Dual-energy computed tomography (DECT) pulmonary angiography (CTPA) is widely studied for pulmonary embolism (PE) evaluation, but heterogeneity in protocols, platforms, and study designs complicates its clinical positioning. This narrative review, with structured search elements adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, synthesized evidence from PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (January 2016-June 2026); 28 studies were eligible (26 of 1,287 screened records and 2 identified through citation tracing). Evidence was organized into a three-tier framework (image quality, diagnostic performance, and clinical outcomes). Low-keV virtual monoenergetic imaging at 40-50 keV improves vascular attenuation and enables iodine load reduction to approximately 6 g in selected protocols. Pooled meta-analytic evidence shows no consistent diagnostic advantage of DECT over single-energy CT. The right ventricular/left ventricular diameter ratio remains the most stable prognostic indicator; DECT perfusion metrics have not surpassed it for mortality prediction. Iodine-map hypoperfusion in distal arteries is suspicious for, but not morphologically confirmed as, subsegmental PE; such findings carry a risk of overdiagnosis and warrant caution before anticoagulation. A body mass index- and estimated glomerular filtration rate-stratified protocol table with Oxford Centre for Evidence-Based Medicine 2011 evidence-level annotations is provided, and knowledge gaps in photon-counting CT, artificial intelligence, and cross-platform standardization are identified.

Congenital left-sided obstructive heart lesions (LSOLs) are a group of rare but serious congenital heart diseases. They encompass a spectrum of structural abnormalities that can obstruct blood flow at any point from the left atrium to the aortic arch. They are broadly divided into two main categories. The first is left ventricular inflow obstruction, including cor triatriatum sinister and congenital mitral stenosis. The second is left ventricular outflow obstruction, including subvalvular aortic stenosis, bicuspid aortic valve, supravalvular aortic stenosis, coarctation of the aorta, aortic arch hypoplasia, and interrupted aortic arch. When stenosis involves both left ventricular inflow and outflow obstructions, the condition is called Shone's syndrome. Computed tomography angiography (CTA) is a valuable tool for the diagnosis, treatment planning, and follow-up of LSOLs. Our goal is to review the CTA manifestations of LSOLs to better understand these congenital heart lesions.

Breast localization marker migration or malposition may create a practical need for image-guided retrieval or repositioning. The technique was performed in two patients using a coaxial needle system and aspiration-assisted marker capture. In both cases, the displaced marker was identified sonographically and accessed with a coaxial needle. Controlled aspiration drew the marker into the coaxial needle, followed by repositioning to the targeted area or removal from the body. No immediate complications occurred. Ultrasound-guided coaxial aspiration may represent an alternative in selected cases of migrated or malpositioned markers when standard vacuum-assisted excision is technically disadvantageous.

Artificial intelligence (AI) in radiology is often described as a sequence of architectures. This conceptual narrative review instead organizes its evolution around two questions: Which computational constraint was relaxed, and where did the resulting capability enter the radiologic chain from signal formation to recommendation? We identify five analytical epochs: handcrafted computer-aided detection, deep and volumetric learning, a branching stage of global-context modeling and learned reconstruction, multimodal foundation models, and an emerging stage of inference-stage reasoning. Epochs I-IV are characterized primarily by changes in representation or image formation; Epoch V shifts the frontier toward adaptive case-specific inference, for which radiology-specific evidence remains largely preclinical. The framework also generates a clinical prediction: Verification should be matched to the level of participation and its characteristic failure mode. Existing studies provide partial empirical support, but later-stage verification requirements remain framework-derived proposals rather than established standards.

This review summarizes established, emerging, and investigational techniques in pediatric thoracic magnetic resonance (MR) imaging (MRI), with emphasis on practical protocol optimization, motion mitigation, clinical implementation, and modality selection relative to computed tomography (CT). Thoracic MRI remains technically challenging because of low proton density, short apparent transverse relaxation time, and continuous cardiorespiratory motion. Conventional fast and motion- robust sequences, including single-shot T2-weighted imaging, three-dimensional T1-weighted spoiled gradient echo imaging, short tau inversion recovery, balanced steady-state free precession, and periodically rotated overlapping parallel lines with enhanced reconstruction/BLADE, are well established and form the basis of routine clinical protocols. Contrast-enhanced MR angiography, perfusion imaging, diffusion-weighted imaging, and dynamic functional imaging are clinically available for selected indications, particularly in experienced centers. In contrast, ultrashort and zero echo time imaging remain emerging techniques because availability, reconstruction, and implementation vary across vendors and institutions. Non-contrast functional approaches, including Fourier decomposition and arterial spin labelling, remain predominantly investigational, and hyperpolarized gas MRI is primarily research-oriented and requires specialized infrastructure. Protocols should be adapted to patient age, cooperation, and the clinical question, using coaching, feed-and-wrap, sedation, or anesthesia when necessary. Magnetic resonance imaging can replace or complement CT in selected settings, including serial assessment of complicated pneumonia, cystic fibrosis, congenital thoracic abnormalities, mediastinal lesions, chest wall disorders, and selected vascular conditions. However, CT remains the reference standard for rapid emergency assessment, subtle interstitial abnormalities, and very small pulmonary nodules. Wider adoption of advanced MRI techniques will require protocol standardization, automated reconstruction and post-processing, cross-platform reproducibility, and prospective multicenter validation.