Magnetic Resonance Imaging Examination Research Articles

Clinicoradiological and Arthroscopic Correlation of Meniscal Injuries

Background: Menisci in knee joint serve very important functions of distributing joint stresses and stabilizing the joint. Meniscus tears are on the rise because of increased sports participation. Along with detailed history taking, the physical examination and special investigations such as magnetic resonance imaging (MRI) are required to diagnose meniscal injuries. A diagnostic arthroscopy is considered as the gold standard. Owing to heavy work duties, overdependence on MRI without due clinical examination is on the rise. The aim of our study was to correlate the findings of clinically diagnosed meniscal tears with its radiological and arthroscopic findings and to find out the reliability of clinical examination and MRI in meniscal injuries considering arthroscopy as the gold standard. Materials and Methods: It was a prospective, longitudinal study performed over 12 months. All patients fulfilling inclusion criteria underwent clinical examination and MRI scan; the data obtained were evaluated and correlated with arthroscopic findings. Using necessary equations sensitivity, specificity and accuracy were calculated. Results: The clinical examination showed sensitivity, specificity, and accuracy of 75%, 90.62%, and 83.33%, respectively, when correlated with arthroscopy. MRI scan showed sensitivity, specificity, and accuracy of 82.86%, 92%, and 86.67%, respectively, when correlated with arthroscopy. Conclusion: MRI and clinical examination are comparably sensitive, specific, and accurate for diagnosing meniscal injuries with a subtle preference toward MRI. Author recommends a thorough clinical examination should suffice, but having a MRI scan beforehand is always beneficial in the absence of other concerns to do MRI.

Structural and Functional Alterations of the Deltoid Muscle After Arthroscopic Rotator Cuff Repair: A 2-Year Longitudinal Observation Study.

Deltoid muscle detachment and atrophy have been reported to occur after shoulder surgery. To investigate the 2-year changes in deltoid muscle structure and function after arthroscopic rotator cuff repair (ARCR) using magnetic resonance imaging (MRI) and electrophysical examination. Case series; Level of evidence, 4. A total of 72 patients (72 shoulders) who underwent ARCR between 2015 and 2020 were enrolled. Whole deltoid muscle volume and regional (anterior, lateral, and posterior) muscle thicknesses were determined on T2-weighted MRI scans of both shoulders taken preoperatively and at 1, 3, 6, 12, and 24 months postoperatively, and their correlations with compound muscle action potentials (CMAPs), shoulder abduction muscle strength, and Constant scores were investigated. Comparison between groups was performed using paired or Student t tests, and the relationship between deltoid muscle volume and various factors was determined using Pearson correlation analysis. The volume of the deltoid muscle on the affected side decreased from 44,369 ± 12,371 mm3 preoperatively to 38,139 ± 10,615 mm3 at 1 month postoperatively (P < .05), representing a 14% decrease. The deltoid muscle volume of the contralateral side also significantly decreased during the same time frame, from 43,278 ± 12,248 to 40,273 ± 11,464 mm3 (P < .05), representing a 7% decrease at 1 month postoperatively. Subsequently, the deltoid muscle volume on both sides recovered to preoperative levels at 12 months and was maintained at 24 months. Only the thickness of the anterior part of the deltoid was markedly decreased, from 13.9 ± 3.7 mm preoperatively to 12.0 ± 3.2 mm at 1 month postoperatively (P < .05), representing a 14% reduction. The CMAP amplitude showed a significant decrease at 1 month postoperatively; however, no significant difference was observed after 12 months when compared with the preoperative values or the values on the contralateral side. Positive correlations were found between deltoid muscle volume and CMAP amplitude at 24 months as well as between deltoid muscle volume and shoulder abduction muscle strength (R 2 = 0.698; P < .05) and Constant score (R 2 = 0.133; P < .05). Our study demonstrated that the early structural and functional decline of the deltoid muscle after ARCR was fully recovered within 1 year, confirming that this procedure does not negatively affect the deltoid muscle.

Iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) for evaluation of early bone mass changes in ageing osteoporosis patients

This study explored the application value of iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) technology in the early diagnosis of ageing osteoporosis (OP). 172 participants were enrolled and underwent magnetic resonance imaging (MRI) examinations on a 3.0T scanner. 100 cases were included in the normal group (50 males and 50 females; mean age: 45 years; age range: 20–84 years). 33 cases were included in the osteopenia group (17 males and 16 females; mean age: 55 years; age range: 43–83 years). 39 cases were included in the OP group (19 males and 20 females; mean age: 58 years; age range: 48–82 years). Conventional T1WI and T2WI were first obtained, followed by 3D-IDEAL-IQ-acquisition. Fat fraction (FF) and apparent transverse relaxation rate (R2*) results were automatically calculated from IDEAL-IQ-images on the console. Based on T1W and T2W-images, 300 ROIs for each participant were manually delineated in L1-L5 vertebral bodies of five middle slices. In each age group of all normal subjects, each parameter was significantly correlated with gender. In male participants from the normal, osteopenia, and OP groups, statistical analysis revealed F values of 11319.292 and 180.130 for comparisons involving FF and R2* values, respectively (all p<0.0001). The sensitivity and specificity of FF values were 0.906 and 0.950, 0.994 and 0.997, 0.865 and 0.820, respectively. For R2*, they were 0.665 and 0.616, 0.563 and 0.519, 0.571 and 0.368, respectively. In female participants from the normal, osteopenia, and OP-groups, statistical analysis revealed F values of 12461.658 and 548.274 for comparisons involving FF and R2* values, respectively (all p<0.0001). The sensitivity and specificity of FF values were 0.985 and 0.991, 0.996 and 0.996, 0.581 and 0.678, respectively. For R2*, they were 0.698 and 0.730, 0.603 and 0.665, 0.622 and 0.525, respectively. Significant differences were indicated in the quantitative values among the three groups. FF value had good performance, while R2* value had poor performance in discriminating osteopenia and OP-groups. Overall, the IDEAL-IQ technique offers specific reference indices that enable noninvasive and quantitative assessment of lumbar vertebrae bone metabolism, thereby providing diagnostic information for OP.

MR staging of rectal cancer: Comparison between the 2012 and 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guidelines

PurposeTo compare the adherence of the interpretation and reporting staging system, respectively proposed in the 2012 and 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guidelines for Magnetic Resonance Imaging (MRI) staging of rectal cancer, focusing on the improvement offered by the criteria introduced by 2016 ESGAR guidelines. MethodFifty-six patients affected by rectal cancer were included; 25/56 patients underwent upfront surgery; 31 underwent to neo-adjuvant chemo-radiotherapy before surgery. All patients underwent 3 T MRI examination for local staging. All MR exams were evaluated by two radiologists with 20- and 4-years’ experience, who were blinded to each other; the T and N stages, the Mesorectal Fascia (MRF) status and the Extramural Vascular Invasion (EMVI) were assessed according to both 2012 and 2016 ESGAR guidelines. The correlation between radiological and pathological findings, as well as the MRI staging were evaluated. ResultsAs to the expert reviewer, no significant differences were found by comparing the MR T and N stages, T and N restaging, MRF status and EMVI according to 2012 and 2016 ESGAR guidelines. As to the 4-years’ experience radiologist the MR staging agreement between 2012 and 2016 guidelines was “moderate” in N-stage evaluation and “fair” in T-restaging evaluation. No significant discrepancies were found for other parameters. ConclusionsMRI is a reliable method in rectal cancer staging/restaging. The assessment of T-restaging is improved by adopting the 2016 ESGAR guidelines, especially for non-expert readers; this result could be justified by the introduction of diffusion-weighted imaging. On the contrary, the newest guidelines do not improve the diagnostic performance in assessing nodal staging and restaging.

Correlation between post-chemotherapy MRI and histopathology of malignant bone tumors treated with extra-articular resection.

Magnetic resonance imaging (MRI) remains the gold standard for diagnosing tumoral joint involvement; however, its interpretation remains uncertain due to the presence of perilesional edema that can lead to unjustified arthrectomy. The aim of the study is to identify precise MRI signs that are predictive of joint involvement. This retrospective multicenter study included 25 patients who underwent extra-articular resection for malignant bone tumor with suspected joint involvement at the shoulder, hip, or knee, between January 2004 and July 2023. Joint resection was indicated based on preoperative MRI examination. MRI signs of joint involvement were joint effusion, capsuloligamentous invasion, disruption of articular cartilage, and intra-articular tumor mass. We then compared histopathological "true" joint involvement of the resected specimen with its preoperative MRI diagnosis. Extra-articular resection was performed in 9 shoulders, 4 hips, and 12 knees. Histological analysis confirmed wide resections for all patients. Based on histopathological analysis, extra-articular resection was unjustified in 40% (44%, 0%, and 50%, respectively). The most specific iconographic criteria were intra-capsular cortical breach and the presence of a tumor mass inside the joint. Articular cartilage disruption is often the most accurate sign. Our results suggest that MRI has a poor ability to accurately diagnose joint involvement. To date, however, this is the best tool available. In addition to obvious signs of joint involvement, MRI analysis must be performed with a thorough understanding of capsular anatomy and its particularities for each joint so as not to miss other signs, such as intra-capsular cortical effraction.

Comparison of distal extremity magnetic resonance imaging findings in Australian racing Standardbreds and Thoroughbreds.

Foot-related lameness is common in Standardbred and Thoroughbred racehorses. Magnetic resonance imaging (MRI) provides information on both the soft tissue and osseous structures of the distal extremity. The aim of this study was to determine whether abnormalities identified on distal limb MRI differed between these two racehorse populations. The records of Standardbred and Thoroughbred racehorse distal extremity MRI examinations conducted at Camden Equine Centre and Ballarat Veterinary Practice between 2013 and 2023 were retrieved. Horses were included if pain causing lameness had been localised to the foot using perineural or intra-articular analgesia. MRI abnormalities of the structures within the distal extremity were recorded and comparisons made between the two groups. There was a significant difference in the rate of occurrence of certain MRI abnormalities between the Thoroughbred and Standardbred racehorse populations, including distal phalangeal fractures, proximal phalangeal short tau inversion recovery (STIR) hyperintensity (distal aspect), the presence and severity of ungular cartilage ossification, abnormalities of the navicular bone distal border synovial invaginations/vascular channels and navicular bone distal border fragments. The presence of distal extremity STIR hyperintensity and fractures was significantly higher in Standardbred compared to Thoroughbred racehorses when these findings were grouped and considered in combination. There were many similarities in the distal extremity MRI abnormalities identified in lame Australian Standardbred and Thoroughbred racehorses. However, distal phalangeal fractures, ungular cartilage ossification and distal extremity STIR hyperintensity were identified in significantly more in Standardbred than Thoroughbred racehorses.

Role of diffusion-weighted imaging in the diagnosis of pituitary region tumors.

This study aimed to assess the role of Diffusion-Weighted Imaging (DWI) in routine pituitary Magnetic Resonance Imaging (MRI) protocols for distinguishing sellar and parasellar tumors, addressing the lack of clear guidelines in contemporary literature. A retrospective analysis of 242 pituitary MRI scans with DWI sequences was conducted in a single-center study using a 1.5T scanner and standard DWI sequence parameters. Measurements of both absolute and relative mean apparent diffusion coefficient (ADC) values, along with minimal ADC values within tumors, were performed. The adopted region of interest (ROI) based method used for these measurements was validated. Invasive pituitary adenomas exhibited significantly lower min ADC and min rADC than meningiomas, with optimal cut-off points of 0.64 (sensitivity 73%, specificity 82%) and 0.78 (sensitivity 73%, specificity 89%), respectively. Post-hemorrhagic pituitary adenomas demonstrated lower ADC values than adamantinomatous craniopharyngiomas, with an AUC of 0.893 for min rADC = 1.07, and Rathke's Cleft Cysts with mucous content, AUC 0.8 for min rADC = 1.01. Specific differentiation with high sensitivity and specificity based on diffusion parameters was observed for these tumor groups. Cystic pituitary non-functional adenomas obtained significantly lower ADC values compared to the adamantinomatous type of craniopharyngiomas and serous Rathke's Cleft Cysts (AUC up to 0.942). The study concludes that integrating DWI into routine pituitary MRI protocols enhances diagnostic accuracy in distinguishing sellar and parasellar tumors. The short scan time of one minute makes DWI a valuable and precise tool, supporting its recommendation as a standard component of pituitary MRI examinations.

Examination of Joint Effusion Magnetic Resonance Imaging of Patients with Temporomandibular Disorders with Disc Displacement.

In this study, we investigated joint effusion in patients with temporomandibular disorders (TMDs) with disc displacement. The magnetic resonance (MR) images of 97 temporomandibular joints (TMJs) were evaluated, and the appearance of joint effusion was investigated. Myofascial pain and TMJ pain were considered in addition to the duration from manifestation. Disc displacement with and without reduction, as well as the region and the area of joint effusion, were investigated using the MR images. Fisher's test was used for the analyses. Joint effusion was recognized in 70 TMJs, including 55 in the superior articular cavity, 1 in the inferior articular cavity, and 14 in both the superior and inferior articular cavities. The appearance of joint effusion did not differ with the existence of myofascial pain or TMJ pain. The region of joint effusion did not differ between disc displacement with and without reduction. A larger area of joint effusion was recognized in disc displacement without reduction (p < 0.05). The results showed that the amount of synovial fluid in the joint effusion did not change with the existence of myofascial pain or TMJ pain. Joint effusion commonly appeared in disc displacement without reduction.

Postnatal outcome of fetal cortical malformations: systematic review.

Parental counseling for fetal malformations of cortical development (MCD) is based on data from studies in children and adults undergoing imaging investigation for abnormal neurodevelopment. However, such postnatal findings may not be applicable to prenatally diagnosed cases. The aim of this study was to review the existing data on postnatal neurodevelopmental outcome for fetuses diagnosed with MCD. A literature search was conducted in PubMed, Web of Science and EMBASE for articles published between 2013 and 2023, using standardized keywords to describe fetal cortical malformations. Full-text articles were accessed for the retrieved citations and data on participant characteristics, imaging findings, and pregnancy and neonatal outcomes were extracted. Fetal MCD was defined as either complex or isolated, according to the presence or absence, respectively, of additional brain or extracranial defects. Overall, 30 articles including 371 cases of fetal MCD were reviewed. The cases were classified as complex (n = 324), isolated (n = 21) or unknown (n = 26). There were 144 terminations and four stillbirths, with pregnancy outcome unreported in 149 cases. A total of 108 cases had postnatal magnetic resonance imaging or postmortem examination data available. In nine of these cases, a diagnosis of complex fetal MCD was changed to isolated MCD after birth, and one case was found not to have MCD. There were 74 live births, for which postnatal neurodevelopment data were available in only 30 cases. Normal neurodevelopmental outcome was reported in seven (23.3% (95% CI, 9.9-42.2%)) infants, with the remaining 23 exhibiting various levels of neurodevelopmental delay (three mild, seven moderate and 13 severe) from 6 months to 7 years of age. Most reviewed cases of fetal MCD were complex in nature and underwent termination of pregnancy. There is a paucity of data on postnatal neurological development in fetuses diagnosed with MCD. The available data suggest antenatal overdiagnosis of case severity in about 5% of cases with known outcome, and either normal neurodevelopment or mild neurodevelopmental delay in approximately one-third of liveborn cases with neurological follow-up. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Small Vessel Disease Burden Predicts Incident Dementia and Poor Functional Outcome in Independent Outpatients.

Total small vessel disease (SVD) score is used to measure the burden of SVD. This study aimed to clarify the predictive value of total SVD score for incident dementia and functional outcomes in independent outpatients with vascular risk factors. We derived data from a Japanese cohort in which patients underwent magnetic resonance imaging and cognitive examinations. They were followed up until March 2023. The primary outcomes was dementia. Secondary outcome was functional outcomes. We measured a modified Rankin scale (mRS) score at the last visit and defined poor functional outcomes as mRS score ≥3. After excluding those with a mRS score ≥2, Mini-Mental State Examination score in Japanese version < 24, and missing T2* images, 692 patients were included. During a median follow-up period of 4.6 years, dementia occurred in 31 patients. In multivariate analysis, the score 4 group showed a significantly higher risk of incident dementia than the score 0-3 groups (adjusted hazard ratio, 6.25; 95% CI, 1.83-21.40, p = 0.003). The total SVD score was also independently related to poor functional outcome. The total SVD score of 4, and ≥1 could predict dementia and poor functional outcomes, respectively. Our results suggest intensive management of patients with SVD to prevent dementia and to maintain independent activities of daily living.

Welding techniques and manganese concentrations in blood and brain: Results from the WELDFUMES study

This study used whole-brain mapping to investigate the effect of different welding processes on manganese (Mn) accumulation in the brain. Exposure measurements were performed at the welders’ workplaces about 3 weeks before a magnetic resonance imaging (MRI) examination. The welders were categorized into three main groups based on welding method, and the T1-relaxation rate (R1) was measured using quantitative MRI (qMRI). Welders using shielded metal arc welding (SMAW) were found to have lower accumulations of total Mn in clusters encompassing white matter, thalamus, putamen, pallidum, and substantia nigra compared with welders using inert gas tungsten arc welding (GTAW) or continuous consumable electrode arc welding (CCEAW). A positive correlation was found between Mn in red blood cells (Mn-RBC) and R1 in a region encompassing pre-and post-central gyri. The results of this study show that the accumulation of free, bound, or compartmentalized Mn ions in the brain differed depending on the welding method used. These differences were predominately located in the basal ganglia but were also found in regions encompassing white matter. The level of Mn-RBC was correlated to the deposition of Mn in the left primary somatosensory and motor cortex and may therefore be linked to neurological and neurobehavioral symptoms.

Role of psychological intervention on the quality of life of the patient with spinal cord injury undergoing Magnetic Resonance Imaging examination

In the modern world, technological progress has also been accompanied by an increase in traumatic suffering, including those followed by spinal cord injury. The severity of spinal cord injury requires an understanding of the physiological and psychological aspects of patient management. Spinal cord lesions impair physical capabilities and tend to reduce the quality of life, thus creating the need for psychological intervention. In order to do the magnetic resonance imaging (MRI), it has been observed that patients frequently experience distress (1) Background: The research highlights the significant influence that psychological interventions have on improving the quality of life of patients undergoing MRI, who have sustained spinal cord injury; (2) Methods: we studied 78 patients hospitalized in the Neurosurgery Clinic 2 of the "Bagdasar Arseni" Hospital for acute spinal cord injuries, in 2 groups of patients with and without psychotherapy, for which we later applied the quality of life test; (3) Results: We observe how, in 2017, SCI were more frequent in the adult male population and psychotherapeutic treatment was slightly more effective in improving QOL in male patients.; (4) Conclusions: For the 27 patients investigated by MRI and operated for SCI in the Neurosurgery Clinic 2 of the "Bagdasar Arseni" Hospital, the average quality of life was higher after the psychotherapy, both for female patients and for male patients and. The psychotherapeutic response and improved quality of life were higher in male patients.

Application of Magnetic Resonance Imaging Report Combined With VI-RADS Bi-Parametric and Multi-Parametric Scoring Systems in Bladder Cancer Diagnosis

To verify by retrospective analysis the performance of applying dual-parametric (T2 weighted image [T2WI] and diffusion weighted image [DWI]) and multi-parametric (T2WI, DWI, and dynamic contrast enhance [DCE]) evaluation systems of Vesical Imaging-Reporting and Data System (VI-RADS) in the magnetic resonance imaging (MRI) diagnosis of bladder cancer. The imaging and clinical data of bladder cancer patients who underwent bladder MRI examination in the Department of Urology of our hospital between January 2020 and December 2021 were collected. A total of 215 bladder cancer patients, among whom there were 183 males and 32 females with an average age of (67.60±11.42) years, were included. The bladder cancer diagnosis of all the cases was verified by pathology analysis of tissue samples. Two radiologists, who were double-blinded, scored multiple sequences separately. Then, a comparative analysis was made on the diagnostic performance of dual-parametric and multi-parametric VI-RADS diagnostic scores. The diagnostic test with receiver operator characteristic (ROC) curves and Cohen's Kappa were used to evaluate the diagnostic efficacy and consistency. The area under the curve (AUC) and 95% confidence interval (CI) of the multi-parametric VI-RADS evaluation system by the two radiologists in the overall population were 0.878 (0.830-0.925) and 0.856 (0.805-0.907), while those for the bi-parametric VI-RADS evaluation system were 0.889 (0.844-0.934) and 0.856 (0.805-0.907), showing no statistically significant difference. No significant difference was observed in the subgroup analysis of patients who underwent transurethral resection of bladder tumor (TURBT). Furthermore, the Kappa values for inter-rater agreement between of the two radiologists were 0.694 and 0.546 (with the VI-RADS score≥3 defined as being positive) and 0.693 and 0.712 (with the VI-RADS score≥4 defined as being positive) in multi-parametric and bi-parametric evaluation, respectively (all P<0.001). The bi-parametric VI-RADS scoring system can achieve a diagnostic efficacy comparable to that of the multi-parametric scoring system, offering an alternative to patients who are unable to undergo contrast-enhanced MRI due to allergic reaction to contrasts.

Anatomo-functional changes in neural substrates of cognitive memory in developmental amnesia: Insights from automated and manual Magnetic Resonance Imaging examinations.

Despite bilateral hippocampal damage dating to the perinatal or early childhood period and severely impaired episodic memory, patients with developmental amnesia continue to exhibit well-developed semantic memory across the developmental trajectory. Detailed information on the extent and focality of brain damage in these patients is needed to hypothesize about the neural substrate that supports their remarkable capacity for encoding and retrieval of semantic memory. In particular, we need to assess whether the residual hippocampal tissue is involved in this preservation, or whether the surrounding cortical areas reorganize to rescue aspects of these critical cognitive memory processes after early injury. We used voxel-based morphometry (VBM) analysis, automatic (FreeSurfer) and manual segmentation to characterize structural changes in the brain of an exceptionally large cohort of 23 patients with developmental amnesia in comparison with 32 control subjects. Both the VBM and the FreeSurfer analyses revealed severe structural alterations in the hippocampus and thalamus of patients with developmental amnesia. Milder damage was found in the amygdala, caudate, and parahippocampal gyrus. Manual segmentation demonstrated differences in the degree of atrophy of the hippocampal subregions in patients. The level of atrophy in CA-DG subregions and subicular complex was more than 40%, while the atrophy of the uncus was moderate (-24%). Anatomo-functional correlations were observed between the volumes of residual hippocampal subregions in patients and selective aspects of their cognitive performance, viz, intelligence, working memory, and verbal and visuospatial recall. Our findings suggest that in patients with developmental amnesia, cognitive processing is compromised as a function of the extent of atrophy in hippocampal subregions. More severe hippocampal damage may be more likely to promote structural and/or functional reorganization in areas connected to the hippocampus. In this hypothesis, different levels of hippocampal function may be rescued following this variable reorganization. Our findings document not only the extent, but also the limits of circuit reorganization occurring in the young brain after early bilateral hippocampal damage.

Multi-parametric magnetic resonance imaging of prostate cancer: correlation between Ktrans, Gleason score, and PI-RADS score

PurposeTo measure Ktrans and correlate it with Gleason score (GS) and PI-RADS score in patients with prostate cancer.MethodsThis retrospective study included patients with pathologically proven prostate cancer who had undergone clinically indicated 1.5 Tesla multi-parametric magnetic resonance imaging (MRI) examination between February and December 2020. T2-weighted (T2w) images, diffusion-weighted images (DWI), and dynamic contrast-enhanced (DCE) sequences were obtained. PI-RADS score was calculated for all tumor lesions. From DCE-MRI dataset, Ktrans was computed and compared between patients with clinically insignificant (GS ≤ 6) and clinically significant (GS ≥ 7) prostate cancer. Spearman rank-order correlation coefficient (ρ) was used to assess the correlation strength between Ktrans and GS and between Ktrans and PI-RADS score.ResultsTwenty-one patients (age: 67 ± 12 years; BMI: 26.63 ± 4.04 kg/m2) with a PSA of 7.91 ± 3.01 were included in the study. Seven patients (33.3%) had clinically insignificant prostate cancer, while 14 patients (66.7%) were diagnosed with clinically significant prostate cancer. Mean Ktrans value was 0.42 ± 0.20 min−1 (range: 0.15–0.75). Ktrans was significantly higher (0.50 ± 0.17 min−1) in clinically significant prostate cancer compared to clinical insignificant prostate cancer (0.23 ± 0.15 min−1; P = 0.001). Ktrans showed moderate significant correlation with GS (ρ = 0.575, P = 0.006), but showed no significant correlation with PI-RADS (ρ = 0.386, P = 0.069).ConclusionKtrans may discriminate between clinically insignificant and significant prostate cancer and shows moderate correlation with GS. Thus, MP-MRI may serve as an imaging biomarker in prostate cancer.

Intracranial Atherosclerotic Disease and Incident Dementia: The ARIC Study (Atherosclerosis Risk in Communities).

Studies of the neurovascular contribution to dementia have largely focused on cerebral small vessel disease (CSVD), but the role of intracranial atherosclerotic disease (ICAD) remains unknown in the general population. The objective of this study was to determine the risk of incident dementia from ICAD after adjusting for CSVD and cardiovascular risk factors in a US community-based cohort. We acquired brain magnetic resonance imaging examinations from 2011 through 2013 in 1980 Black and White participants in the ARIC study (Atherosclerosis Risk in Communities), a prospective cohort conducted in 4 US communities. Magnetic resonance imaging examinations included high-resolution vessel wall magnetic resonance imaging and magnetic resonance angiography to identify ICAD. Of these participants, 1590 without dementia, without missing covariates, and with adequate magnetic resonance image quality were followed through 2019 for incident dementia. Associations between ICAD and incident dementia were assessed using Cox proportional hazard ratios adjusted for CSVD (characterized by white matter hyperintensities, lacunar infarctions, and microhemorrhages), APOE4 genotype (apolipoprotein E gene ε4), and cardiovascular risk factors. The mean age (SD) of study participants was 77.4 (5.2) years. ICAD was detected in 34.6% of participants. After a median follow-up of 5.6 years, 286 participants developed dementia. Compared with participants without ICAD, the fully adjusted hazard ratios (95% CIs) for incident dementia in participants with any ICAD, with ICAD only causing stenosis ≤50%, and with ICAD causing stenosis >50% in ≥1 vessel were 1.57 (1.17-2.11), 1.41 (1.02-1.95), and 1.94 (1.32-2.84), respectively. ICAD was associated with dementia even among participants with low white matter hyperintensities burden, a marker of CSVD. ICAD was associated with an increased risk of incident dementia, independent of CSVD, APOE4 genotype, and cardiovascular risk factors. The increased risk of dementia was evident even among participants with low CSVD burden, a group less likely to be affected by vascular dementia, and in participants with ICAD causing only low-grade stenosis. Our results suggest that ICAD may partially mediate the effect that cardiovascular risk factors have on the brain leading to dementia. Both ICAD and CSVD must be considered to understand the vascular contributions to cognitive decline.

Changes in the Articular Cartilage Thickness in Patients with Symptomatic Rotator Cuff Tears: A Prospective Study with a Mean 5-Year Follow-Up.

Objectives: The purpose of this study was to prospectively investigate the progression of cartilage thinning in patients with symptomatic rotator cuff tears using MRI. Methods: Two hundred twenty-five consecutive patients with symptomatic rotator cuff tears visited our institute between 2009 and 2019. Of these, 28 shoulders of 27 patients (mean age, 65 years) who underwent at least two magnetic resonance imaging (MRI) examinations were prospectively enrolled. They all received conservative treatment. The mean follow-up was 67 months. Changes in cartilage thickness and the combined cartilage and subchondral bone thickness at the initial and final MRI were measured using a RadiAnt DICOM-viewer (Medixant, Poznan, Poland). The cartilage thickness of the humeral head was measured in the oblique coronal and sagittal images. The glenoid cartilage was measured in the axial and oblique coronal images. Results: At an average period of 5 years, 12 of 28 shoulders (42%) showed more than a 30% decrease in cartilage thickness in the humeral head. The glenoid showed cartilage thinning in only one shoulder (4%). In the humeral head, progressive cartilage thinning was seen mainly in the anterior and posterior parts of the humeral head in the sagittal plane. In the glenoid, progressive cartilage thinning was seen on the entire surface except the posterior area. There was no significant difference in cartilage thickness between the first and final follow-ups for both the humeral head and the glenoid. Conclusions: A total of 12 of 28 shoulders (42%) showed more than a 30% decrease in cartilage thickness in the humeral head, which was mainly observed in the anterior and posterior areas of the humeral head.

Magnetic resonance imaging of the dromedary camel carpus

BackgroundThe dromedary camel (Camelus dromedarius) carpal joint presents multiple joints and constitutes several bones and soft tissues. Radiography and/or ultrasonography of the carpus are challenging due to structural superimposition. High-field magnetic resonance imaging (MRI) technique precludes superimposed tissues and offers high soft tissue contrast in multiple sequences and planes. Hence, understanding the normal MRI anatomy is crucial during clinical investigations. Magnetic resonance imaging is highly sensitive for investigation of soft tissues and articular cartilage; therefore, it is extensively used for outlining joint anatomy and evaluation of a wide range of musculoskeletal conditions. MRI images of a specific anatomical region acquired by using multiple sequences in various planes are necessary for a complete MRI examination. Given the dearth of information on the MRI features of the dromedary camel carpus, the current study demonstrates the MRI appearance of the clinically significant structures in the camel carpus in various sequences and planes using a high-field 1.5 Tesla superconducting magnet. For this purpose, twelve cadaveric forelimbs, obtained from 6 clinically sound lameness free adult dromedary camels, were examined.ResultsThe cortex and medulla of the radius, carpal bones and metacarpus were evaluated. Articular cartilage of the carpal joints was depicted and showed intermediate intensity. Carpal tendons expressed lower signal intensity in all pulse sequences. The collateral and inter-carpal ligaments showed mixed signal intensity.ConclusionsThe obtained data outlines the validation of MRI for investigation of the camel carpus and could set as a reference for interpretation in clinical patients.

Development and Assessment of a Predictive Model for Ki-67 Expression Using Ultrasound Indicators and Non-Morphological Magnetic Resonance Imaging Parameters Before Breast Cancer Therapy.

To formulate a predictive model for assessing Ki-67 expression in breast cancer by integrating pre-treatment ultrasound features with non-morphological magnetic resonance imaging (MRI) parameters, encompassing functional and hemodynamic indicators. A retrospective study was conducted on 167 patients. All patients underwent a breast mass biopsy for histopathological and Ki-67 analysis prior to neoadjuvant chemotherapy (NAC) treatment. Additionally, all patients underwent ultrasonography and MRI examinations prior to the biopsy. The recorded variables were Ki-67, apparent diffusion coefficient (ADC) values, Max Slope, time to peak (TTP), signal enhancement ratio (SER), early enhancement rate (EER), time-signal intensity curve (TIC), tumor maximum diameter, tumor margins and boundaries, aspect ratio, microcalcification, color Doppler flow imaging grading, resistance index (RI), and axillary lymph node metastasis. Statistical analysis was performed using the R software package. Normally distributed continuous data are presented as mean ± standard deviation (SD), skewed continuous data as median, and categorical variables as frequency or percentage. The dataset was randomly divided into a modeling group and a validation group following a 7:3 ratio, employing a predetermined random seed. The selection of variables was conducted using the random forest algorithm. Specifically, in the initial analysis, we trained a random forest model using all available variables. By evaluating the Gini importance scores of each variable, we identified those that contributed the most to predicting Ki-67 expression. The predictive model for Ki-67 expression was constructed using selected variables: Maximum Diameter, ADC value, SER value, Max Slope value, TTP value, and EER value. Within the validation group, the evaluation metrics demonstrated an Area under the curve of 0.961 with a 95% confidence interval ranging from 0.865 to 0.995. The model achieved a kappa score of 1.00, precision of 0.949, recall of 1, an F1 score of 0.974, sensitivity of 100%, specificity of 85.71%, a positive predictive value of 94.87%, and a negative predictive value of 100%. The combination of non-morphological MRI parameters and pre-treatment ultrasound features in a breast cancer prediction model powered by RF machine learning demonstrated favorable clinical outcomes and improved diagnostic performance.

Evaluation of guided reporting: quality and reading time of automatically generated radiology report in breast magnetic resonance imaging using a dedicated software solution.

Unstructured, free-text dictation (FT), the current standard in breast magnetic resonance imaging (MRI) reporting, is considered time-consuming and prone to error. The purpose of this study is to assess the usability and performance of a novel, software-based guided reporting (GR) strategy in breast MRI. Eighty examinations previously evaluated for a clinical indication (e.g., mass and focus/non-mass enhancement) with FT were reevaluated by three specialized radiologists using GR. Each radiologist had a different number of cases (R1, n = 24; R2, n = 20; R3, n = 36). Usability was assessed by subjective feedback, and quality was assessed by comparing the completeness of automatically generated GR reports with that of their FT counterparts. Errors in GR were categorized and analyzed for debugging with a final software version. Combined reading and reporting times and learning curves were analyzed. Usability was rated high by all readers. No non-sense, omission/commission, or translational errors were detected with the GR method. Spelling and grammar errors were observed in 3/80 patient reports (3.8%) with GR (exclusively in the discussion section) and in 36/80 patient reports (45%) with FT. Between FT and GR, 41 patient reports revealed no content differences, 33 revealed minor differences, and 6 revealed major differences that resulted in changes in treatment. The errors in all patient reports with major content differences were categorized as content omission errors caused by improper software operation (n = 2) or by missing content in software v. 0.8 displayable with v. 1.7 (n = 4). The mean combined reading and reporting time was 576 s (standard deviation: 327 s; min: 155 s; max: 1,517 s). The mean times for each reader were 485, 557, and 754 s, and the respective learning curves evaluated by regression models revealed statistically significant slopes (P = 0.002; P = 0.0002; P < 0.0001). Overall times were shorter compared with external references that used FT. The mean combined reading and reporting time of MRI examinations using FT was 1,043 s and decreased by 44.8% with GR. GR allows for complete reporting with minimized error rates and reduced combined reading and reporting times. The streamlining of the process (evidenced by lower reading times) for the readers in this study proves that GR can be learned quickly. Reducing reporting errors leads to fewer therapeutic faults and lawsuits against radiologists. It is known that delays in radiology reporting hinder early treatment and lead to poorer patient outcomes. While the number of scans and images per examination is continuously rising, staff shortages create a bottleneck in radiology departments. The IT-based GR method can be a major boon, improving radiologist efficiency, report quality, and the quality of simultaneously generated data.