Clinical Value Of MRI Research Articles

Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children

BackgroundHumeral lateral condyle fractures (HLCFs) are common paediatric fractures. Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs.Methods60 children who should be suspected to be HLCFs in clinical practice from Dec 2015 to Nov 2017 were continuously included as the first part patients. Subsequently, 35 HLCFs patients with complete follow-up information who had no obvious displacement on radiograph were the second part patients. The sensitivity and specificity of radiograph and MRI in diagnosing of HLCFs and their stability were calculated respectively. Calculated the sensitivity and specificity of each scan sequence of MRI in diagnosing of HLCFs osteochondral fractures. The degree of fracture displacement was measured respectively. Compared the ratio of surgical treatment, secondary fracture displacement and complications between the stable fracture group and the unstable fracture group on MRI in part 2 patients.ResultsSensitivity of diagnosing HLCFs by MRI was significantly higher than radiograph (100.00% vs. 89.09%, P = 0.03). Sensitivity of diagnosing integrity of trochlear cartilage chain by MRI was 96.30%, which was significantly higher than that by radiograph (62.96%, P < 0.01). The sensitivity of cartilage sensitive sequence (3D-FS-FSPGR/3D-FSPGR) was different with FS-PDWI and FS-T2WI (P = 0.01 and P = 0.02, respectively). The degree of HLCFs displacement by MRI was higher than radiograph (P < 0.05). In the unstable fracture group, 5 cases (45.45%) had a fracture displacement of more than 2 mm on MRI, which was significantly higher than that in stable fracture group (0.00%, P < 0.01).ConclusionsMRI is superior to the radiograph of elbow joint in evaluating and diagnosing children HLCFs and their stability. The coronal 3D-FS-FSPGR/3D-FSPGR sequence is a significant sequence for diagnosing osteochondral fractures in HLCFs. MRI can provide important clinical value for treatment decisions of HLCFs without significant displacement.

Comparative Analysis of Clinical Value of MRI and MSCT in the Diagnosis of Pancreatic Cystic Lesions

Comparative Analysis of Clinical Value of MRI and MSCT in the Diagnosis of Pancreatic Cystic Lesions

Clinical Value of MRI in the Diagnosis of Lumbar Disc Herniation

Clinical Value of MRI in the Diagnosis of Lumbar Disc Herniation

Clinical value of MRI, interictal 18F-FDG and 11C-FMZ PET/CT imaging in the diagnosis of hippocampal sclerosing refractory epilepsy

Objective To compare the lateralization accuracy and localization accuracy of MRI, interictal 18F-fluorodeoxyglucose(FDG) and 11C-flumazenil(FMZ) PET/CT imaging for refractory epilepsy(REP) in patients with hippocampal sclerosis(HS). Methods A total of 41 classical HS patients (25 males, 16 females; age: 15-61 years) with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed. All patients underwent MRI, interictal 18F-FDG and 11C-FMZ PET/CT imaging, followed by the resection of epileptogenic foci. The pathological diagnosis was taken as the gold standard. Visual and semi-quantitative analyses were used to analyze the images. The lateralization accuracy and localization accuracy of the three imaging methods for epileptogenic foci were calculated and compared(χ2 test). Results The lateral accuracy and localization accuracy of MRI were 70.73%(29/41) and 60.98%(25/41), those of interictal 18F-FDG PET/CT imaging were 78.05%(32/41) and 70.73%(29/41), and those of interictal 11C-FMZ PET/CT imaging were 100%(41/41) and 100%(41/41), respectively. The interictal 11C-FMZ PET/CT imaging was the best among 3 imaging methods(χ2 values: 1.976-12.902, all P<0.01). Conclusions All 3 imaging methods have their advantages and limitations. The interictal 11C-FMZ PET/CT imaging has a high value in the localization of classical HSREP, which can significantly improve the diagnostic accuracy of classical HSREP and guide clinical operation. Key words: Epilepsy, temporal lobe; Sclerosis; Hippocampus; Positron-emission tomography; Tomography, X-ray computed; Flumazenil; Carbon radioisotopes; Deoxyglucose; Magnetic resonance imaging

Clinical value of MRI in the diagnosis of placental implantation

Objective To determine imaging features that may help predict the presence of placenta accreta, placenta increta or placenta percreta on prenatal MRI scanning in order to identify the most diagnostic findings. Methods The prenatal MRI scan data of placenta accreta, placenta increta or placenta percreta (placenta implantation group, n=15) and normal placenta(placenta normal group, n=15) diagnosed and treated by surgical pathology from January 2010 to December 2017 in the People's Hospital of Huadu District were retrospectively analyzed.Two expert MRI doctors were blinded to the patients' true diagnosis and were asked to score a total of 10 MRI features of the placenta and adjacent structures.The interrater reliability was assessed using kappa statistics.The features with a moderate kappa statistic or better(kappa>0.40 ) were then compared with the true diagnosis for each observer. Results Eight of the scored features had an interobserver reliability of kappa>0.40: placenta previa(κ=0.89); abnormal uterine bulging(κ=0.57); intraplacental hemorrhage(κ=0.45); the presence of dark intraplacental bands on T2W imaging(κ=0.76); flow-empty blood vessels in placenta(κ=0.67); border on placenta and uterus blurring(κ=0.63); heterogeneity of signal intensity on T2-weighted(T2W) imaging(κ=0.53); and continuity of myometrium was interrupted(κ=0.64). Using Fisher's two-sided exact test, there were statistically significant differences between the proportion of patients with placental invasion and those without placental invasion for three of the features: abnormal uterine bulging(P=0.015, P=0.011); heterogeneity of T2W imaging signal intensity(P=0.006, P=0.013); and presence of dark intraplacental bands on T2W imaging(P=0.032, P=0.010). Conclusion MRI can be a useful adjunct to ultrasound in diagnosing placenta accreta prenatally.Three features that are seen on MRI in patients with placental invasion appear to be useful for diagnosis: uterine bulging; heterogeneous signal intensity within the placenta; and the presence of dark intraplacental bands on T2W imaging. Key words: Magnetic resonance imaging; Placenta diseases; Placenta accreta; Placenta previa; Prenatal diagnosis; Diagnosis

Comparison of the clinical value of CT and MRI in the early diagnosis of cerebral infarction

Objective To compare the clinical value of CT and MRI in the early diagnosis of cerebral infarction. Methods 50 patients with cerebral infarction were selected.All patients underwent CT and MRI examination within 6 hours of the onset.The clinical value and diagnostic accuracy of two kinds of examination methods were compared. Results The CT examination diagnosed 8 cases of cerebral infarction, the diagnostic accuracy of CT examination was 16.0%.The MRI diagnosed 48 cases of cerebral infarction, the diagnostic accuracy of MRI examination was 96.0%.The diagnostic accuracy of MRI was significantly higher than CT(χ2=8.019, P<0.05). Conclusion The clinical value of MRI in the early diagnosis of cerebral infarction is higher than CT, it can clearly show the location of lesions, morphology, size, MIR is conducive to the early diagnosis of cerebral infarction and is helpful for clinical treatment in a timely manner. Key words: Tomography, spiral computed; Magnetic resonance imaging; Infarction, middle cerebral artery; Early diagnosis

Clinical value of MRI in treatment choice of anterior disc displacement with reduction

Objective To investigate the clinical value of MRI in treatment choice of anterior disc displacement with reduction. Methods 1.5 T superconducting MR was used to scan bilateral temporomandibular joints in 72 consecutive patients who were diagnosed by MRI as unilateral (66 patients) /bilateral(6 patients) anterior disc displacement with reduction at closed and open mouth. MRI sequences included oblique sagittal T2 weighted image and proton density weighted image, and 78 joints' images were acquired. According to the severity of clinical symptoms, all joints were divided into severe symptom group (45 joints) and mild symptom group (33 joints). Treatment was performed in severe symptom group, while follow up was conducted in mild symptom group. Disk position(angle between posterior margin of the disc and the condyle vertical line), disk morphology(biconcave, biplanar, biconvex, rounded, folded, thick posterior band), and joint effusion (none effusion, mild effusion, moderate effusion, marked effusion) were evaluated by two radiologists. The observer agreement for image evaluation was calculated using Kappa statistics. Group difference in disk position was compared using t-test and Chi-square test was used to compare group difference in disk morphology and joint effusion. Results The Kappa value between two radiologists were 0.816 and 0.832 (P<0.01) on evaluation of disk morphology and joint effusion. Statistical results indicated that the angles between posterior margin of the disc and the condyle vertical line in severe symptom group (54.2±10.9)° were larger than those in mild symptom group (46.4±9.0)° (t=3.37, P<0.05). There was no significant difference in disc deformation incidence between the two groups (χ2=1.18, P=0.277). The common deformation in sever symptom group was thick posterior band (χ2=5.65, P<0.05), and in mild symptom group was biplanar (χ2=5.67, P<0.05). No statistical difference in joint effusion incidence was observed(χ2=1.02, P=0.312). Moderate and marked effusion were more common in sever symptom group than that in mild symptom group (χ2=6.55, P<0.05). Conclusions MRI is a useful tool for making treatment choice in anterior disc displacement with reduction. Treatment should be given when the following occurred on MRI: moderate anterior disc displacement, disc deformation (excepting for biplanar), moderate or marked joint effusion. Key words: Temporomandibular joint dysfunction syndrome; Temporomandibular joint disk; Magnetic resonance imaging; Anterior disc displacement with reduction

MRI diagnosis of osteochondral lesions in the talus and the dynamic follow up analysis after osteochondral transplantation

To investigate MRI findings of osteochondral lesions in the talus;to evaluate the value of MRI in diagnosing and determining the stage of osteochondral lesions;to analyze the follow up clinical value of MRI in osteochondral transplantation of autologous bone. A total of 79 patients from February 2013 to March 2015 had been retrospectively analyzed. All the patients were treated in our hospital. The ankle arthroscopy results were used as the reference standard, and the accuracy of MRI in diagnosis and Hepple staging had been investigated. Fifteen patients with cartilage transplantation of autologous bone were followed up with MRI examination and evaluation of cartilage repair score(MOCART) after one year. The values of MRI in the postoperative follow up were analyzed. Hepple staging of 79 patients was shown as follows:7 cases of stage I, 12 cases of stage II, 24 cases of stage III, 16 cases of stage IV, and 20 cases of stage V. Ankle arthroscopy grading of 59 patients in this group(in addition of 20 cases of stage V):2 cases of grade A, 2 cases of grade B, 4 cases of grade C, 14 cases of grade D, 22 cases of grade E, and 15 cases of grade F. The accuracy rate of MRI in determining Hepple V was set at 100%, and Hepple stage I corresponds to the arthroscopic A, B, C stage, stage II corresponds to D stage, stage III corresponds to E stage, stage IV corresponds to F stage. The accuracy rate of MRI in determining Hepple stage I to IV was 87.5%, 85.7%, 95.4% and 93.3% respectively. After cartilage transplantation of autologous bone, MRI of 15 patients showed cartilage surface in transplanted area was smooth, bone healed well, and the surrounding edema disappeared. The MOCART was 30 to 80 scores with an average score 59.0±15.6;9 cases of these 15 patients were(9/15, 60%) higher than 60 score. MRI plays a significant role in clinical diagnosis and staging of the talus osteochondral injury. As a method of long term follow up after cartilage transplantation, MRI can well evaluate the rapair of the postoperative osteochondral injury.

Accuracy of MRI, mammography (MG), and 2D and 3D ultrasound (2DUS/3DUS) in determining the pathologic tumor response after neoadjuvant chemotherapy (NACT) in breast cancer patients.

1067 Background: The pathological tumor response in patients with locally advanced breast cancer to NACT is essential for survival and for surgical strategies. Therapy monitoring based on German recommendations is routinely performed by clinical examination, MG and 2DUS. The clinical value of MRI and 3DUS has not been established yet. The aim of the study was to determine the accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) between the different imaging techniques in predicting postoperative histological tumor response after NACT. Methods: Patients with primary breast cancer (cT1-T4, cN0-1, M0) undergoing neoadjuvant chemotherapy between 2005 and 2010 were eligible for this prospective trial. The response was measured by MRI, MG, 2DUS and 3DUS for complete or partial remission versus stable disease after the last cycle of treatment and compared with the final pathological response. Patients with progressive disease were excluded from the study. Statistical analysis was done by calculating the accuracy of each imaging technique and the size difference between imaging and histological tumor size. Sensitivity, specificity, PPV and NPV were calculated for complete or partial pathological response. The study was approved by the local ethic committee (BCD001 194/2004). Results: 103 patients with the mean age of 47.7 (range 24.5 – 71.4) years were evaluated. The accuracy was 0.680 (95%CI: 0.580 -0.768) for MRI, 0.563 (95%CI: 0.453-0.669) for MG, 0.724 (95%CI: 0.618 -0.815) for 2DUS and 0.710 (95%CI: 0.588-0.813) for 3DUS. Sensitivity, specificity, PPV and NPV were 78%, 47%, 75% and 52% for MRI, 61%, 45%, 69% and 36% for MG, 93%, 23%, 74% and 60% for 2DUS, 94%, 19%, 73% and 57% for 3DUS. The mean (standard deviation) size difference was -1.8 mm (14.8) on MRI, 1.5 mm (26.0) on MG, -9.1mm (19.1) on 2DUS and for the volume difference -6916mm3 (15831) on 3DUS. Conclusions: The data suggest that 2DUS is sufficient in predicting tumor response between NACT treatment. MRI and MG are more accurate the 2DUS in predicting the tumor size for surgical planning.

The clinical value of MRI using single-shot echoplanar DWI to identify liver involvement in patients with advanced gastroenteropancreatic-neuroendocrine tumors (GEP-NETs), compared to FSE T2 and FFE T1 weighted image after i.v. Gd-EOB-DTPA contrast enhancement

SummaryBackgroundTo assess the detection rate of liver lesions in patients with advanced gastroenteropancreatic neuroendocrine carcinomas (GEP-NETs) using echo planar (EP) DWI (diffusion weighted imaging) as compared to standard FSE T2 wi and FFE T1 wi with i.v. (Gd-EOB)-DTPA.Material/MethodsThis prospective single-institution study included 55 patients with liver involvement confirmed by GEP-NETs 1.5T MRI system, using FSE T2, EP DWI and FFE T1 with i.v. (Gd-EOB)-DTPA. The potential differences between detection rates of liver deposits using 3 different MR approaches and between groups of patients were compared.ResultsMean number of liver deposits: FSE T2=20.7, FFE T1=25.7 and tested EP DWI=24.0. No significant difference was found in overall detection rate of liver deposits seen in 3 different techniques. A significant difference in detection rate of liver deposits was noted between male vs. female and secreting vs. non-secreting cancers. There was nearly perfect agreement between both observers, and each of the tested MRI approaches in regards to number of detected liver lesions (Cohen’s κ=0.848–1).ConclusionsThere were no significant differences among the 3 different MRI approaches in detection rates of liver deposits. Perfect agreement with high detection rate of liver deposits provides a rationale for the use of EP DWI in follow-up studies in GEP-NET patients.

Appearance and clinical value of MRI in sinonasal embryonal rhabdomyosarcoma

To investigate the appearance and clinical value of MRI in the diagnosis of embryonal rhabdomyosarcoma in nasal cavity and paranasal sinuses. The clinical, pathological and MRI findings of five patients with pathology proved embryonal rhabdomyosarcoma in nasal cavity and paranasal sinuses were retrospectively analyzed. The major clinical symptoms included nasal obstruction (4 cases), exophthalmus (4 cases), decreased eyesight (2 cases), epistaxis (1 case), decreased olfactory sensation (1 case) and restriction of eyeball movement (1 case). All 5 cases involved multi-location. Among them, 4 cases mainly located in the ethmoid sinus, one mainly located in the nasal septum. According to the IRS, 1 case was at stage II, the other 4 cases were at stage III. Compared to the grey matters, on T1 weighted image, the masses were homogenously isointensity in 2 cases, isointensity with patchy hyperintensity in 3 cases. On T2 weighted images, the masses were slightly hyperintensity with patchy hypointensity in 2 cases. Slightly hyperintensity with patchy hyperintensity in 3 cases. All 5 cases were markley heterogeneously enhanced after administration of contrast agents, with patchy of non-enhanced area. Of them, two were grape-like enhanced. Four cases presented with intratumor hemorrhage. Five with bony destruction. All of the 5 cases showed orbits and anterior cranial fossa meningeal involvement. There are some special MRI findings in embryonal rhabdomyosarcoma located in nasal cavity and paranasal sinuses. MRI can depict the encroachment of the tumor accurately, and may play an important role in clinical staging and in curative effect evaluation.

The clinical value of MRI in the diagnosis of small-bowel diseases

Objective To evaluate the feasibility and the clinical value of MRI in the diagnosis of small-bowel disease. Methods Sixty-three patients with suspected small-bowel diseases and 3 volunteers without signs of small bowel disease underwent MRI examination. Thirty-one patients whose diagnoses were confirmed by pathology or clinical results were categorized into two groups (neoplastic and normeoplastic). The conspicuity of bowel wall, the sensitivity of MRI in detecting small-bowel lesions, and the accuracy rate of diagnosis were calculated. The average bowel wall thickness between the two groups was assessed by using Wilcoxon signed-rank test. Enlarged mesenteric lymph nodes, mesenteric infiltration, and small-bowel stenosis were analyzed by using Fisher's exact test in each group respectively. Results MRI examinations of all 66 subjects were successfully performed. Images were rated on a continuous 4-peint scale. Sixty-two cases (93.9%) were scored as 2 or 3. The diagnoses of 31 patients (neoplastic group (n = 10) and nonneoplastic group (n = 21) were confirmed by pathology or clinical results. The sensitivity, accuracy of MRI in identifying small bowel diseases were 100% (31/31) and 77.4% (24/31) respectively. The average bowel wall thickness of the two groups was 23 mm(7.0-65.0 mm) and 5 mm(2.0-35.0 mm) respectively, and there was a statistically significant difference between the two groups (Z = - 2.949, P 0.05). Conclusion MRI can depict the location and extension of the small-bowel disease accurately and it is an effective method in the diagnosis of small-bowel disease. Key words: Intestine,small; Intestinal diseases; Magnetic resonance imaging

Clinical value of MRI on wrists with arthritis

目的 研究各种关节炎腕关节MRI表现,及其对关节炎的鉴别诊断的价值.方法搜集在风湿科曾有腕关节疼痛病史的门诊及住院患者151例,男45例,女106例.进行临床及双腕关节MR检查.151例中临床诊断类风湿性关节炎80例、未分化脊柱关节病29例、血清阴性脊柱关节病20例、其他结缔组织关节病22例.结果 80例类风湿性关节炎均可见双侧血管翳表现,29例未分化脊柱关节病中3例可见双侧血管翳表现,24例可见单侧血管翳表现,20例血清阴性脊柱关节病中4例可见双侧血管翳表现,15例可见单侧血管翳表现;22例其它结缔组织关节病中21例可见单侧血管翳表现.MRI显示各种关节炎组单侧血管翳差异无统计学意义(χ2＝6.157,P>0.05).各种关节炎组在双侧关节血管翳方面的差异有统计学意义(χ2＝126.882,P<0.001).类风湿性关节炎与未分化脊柱关节病(χ2＝94.192,P<0.001)、类风湿性关节炎与血清阴性脊柱关节病(χ2＝70.354,P<0.001)、类风湿性关节炎与其他结缔组织关节病(χ2＝96.174,P<0.001)差异均有统计学意义.结论 MRI在各种关节炎的鉴别诊断中具有重要价值。

Clinical value of MRI concerning dissection of the supraaortic vessels

Purpose: Evaluation of the potential of MRI concerning dissection of the supra-aortic vessels after cervical trauma. Patients and methods: During the time period from August 1998 to February 2001, 148 patients with trauma were examined by means of MRI scan of the neck / cervical spine or skull concerning morphology of the cervical spine as well as the brain tissue. MRI sequences were weighted T 1 and T 2 before and after contrast medium in transverse and sagittal slices. Additional time of flight (TOF) sequences and contrast-enhanced angiography were aquired. The MRI images were examined by two experienced radiologists when tied consensus was reached. Results: 7 patients (4,7%) with a total of 9 dissections of the vertebral and/or internal carotid artery were found; diagnosis was done on TOF images, contrast enhances MR-angiography, transversal T 1 - and T 2 -weighted sequences as well as T 1 -weighted images post-contrast medium. Therapy was changed accordingly in 4 cases and anticoagulation initiated. Conclusion: All patients with cervical injuries should be screened by MRI including MR-angiography, T 1 -weighted images pre- and post-contrast agent to achieve a sure diagnosis concerning the precise size of the dissection. MRI has proven to be an excellent diagnostic tool for our patient group.