptomatic patients due to the improvement and frequency of the use of advanced imaging modalities, such as CT and MRI. The purpose of the following review is to illustrate the main and most important aspects of renal cysts, including a checklist of top differential diagnoses and also, their further management and treatment options. Some renal cysts can have significant clinical implications; this is why increased awareness of these renal lesions is of the utmost importance to avoid diagnostic pitfalls or further complications.

Clear cell renal cell carcinoma is the most frequent type of renal cell carcinoma, which is often diagnosed incidentally in an advanced stage. We present the case of a 49-year-old man who presented to the emergency department with no specific symptoms. After computed tomography (CT) evaluation, the suspicion was raised of a left renal tumour. The aim of this case study is to underline the importance of rapid diagnosis and further investigation of clear cell renal cell carcinoma and the severity of this type of cancer. Clear cell renal cell carcinoma has no specific symptoms. For the complete diagnosis and further monitoring, the use of CT is necessary. Clear cell renal cell carcinoma treated with partial nephrectomy can relapse near the surgical scar and progress with metachronous bilateral adrenal metastases, especially when close follow-up is not performed due to the pandemic situation.

McCune–Albright syndrome is a rare sporadic disease characterized by bone fibrous dysplasia, café-au-lait skin spots and a variable association of hyperfunctional endocrine disorders. Fibrous dysplasia (FD), which can involve the craniofacial, axial, and appendicular skeleton, may range from an isolated, asymptomatic monostotic lesion to a severe disabling polyostotic disease involving the entire skeleton. A twenty-five-year old male patient presented to our clinic with recently developed heart palpitations. He had also been feeling pain in the right femur since he was younger, without any trauma history, leading to difficulties of ambulation and limping occasionally. His physical examination revealed café-au-lait spots with irregular borders and right testicular agenesis. Laboratory findings identified hyperthyroidism with hyperparathyroidism. Radiographs of the pelvis revealed multiple lytic lesions of the right femur and magnetic resonance imaging (MRI) characterized these lesions as specific to fibrous dysplasia of the bone, without any insufficiency fracture at this level.The association of café-au-lait skin spots with bone fibrous dysplasia, and hyperthyroidism in this patient suggested the diagnosis of McCune – Albright syndrome.

Hemimegalencephaly on magnetic resonance imaging scan (MRI) consists of cortical gray matter almost uniformly abnormal, areas of increased thickness of the cortical gray matter (GM), abnormal gyral patterns, blurring of the grey-white matter transition, atrophy or hemispheric hypertrophy, demyelination, gliosis. We present a case of ten-year-old boy with a history of infantile spasms and developmental delay who presented to the pediatric neurology room with an episode of disinhibited behavior in family environment. An MRI was performed and isolated hemimegalencephaly with polymicrogyria of the right occipital lobe was diagnosed.

Epidural abscess in infancy is very rare and has non-specific features, requiring very careful attention and early diagnosis. We present a case of a 3-month-old girl in which the diagnosis of spontaneous cervical epidural abscess developed after an initial episode of acute enterocolitis and was subsequently identified at a later visit to the emergency department for right-upper extremity hypotonia. Endoscopy revealed slightly domed retro pharynx and magnetic resonance imaging (MRI) scan showed cervical spondylodiscitis at the level of intervertebral disc C5-C6 with right-sided epidural abscess that compressed the spinal cord and right C6 nerve root, without extension into superior mediastinum. The systemic antibiotic treatment with meropenem and clindamycin solved the symptoms but the spondylodiscitis complicated with vertebral body fusion which can be symptomatic or not in the future and needs follow-up. Cervical spontaneous spondylodiscitis with abscess is very rare, especially in this age group. This case emphasizes the importance of investigating an upper extremity motor deficiency in infancy and diagnosing any potential spondylodiscitis complication.