Magnetic Resonance Imaging Experience Research Articles

Journey to the Center of the Bore: A Service Evaluation of the Patient Experience in Magnetic Resonance Imaging

IntroductionPatient experience is an essential component of delivering person-centered care. This is particularly the case for patients referred for magnetic resonance imaging (MRI) which is a known trigger of emotional anxiety and stress. MethodsPatients referred for MRI were invited to participate in a service evaluation via a survey. The aim was to record and report upon their experience of MRI and what mattered to them when having a scan. Insights on their use of support strategies and their considered effectiveness were also obtained. ResultsPatients experienced the early stages of their journey as an emotional low, with greatest concern noted on entry to the scan room and during the scan. The importance of staff interaction was emphasized along with being sufficiently informed on what to expect. ConclusionThe experience of MRI varies from patient to patient but understanding the potential sources and triggers of anxiety that may require additional support can help staff better deliver person-centered care.

Intravoxel Incoherent Motion Diffusion-Weighted Imaging for Predicting and Monitoring the Response of Anti-Angiogenic Treatment in the Orthotopic Nude Mouse Model of Lung Adenocarcinoma.

The treatment efficacy of angiogenesis inhibitor could be underestimated at an early stage based on tumor volume changes. Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) can quantitatively assess tumors at the cellular level, but it is unclear whether it can provide useful information for assessing treatment response of anti-angiogenic treatment for lung adenocarcinoma. To determine the use of IVIM-DWI for non-invasive monitoring of the early response to anti-angiogenic treatment in the orthotopic transplantation of lung adenocarcinoma model. Prospective. Thirty-seven nude mice were randomized into two groups: treatment group (received bevacizumab + cisplatin, N= 20) and control group (received saline, N= 17). Single-shot turbo spin-echo (TSE) IVIM-DWI, TSE T2-weighted imaging at 3.0 T. Tumor volume, IVIM parameters (apparent diffusion coefficient [ADC], diffusivity [D], perfusion fraction [f], and pseudo-diffusion coefficient [D*]) were measured before and 2 hours, 3, 7, 10 and 14 days after treatment. Regions of interest were manually drawn along the inner edge of the tumor by two radiologists with 5 and 10-year experience in magnetic resonance imaging. Pathological examinations (hematoxylin and eosin stain, cluster of differentiation 34) were performed. Kolmogorov-Smirnov test, repeated-measure two-way analysis of variance test, Mann-Whitney U test, Pearson correlation analysis, receiver operating characteristic curve. P< 0.05 was considered statistically significant. The tumor volume of the two groups was significantly different only on day 14 (control group vs. treatment group, 43.15 ± 18.28 mm3 vs. 28.41 ± 1.71 mm3 ). ADC2h , ADC10d , D2h , D7d , D10d , and D14d were significantly higher, while f10d and f14d were significantly lower in the treatment group compared to those of the control group. Both the △ADC2h (r=-0.631) and △D2h (r=-0.700) showed moderate correlations with the relative tumor volume on day 14. IVIM has the potential to predict and monitor the early response to anti-angiogenic treatment, earlier than size changes, for lung adenocarcinoma. 2 TECHNICAL EFFICACY: Stage 4.

Making Magnets More Attractive

Patient comfort is an important factor of a successful magnetic resonance (MR) examination, and improvements in the patient's MR scanning experience can contribute to improved image quality, diagnostic accuracy, and efficiency in the radiology department, and therefore reduced cost. Magnet designs that are more open and accessible, reduced auditory noise of MR examinations, light and flexible radiofrequency (RF) coils, and faster motion-insensitive imaging techniques can all significantly improve the patient experience in MR imaging. In this work, we review the design, development, and implementation of these physics and engineering approaches to improve patient comfort.

Nonoperative Treatment of Elbow Ulnar Collateral Ligament Injuries With and Without Platelet-Rich Plasma in Professional Baseball Players: A Comparative and Matched Cohort Analysis

Background: Recent studies evaluating nonoperative treatment of elbow ulnar collateral ligament (UCL) injuries augmented with platelet-rich plasma (PRP) have shown promising results. To date, no comparative studies have been performed on professional baseball players who have undergone nonoperative treatment with or without PRP injections for UCL injuries. Hypothesis: Players who received PRP injections would have better outcomes than those who did not receive PRP. Study Design: Cohort study; Level of evidence, 3. Methods: The Major League Baseball (MLB) Health and Injury Tracking System identified 544 professional baseball players who were treated nonoperatively for elbow UCL injuries between 2011 and 2015. Of these, 133 received PRP injections (PRP group) before starting their nonoperative treatment program, and 411 did not (no-PRP group). Player outcomes and a Kaplan-Meier survival analysis were compared between groups. In addition, to reduce selection bias, a 1:1 matched comparison of the PRP group versus the no-PRP group was performed. Players were matched by age, position, throwing side, and league status: major (MLB) and minor (Minor League Baseball [MiLB]). A single radiologist with extensive experience in magnetic resonance imaging (MRI) interpretation of elbow injuries in elite athletes analyzed 243 MRI scans for which images were accessible for tear location and grade interpretation. Results: Nonoperative treatment of UCL injuries resulted in an overall 54% rate of return to play (RTP). Players who received PRP had a significantly longer delay in return to throwing (P < .001) and RTP (P = .012). The matched cohort analysis showed that MLB and MiLB pitchers in the no-PRP group had a significantly faster return to throwing (P < .05) and the MiLB pitchers in the no-PRP group had a significantly faster RTP (P = .045). The survival analysis did not reveal significant differences between groups over time. The use of PRP, MRI grade, and tear location were not statistically significant predictors for RTP or progression to surgery. Conclusion: In this retrospective matched comparison of MLB and MiLB pitchers and position players treated nonoperatively for a UCL tear, PRP did not improve RTP outcomes or ligament survivorship, although there was variability with respect to PRP preparations, injection protocols, time from injury to injection, and rehabilitation programs. MRI grade and tear location also did not significantly affect RTP outcomes or progression to surgery.

The Fetal Magnetic Resonance Imaging Experience in a Large Community Medical Center

Fetal magnetic resonance imaging (MRI) continues to prove a useful problem solving tool for diagnostic and management decision making issues encountered in the antenatal period. In this paper, we attempt to review basic fetal MRI protocol considerations and demonstrate key imaging findings through multiple modalities, with pathologic correlation in several cases. A study of five fetal MRI cases, from our institution, were selected in order to highlight both the indications for, and benefits obtained from this advanced imaging technique. Fetal MRI proved useful in each case in better defining fetal anomalies, especially where ultrasound (due to drawbacks such as shadowing by pelvic bones) was unable to be completely diagnostic. The more in-depth study made possible by MRI also helped with formulation of disease prognosis and estimation of survival chances of the fetus. Further, MRI as a diagnostic and prognostic tool has become more ubiquitous across the medical community. This imparts tangible benefit to patients, who are now able to find this service within arm's reach. Whereas previously these patients were obligatorily referred up to 90 miles away from our centre for further medical work-up, now a large percentage can obtain their prenatal imaging and perinatal care locally. In addition, medical education benefits as new types of cases, those with pathology of the antenatal period, are retained for work-up and management in these large community settings. Cases from our institution exemplify these types of pathologies, from fetal chest masses to a syndromic presentation of bilateral renal agenesis.

Magnetic Resonance Elastography for the Noninvasive Staging of Liver Fibrosis

The purpose of our study was to prospectively compare the success rate and diagnostic accuracy of magnetic resonance elastography, ultrasound elastography, and aspartate aminotransferase to platelets ratio index (APRI) measurements for the noninvasive staging of fibrosis in patients with chronic liver disease. We performed a prospective blind comparison of magnetic resonance elastography, ultrasound elastography, and APRI in a consecutive series of patients who underwent liver biopsy for chronic liver disease in a university-based hospital. Histopathologic staging of liver fibrosis according to the METAVIR scoring system served as the reference. A total of 141 patients were assessed. The technical success rate of magnetic resonance elastography was higher than that of ultrasound elastography (133/141 [94%] vs 118/141 [84%]; P = .016). Magnetic and ultrasound elastography, APRI measurements, and histopathologic analysis of liver biopsy specimens were technically successful in 96 patients. The areas under the receiver operating characteristic curves of magnetic resonance elasticity (0.994 for F >or= 2; 0.985 for F >or= 3; 0.998 for F = 4) were larger (P < .05) than those of ultrasound elasticity, APRI, and the combination of ultrasound elasticity and APRI (0.837, 0.709, and 0.849 for F >or= 2; 0.906, 0.816, and 0.936 for F >or= 3; 0.930, 0.820, and 0.944 for F = 4, respectively). Magnetic resonance elastography has a higher technical success rate than ultrasound elastography and a better diagnostic accuracy than ultrasound elastography and APRI for staging liver fibrosis.

The Bronchi

Recent advances in high-resolution computed tomography (HRCT), inspiratory/expiratory CT staining of the lung, helical multiplanar reconstruction CT, and a broadened experience in magnetic resonance imaging of bronchial pathological conditions provide additional diagnostic information about the bronchi. This article reviews diffuse and focal lesions involving the large bronchi and small airways of the lung.

Magnetic resonance imaging of the musculoskeletal system.

During the last few years, the interest and experience in magnetic resonance imaging (MRI) of the musculoskeletal system has increased rapidly. Modern equipment with good spatial resolution and multislice, multiecho technique provides detailed information on the joints, soft tissue and spine within a reasonable examination time, both with superconductive and resistive systems. Today, MRI is an established technique for examination of musculoskeletal tumors and aseptic bone necrosis and it has proven to be of great value for evaluation of diseases of the spine and spinal canal. The definite place of MRI within musculoskeletal diagnostic imaging is not yet settled, but its potential is great, and it will have an important role in the future.