Background/Objectives: Myocarditis is a recognized complication of COVID-19 infection, with potential long-term cardiac sequelae. While acute cardiac involvement has been frequently reported, late-stage myocardial effects remain less well characterized. Cardiac magnetic resonance (CMR) imaging, particularly T1 and T2 mapping, offers non-invasive tissue characterization for myocardial inflammation and fibrosis. This study aimed to evaluate segmental myocardial tissue changes in patients with late-stage COVID-19–related myocarditis using CMR and compare findings with patients with non-COVID-19 myocarditis and healthy controls. Methods: This retrospective, single-center study included 25 patients with clinically suspected COVID-19 myocarditis who underwent CMR between 36 and 565 days post-infection. T1 and T2 mapping values and late gadolinium enhancement (LGE) patterns were assessed and compared with 14 non-COVID-19 myocarditis patients and 19 healthy controls. Subgroup analyses were performed according to vaccination status and left ventricular ejection fraction (LVEF). Results: Patients with reduced LVEF had significantly higher T1 and T2 values in several myocardial segments. Compared to controls, the COVID-19 myocarditis group showed significantly elevated T1 values in all segments except 2 and 3. No significant difference in T2 values was observed. LGE was present in 61% of COVID-19 myocarditis patients, predominantly with a subepicardial pattern. No significant differences were observed between vaccinated and unvaccinated patients. Conclusions: Late-stage COVID-19 myocarditis is associated with persistent segmental myocardial tissue abnormalities, particularly elevated T1 values and subepicardial LGE. Segmental CMR mapping may provide additional diagnostic value in identifying residual myocardial injury in patients with ongoing cardiac symptoms after COVID-19 infection.

Objective: Sympathetic nervous system hyperactivation in chronic conditions, such as hypertension and metabolic syndrome, can lead to carotid body (CB) hyperplasia, potentially mimicking small carotid body tumours (CBTs) in radiological evaluations. This study aimed to investigate CT angiography (CTA) findings to differentiate CBTs from non-neoplastic CBs. Methods: Patients were categorized into CBT and non-neoplastic CB groups. Demographics (smoking status, hypertension, diabetes mellitus), shape, dimensions, volume, and density (including standard deviations) were assessed. Density ratios were calculated using CB/CBT and ipsilateral common carotid artery density. Diagnostic performance was evaluated via ROC analysis, and logistic regression identified factors associated with increased CBT risk. Results: Significant differences between the CB and CBT groups were found in gender, smoking status, and shape (P < .01), while age, location, hypertension, and diabetes mellitus showed no association (P > .05). The CBT group had significantly higher density, standard deviation, and density ratios (P < .001). Multivariate analysis, adjusted for age, gender, and smoking, showed that saddle shape, standard deviation ≥21.5, and density ratio ≥0.5603 predicted CBT diagnosis with 92.6% sensitivity and 99.3% specificity. Conclusions: Saddle shape, along with increased density and standard deviation values, emerges as findings suggestive of a CBT diagnosis. The proposed imaging features may improve differentiation of small CBTs from non-neoplastic CBs, particularly in cases with enlarged CBs lacking typical tumour features. Advances in knowledge: Specific CTA findings, including saddle shape, increased density, and standard deviation, can effectively differentiate small CBTs from non-neoplastic CBs, offering a novel approach to improving radiological diagnostics in cases with CB hyperplasia.

SUMMARY OBJECTIVE: Endometrial hyperplasia is a precursor lesion that may progress to endometrial carcinoma, particularly in cases with atypia. Early and accurate diagnosis is essential for timely intervention. The aim of the study was to evaluate the diagnostic performance of shear wave elastography in differentiating normal endometrium, non-atypical hyperplasia, and atypical hyperplasia in premenopausal women with abnormal uterine bleeding. METHODS: This prospective study included 235 premenopausal women over 45 years of age with abnormal uterine bleeding. All patients underwent transvaginal ultrasonography and shear wave elastography using a Toshiba Aplio 500 system. Five regions of interest were placed within heterogeneous endometrial areas, and mean shear wave elastography (mean-SWE) and highest shear wave elastography (highest-SWE) values were recorded. Histopathological evaluation was performed via probe curettage, and patients were categorized into three groups: normal endometrium, non-atypical hyperplasia, and atypical hyperplasia. Receiver operating characteristic curve analysis and logistic regression were conducted. RESULTS: Mean-SWE and highest-SWE values were significantly higher in the hyperplasia groups compared to the normal endometrium group (p=0.021, p=0.001). Highest-SWE had the highest diagnostic accuracy (cut-off: 37.71 kPa, sensitivity: 85.9%, specificity: 48.0%). Logistic regression identified body mass index, uterine free fluid, mean-SWE, and highest-SWE as independent predictors of endometrial hyperplasia (p<0.05). CONCLUSIONS: Shear wave elastography demonstrated significant potential as a non-invasive tool for diagnosing endometrial hyperplasia. Mean-SWE and highest-SWE were independent predictors, supporting shear wave elastography as a complementary method to transvaginal ultrasonography. Future research should optimize shear wave elastography protocols for gynecological assessments.