Accuracy Of Magnetic Resonance Imaging In Diagnosis Research Articles

Factors Limiting Magnetic Resonance Imaging Diagnosis of Placenta Accreta Spectrum.

Placenta accreta spectrum (PAS) disorders are characterized by an abnormal adherence of the placenta to the uterine myometrium. Magnetic resonance imaging (MRI) is an important adjunct in antenatal diagnosis. We sought to determine if there are patient and MRI characteristics that limit the accuracy of PAS diagnosis and degree of invasion. We conducted a retrospective cohort analysis of patients who were evaluated for PAS by MRI from January 2007 to December 2020. Patient characteristics evaluated included number of prior cesarean deliveries, history of dilation and curettage (D&C) or dilation and evacuation (D&E), short interval pregnancy less than 18 months, and delivery body mass index (BMI). All patients were followed until delivery and MRI diagnosis was compared with final histopathology. Of the 353 patients with suspected PAS, 152 (43%) underwent MRI evaluation and were included in the final analysis. In patients who underwent MRI evaluation, 105 (69%) had confirmed PAS on pathology. Patient characteristics were similar between groups and not associated with accuracy of MRI diagnosis. MRI was accurate in diagnosing PAS and the associated degree of invasion in 83 (55%) patients. Accuracy was associated with lacunae (8 vs. 0%, p = 0.02), abnormal bladder interface (25 vs. 6%, p = 0.002), and T1 hyperintensity (13 vs. 1%, p = 0.002). Of the 69 (45%) patients in whom MRI was inaccurate, overdiagnosis was seen in 44 (64%) patients and underdiagnosis in 25 (36%) patients. Overdiagnosis was significantly associated with dark T2 bands (45 vs. 22%, p = 0.005). Underdiagnosis was associated with earlier gestational age at MRI (28 vs. 30 weeks, p = 0.049) and lateral placentation (16 vs. 2.4%, p = 0.025). Patient factors did not change MRI accuracy of PAS diagnosis. MRI is associated with a significant overdiagnosis of PAS when dark T2 bands are present, and underdiagnose PAS when performed earlier in gestation or when lateral placentation is present. · Patient factors are not associated with MRI accuracy of PAS diagnosis.. · MRI overdiagnoses PAS invasion when there are dark T2 bands.. · MRI underdiagnoses PAS invasion when performed earlier in gestation.. · Underdiagnosis of PAS is associated with lateral placentation..

Accuracy of MRI in Diagnosis of Invasive Placenta by Taking Per Operative Findings as Gold Standard

Objective: To assess the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting invasive placentas using per-operative findings as the gold standard.Methodology: A prospective cross-sectional study was conducted in the diagnostic radiology department of KRL General Hospital Islamabad during Oct 2019 to Sep 2021. Sixty prenatal individuals were identified as having a high risk of invasive placenta and underwent MRI (Phillips 1.5 T) to confirm the diagnosis. A trainee radiologist and a consultant radiologist reviewed the images. The MRI's sensitivity, specificity, positive predictive value, negative predictive value, and accuracy was calculated using a 2×2 contingency tables. Results: Ten cases of invasive placenta were detected postoperatively (gold standard). The MRI had a sensitivity of 90%, a specificity of 93%, a positive predictive value of 90%, a negative predictive value of 90%, and an accuracy of 92.3 percent, respectively. Conclusion: The study concluded that magnetic resonance imaging (MRI) offers a good diagnostic accuracy and is a reproducible technology for prenatal identification of invasive placentas.

Diagnostic Performance of Magnetic Resonance Imaging for Detection of Acute Appendicitis in Pregnant Women; a Systematic Review and Meta-Analysis.

The diagnosis of acute appendicitis (AA) in pregnant women is commonly challenging owing to the normal results of laboratory tests, organ displacement, and normal physiological inflammatory alterations. This meta-analysis aimed to investigate the accuracy of magnetic resonance imaging (MRI) in diagnosis of AA in pregnant women. Two investigators independently performed a comprehensive systematic literature search of electronic databases including MEDLINE, Cochrane Central, EMBASE, Web of Science, Scopus, and Google Scholar to identify studies that reported accuracy of MRI for diagnosis of AA in pregnant women from inception to April 1, 2022. Our systematic search identified a total of 525 published papers. Finally, a total of 26 papers were included in the meta-analysis. The pooled sensitivity and specificity of MRI in diagnosis of AA in pregnant women were 0.92 (95% CI: 0.88-0.95) and 0.98 (95% CI 0.97-0.98), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 29.52 (95% CI: 21.90-39.81) and 0.10 (95% CI: 0.04-0.25), respectively. The area under hierarchical summary receiver operating characteristic (HSROC) curve indicated that the accuracy of MRI for diagnosis of AA in pregnant women is 99%. This meta-analysis showed that MRI has high sensitivity, specificity, and accuracy for diagnosis of AA in pregnant women and can be used as a first-line imaging modality for suspected cases of AA during pregnancy. Furthermore, it should be noted that when the result of ultrasonography is inconclusive, the use of MRI can reduce unnecessary appendectomy in pregnant patients.

Clinical value of MRI, serum SCCA, and CA125 levels in the diagnosis of lymph node metastasis and para-uterine infiltration in cervical cancer

BackgroundCervical cancer shows great differences in depth of invasion, metastasis, and other biological behaviors. The location of the lesion is special, so it is usually difficult to determine the clinical stage. This study aimed to explore the clinical value of magnetic resonance imaging (MRI) and tumor serum markers for the preoperative diagnosis of cervical cancer lymph node metastasis and para-uterine invasion.MethodsA total of 200 patients with cervical cancer admitted to our hospital from January 2019 to January 2020 were collected as the research subjects. Comparing the diagnosis results of preoperative MRI scan, serum tumor markers, and postoperative pathological examination using single factor comparison, we determined the MRI scan results, the comprehensive matching rate between serum tumor markers (squamous cell carcinoma antigen (SCCA), carbohydrate antigen 125 (CA125)) and postoperative pathological results, and the differences of sensitivity, specificity, and accuracy in the prediction of lymph node metastasis and para-uterine infiltration of cervical cancer.ResultsThe levels of SCCA and CA125 in patients with para-uterine invasion and lymph node metastasis were higher than those of patients without invasion and metastasis. Among them, the level of SCCA was significantly different (P<0.05). The level of CA125 was not statistically significant (P>0.05), so MRI combined with serum SCCA was selected for combined diagnosis in the later period. The sensitivity, specificity, and accuracy of MRI diagnosis of cervical cancer and para-uterine infiltrating lymph node metastasis and metastasis were 55.2, 91.6, and 89.5% and 55.2, 91.6, and 89.5%, respectively. These data in MRI combined with serum SCCA were 76.3, 95.3, and 94.3% and 63.2, 96.0, and 95.1%, respectively. The accuracy of tumor markers combined with MRI in the diagnosis of cervical cancer lymph node metastasis and para-uterine invasion was higher than that of MRI.ConclusionsMRI combined with serum SCCA can more accurately identify cervical cancer lymph node metastasis and para-uterine invasion compared with MRI alone. Tumor marker combined with MRI diagnosis is an important auxiliary method for cervical cancer treatment and can provide comprehensive and reliable clinical evidence for evaluation before cervical cancer surgery.

Evaluation of magnetic resonance imaging in staging of rectal cancer and its relationship with P16 expression.

To explore the use of magnetic resonance imaging (MRI) in the staging of rectal cancer and its relationship with p16 expression. A total of 75 patients with rectal cancer treated in Oncology Department of our hospital from March 2013 to March 2017 were randomly included in this study. The entire pelvis was scanned by MRI, and clinicopathological staging was diagnosed. Subsequently, all patients underwent total mesorectal excision (TME). Histopathological gold standard [hematoxylin-eosin (HE) staining] was used to determine the stage. Immunohistochemistry (IHC) was adopted to detect the expression of p16 in cancer tissues and cancer-adjacent tissues. Compared with the results of the pathological examination, the accuracy of MRI diagnosis was analyzed. The relationship between p16 expression and MRI diagnostic materials was analyzed. Compared with the results of the pathological examination, the total accuracy of MRI in the evaluation of T staging was 76.0% (57/75), and the excessive staging rate and insufficient staging rate were 8.0% (6/75) and 16.0% (12/75), respectively in the assessment of tumor T staging. IHC indicated that the positive expression rate of p16 in the tumor tissues was significantly lower than that in the tumor-adjacent tissues [34.67% (26/75) vs. 85.33% (64/75), p<0.05]. The chi-square test showed that the expression of p16 in the tumors was notably correlated with T staging, N staging, and myometrial invasion diagnosed with MRI. P16 is significantly deficient in the rectal cancer tissues. MRI examination and identification are helpful for clinical diagnosis of rectal cancer staging. The combination of the two items may be helpful for the diagnosis of clinical rectal cancer staging and the establishment of reasonable treatment regimens.

Comparative analyses of diagnostic methods in knee injuries

Objective: This study is analyzing the role and significance of the three diagnostic methods (clinical diagnosis, magnetic resonance imaging (MRI) and arthroscopy), in establishing accurate diagnosis in knee injuries. The goal is to determine the diagnostic accuracy of each diagnostic method, using arthroscopy as gold standard. Material and Methods: We examined 70 patients with knee injuries. Clinical diagnosis was established using patient's history and positive clinical tests for meniscal lesions, ACL injury and articular cartilage lesions. All patients underwent MRI on a 1.5 T magnet for MRI diagnosis. This was followed by arthroscopy for making the final diagnosis. Results: We analyzed the results of clinical tests for meniscal, ligamentous and articular cartilage injuries of the patients in both groups. Validity of the clinical tests was compared to the results got from MRI and arthroscopy. Accuracy of clinical diagnosis versus MRI diagnosis for medial(69.6% vs. 68.5%) and lateral (84% vs. 82.6%) meniscal lesions was almost identical. Accuracy of clinical diagnosis compared with the accuracy of MRI diagnosis for ACL injuries was higher (91.3% vs. 81.4%). Accuracy (85.5% vs. 72.8%) of clinical diagnosis versus MRI diagnosis for articular cartilage lesions was better. Conclusion: Affirmation of clinical diagnosis in this study is a result of usage of standard clinical signs and tests which are fundamental in establishing clinical diagnosis of knee injuries. MRI is a diagnostic method which enriches the diagnostic process. Arthroscopy is defined as superior diagnostic method, also a gold standard for comparison of the other two diagnostic methods.

Solitary liver lesions in children: interobserver agreement and accuracy of MRI diagnosis

PurposeThe purpose of the study was to evaluate interobserver agreement (IOA) and accuracy of magnetic resonance imaging (MRI) diagnosis of pediatric solitary liver lesions (PSLLs). MethodsFifty consecutive MRIs performed for PSLLs were reviewed to assess IOA and agreement between consensus imaging diagnosis and final diagnosis indicating accuracy using kappa statistics. ResultsIn 39/50 cases, the MRI diagnosis given by two readers matched with substantial IOA (kappa=0.7294). There was moderate agreement (kappa=0.60784) between consensus imaging diagnosis and the final diagnosis in 10 cases with available pathology. ConclusionBased on the limited available pathology and follow-up, we found that most PSLLs can be noninvasively characterized and accurately diagnosed using MRI.

Accuracy of magnetic resonance imaging for diagnosis and preoperative assessment of deeply infiltrating endometriosis

Objective To evaluate the accuracy of preoperative magnetic resonance imaging (MRI) findings relative to surgical presence of deeply infiltrating endometriosis (DIE). Methods This prospective study included 92 women with clinical suspicion of DIE. The MR images were compared with laparoscopy and pathology findings. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI for diagnosis of DIE were assessed. Results DIE was confirmed at histopathology in 77 of the 92 patients (83.7%). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI to diagnose DIE at each of the specific sites evaluated were as follows: retrocervical space (89.4%, 92.3%, 96.7%, 77.4%, 90.2%); rectosigmoid (86.0%, 92.9%, 93.5%, 84.8%, 89.1%); bladder (23.1%, 100%, 100%, 88.8%, 89.1%); ureters (50.0%, 100%, 95.5%, 95.7%); and vagina (72.7%, 100%, 100%, 96.4%, 96.7%). Conclusion MRI demonstrates high accuracy in diagnosing DIE in the retrocervical region, rectosigmoid, bladder, ureters, and vagina.

The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis

Magnetic resonance imaging (MRI) may be used to diagnose deep vein thrombosis (DVT) in patients for whom ultrasound examination is inappropriate or unfeasible. We undertook a systematic review of the literature and meta-analysis to estimate the diagnostic accuracy of MRI for DVT. We searched databases of medical literature and citation lists of retrieved articles. We selected studies that compared MRI with a reference standard in patients with suspected DVT or suspected pulmonary embolus, or high-risk asymptomatic patients. Data were analysed by random effects meta-analysis. We included 14 articles in the meta-analysis. Most compared MRI with venography in patients with clinically suspected DVT. The pooled estimate of sensitivity was 91.5% (95% CI: 87.5-94.5%) and the pooled estimate of specificity was 94.8% (95% CI: 92.6-96.5%). Sensitivity for proximal DVT was higher than sensitivity for distal DVT (93.9% versus 62.1%). However, pooled estimates should be interpreted with caution as estimates of both sensitivity and specificity were subject to significant heterogeneity (P<0.001). Individual studies reported sensitivity ranging from zero to 100%, while specificity ranged from 43 to 100%. MRI has equivalent sensitivity and specificity to ultrasound for diagnosis of DVT, but has been evaluated in many fewer studies, using a variety of different techniques.

Inflammation, infection, cavitary disorders, and ischemia

Demyclinating lesions of the spinal cord, including multiple sclerosis as well as other less common diseases, probably represent the etiology of a substantial proportion of all idiopathic myelopathies. Magnetic resonance imaging (MRI) has made major advances in the diagnosis and characterization of demyclinating disease. Infections of the spine may have severe consequences and, if detected early, are usually treatable processes. Osteomyelitis and epidural abscesses have characteristic imaging findings. Poor outcomes are more often due to delays in clinical presentation or the debilitated condition of the patients than to limitations in the accuracy of MRI diagnosis. Cavitary lesions of the spinal cord were among the first applications in which MRI proved its superiority to previously available techniques. Accurate diagnosis of these lesions involves detecting characteristics findings and relating these observations to the clinical history. Spinal cord infarction is relatively rare due to the extensively collateralized blood supply to the spinal canal. However, aortic aneurysms and the surgery for these lesions places the blood supply of the distal spinal cord and conus at risk. The syndrome of postoperative spinal cord infarction has characteristic clinical findings. However, MRI may contribute to distinguishing transient ischemia from true infarction and to predicting the severity of the final deficit.