Luigi Tessitore

Meniscal ramp lesions (RAMP) are longitudinal tears at the meniscocapsular or meniscotibial attachments of the posterior horn of the medial meniscus, commonly associated with anterior cruciate ligament (ACL) tears. Their preoperative detection on standard MRI remains limited, especially for "hidden" variants. Magnetic resonance arthrography (MRA) may theoretically enhance visualization of the posteromedial compartment through capsular distension and improved tissue contrast; however, its diagnostic superiority remains to be validated. This pictorial review introduces a conceptual MRA-based framework for describing ramp lesions (types A-E), derived from previously reported anatomical and imaging concepts in the literature and illustrated with representative institutional cases. The proposed framework emphasizes lesion topography, morphology, and contrast-medium behavior on MRA and is intended as an educational and hypothesis-generating model rather than as a validated diagnostic tool. Further studies with arthroscopic correlation, reproducibility assessment, and prospective validation are needed to determine the diagnostic and clinical value of this framework.

Background/Objectives: To evaluate dual-energy computed tomography (DECT) in comparison with conventional CT for periprosthetic bone and surrounding soft tissues in total hip arthroplasty (THA). Methods: Two authors independently screened titles and abstracts for eligibility, discussing any disagreements with a third author for final decisions. The articles were categorized into two main groups: those focusing on periprosthetic bone and those on blood vessels or pelvic organs. Results: A total of 37 articles were selected to be included in this systematic review. Conclusions: Our systematic review reveals significant variability in the use of DECT for periprosthetic bone and soft tissue imaging, due to differences in equipment, protocols, and clinical settings. While many studies indicate that virtual monochromatic imaging (VMI), especially when combined with metal artifact reduction (MAR), improves image quality, there is no consensus on optimal energy levels. Future research should focus on large-scale, multicenter studies with standardized protocols to compare reconstruction techniques, energy levels, and combined MAR-VMI use.

Dual-Energy computed tomography (DECT) with its various advanced techniques, including Virtual Non-Contrast (VNC), effective atomic number (Z-eff) calculation, Z-maps, Iodine Density Index (IDI), and so on, holds great promise in the diagnosis and management of urogenital tumours. In this narrative review, we analyze the current status of knowledge of this technology to provide better lesion characterization, improve the staging accuracy, and give more precise treatment response assessments in relation to urological tumours.