Magnetic Resonance Imaging Sections Research Articles

Anatomy of the brain of capybara (Hydrochoerus hydrochaeris) using magnetic resonance imaging.

Capybara is considered the largest living rodent and is widespread distributed in the South America and in the Brazilian territory. The purpose of this study was to provide the anatomical description of the brain in the capybara (Hydrochoerus hydrochaeris) using magnetic resonance imaging (MRI). Brains of ten normal capybaras were imaged and sectioned in the anatomical studies. MRI was acquired on 0.25 Tesla equipment, promoting good-quality images capable to identify and classify the main anatomical structures of clinical interest. MRI reference images were validated by comparing them with gross anatomical sections. The capybara sulci and gyri were named for its similar location and orientation to those described in the previous descriptions in the capybara and in the domestic dog. Capybaras presented prominent cerebral sulcus and gyrus in relation to other caviomorph rodents, but in reduced number when compared to domestic animals and other wild mammals such as elephants and giraffes. The findings of this study indicate that the shape of the capybara brain is remarkably similar to that of the caviomorph rodents with a higher neocortilization. The capybara rhinencephalon was well-developed implying a good sense of smell. Due to this development of the rhinencephalon, we can suggest that capybara brain is a macrosmatic brain. The MRI and gross anatomical sections of capybara brain may help veterinary researchers and clinicians increase the accuracy of brain MRI scans interpretation in these animals.

The individual variability of the dentato-rubro-thalamic tract in the planning of stereotactic operations in patients with tremor

Background. Stereotactic operations on the ventral‑intermediate nucleus of the thalamus (Vim) and the posterior subthalamic area (PSA) are used for the surgical treatment of tremor. Since these structures are invisible in standard magnetic resonance imaging (MRI) regimes, indirect stereotactic guidance is mainly used during operations. MRI tractography allows taking into account the individual variability of the target structures for tremor, visualizing the target directly, but this technique has not yet entered the routine practice of preparing operations.Aim. The aim of the work is to study the variability of the position of the dentato‑rubro‑thalamic tract (DRT), determined according to MRI tractography data, in relation to the main reference points for indirect stereotactic guidance, as well as to the visible landmarks on MRI in FGATIR mode, to assess the validity of the currently used methods of preparing operations in patients with tremor.Materials and methods. Probabilistic MRI tractography of DRT based on the HARDY protocol was performed in 34 patients. Additionally, 3D T1 tomograms were obtained with axial slices with an isotropic voxel size equal to 1 mm, as well as FLAIR sagittal slices with a thickness of 1.12 and a pitch of 0.56 mm. Eleven patients additionally underwent a series of MRI sections according to the FGATIR program with a thickness of 1 mm, without an intersectional gap.Results. A significant variability of the DRT position has been established both in the coordinate system of the anterior and posterior commissures, and in relation to standard targets for indirect stereotactic guidance. In addition, a visible interhemispheric asymmetry of the position of the tracts was revealed. The smallest degree of deviation from the tract was noted for the trajectories of deep brain stimulation electrodes implanted in the caudal zona incerta (cZI) at the level of the maximum diameter of the red nuclei. A high degree of correspondence between the tract and the target zone of prelemniscal radiations (Raprl) was also established on tomograms in the FGATIR mode.Conclusions. The standard target points for the indirect targeting of Vim targets and the cerebello‑thalamic tract in PSA give a deviation of more than 2 mm from DRT in almost half of patients. During the use of cZI as a standard target for indirect guidance in the treatment of tremor, the DRT is located at the zone of stereotactic impact at the level of the 2nd or 3rd contact of the electrode in 76.5 % of cases. FGATIR mode allows visualizing the structure of Raprl, with stereotactic guidance on which the effect on the DRT can be achieved in 86.4 % of cases.

Comparative MRI analysis of the forebrain of three sauropsida models

The study of the brain by magnetic resonance imaging (MRI) allows to obtain detailed anatomical images, useful to describe specific encephalic structures and to analyze possible variabilities. It is widely used in clinical practice and is becoming increasingly used in veterinary medicine, even in exotic animals; however, despite its potential, its use in comparative neuroanatomy studies is still incipient. It is a technology that in recent years has significantly improved anatomical resolution, together with the fact that it is non-invasive and allows for systematic comparative analysis. All this makes it particularly interesting and useful in evolutionary neuroscience studies, since it allows for the analysis and comparison of brains of rare or otherwise inaccessible species. In the present study, we have analyzed the prosencephalon of three representative sauropsid species, the turtle Trachemys scripta (order Testudine), the lizard Pogona vitticeps (order Squamata) and the snake Python regius (order Squamata) by MRI. In addition, we used MRI sections to analyze the total brain volume and ventricular system of these species, employing volumetric and chemometric analyses together. The raw MRI data of the sauropsida models analyzed in the present study are available for viewing and downloading and have allowed us to produce an atlas of the forebrain of each of the species analyzed, with the main brain regions. In addition, our volumetric data showed that the three groups presented clear differences in terms of total and ventricular brain volumes, particularly the turtles, which in all cases presented distinctive characteristics compared to the lizards and snakes.

Congenital diaphragmatic hernia: automatic lung and liver MRI segmentation with nnU-Net, reproducibility of pyradiomics features, and a machine learning application for the classification of liver herniation

Prenatal assessment of lung size and liver position is essential to stratify congenital diaphragmatic hernia (CDH) fetuses in risk categories, guiding counseling, and patient management. Manual segmentation on fetal MRI provides a quantitative estimation of total lung volume and liver herniation. However, it is time-consuming and operator-dependent. In this study, we utilized a publicly available deep learning (DL) segmentation system (nnU-Net) to automatically contour CDH-affected fetal lungs and liver on MRI sections. Concordance between automatic and manual segmentation was assessed by calculating the Jaccard coefficient. Pyradiomics standard features were then extracted from both manually and automatically segmented regions. The reproducibility of features between the two groups was evaluated through the Wilcoxon rank-sum test and intraclass correlation coefficients (ICCs). We finally tested the reliability of the automatic-segmentation approach by building a ML classifier system for the prediction of liver herniation based on support vector machines (SVM) and trained on shape features computed both in the manual and nnU-Net-segmented organs. We compared the area under the classifier receiver operating characteristic curve (AUC) in the two cases. Pyradiomics features calculated in the manual ROIs were partly reproducible by the same features calculated in nnU-Net segmented ROIs and, when used in the ML procedure, to predict liver herniation (both AUC around 0.85). Conclusion: Our results suggest that automatic MRI segmentation is feasible, with good reproducibility of pyradiomics features, and that a ML system for liver herniation prediction offers good reliability. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04609163?term=NCT04609163&draw=2&rank=1; Clinical Trial Identification no. NCT04609163.What is Known:• Magnetic resonance imaging (MRI) is crucial for prenatal congenital diaphragmatic hernia (CDH) assessment. It enables the quantification of the total lung volume and the extent of liver herniation, which are essential for stratifying the severity of CDH, guiding counseling, and patient management.• The manual segmentation of MRI scans is a time-consuming process that is heavily reliant upon the skill set of the operator.What is New:• MRI lung and liver automatic segmentation using the deep learning nnU-Net system is feasible, with good Jaccard coefficient values and satisfactory reproducibility of pyradiomics features compared to manual results.• A feasible ML system for predicting liver herniation could improve prenatal assessments and CDH patient management.

Cervical angle as a possible predictor of abnormal placental position in women with endometriosis.

We aimed to examine the effects of endometriosis on the rate of abnormal placentation by comparing the data of pregnant women with and without endometriosis. A case-control study was conducted to compare the perinatal outcomes between women with and without endometriosis. In the subgroup analysis, magnetic resonance imaging (MRI) scans of pregnant women with placenta previa were used to measure the cervical angle and its relationship with endometriosis. The cervical angle was measured as the angle between the cervical glands and the line perpendicular to the spinal column in each sagittal MRI section. We retrospectively analyzed data from 3453 cases of singleton deliveries between 2015 and 2019 at two study facilities. Among them, 159 had clinically or surgically confirmed endometriosis. The odds ratio (OR) for abnormal placental position was significantly higher in pregnant women with endometriosis (OR. 2.82; 95% confidence interval [CI], 1.58-5.04). The OR was 3.21 (95% CI, 1.57-6.55) in the endometriosis-surgery group (91 patients) and 2.32 (95% CI, 0.91-5.88) in the non-surgery group (68 patients). Furthermore, 44 women who underwent pelvic MRI after 30 weeks of gestation were included to examine the cervical angle. Then, we compared the date of pregnant women with (n = 6) and without endometriosis (n = 38). Regardless of placental attachment position, the cervical angle was significantly lower in the group with than in the group without a history of endometriosis. Pregnant women with a history of endometriosis may have stronger uterine retroversion, which could potentially contribute to abnormal placental positioning.

Correlation of IVIM/DKI Parameters with Hypoxia Biomarkers in Fibrosarcoma Murine Models: Direct Control of MRI and Pathological Sections

To investigate whether intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters correlate with hypoxia biomarkers, namely hypoxia inducible factor-1ɑ (HIF-1ɑ), carbonic anhydrase IX (CAIX), and pimonidazole (PIMO), in fibrosarcoma (FS) murine models. A model of 30 FS nude mice was established. All mice underwent magnetic resonance imaging (MRI) scans after which the IVIM (standard apparent diffusion coefficient [standard ADC], pure diffusion coefficient [D], pseudo-diffusion coefficient [D*], and perfusion fraction [f]) and DKI parameters (mean diffusion [MD], mean kurtosis [MK]) were obtained. Based on an MRI-pathology controlled method, correlations between each MRI parameter and hypoxia biomarkers were assessed by Pearson or Spearman tests. An independent sample t-test or Wilcoxon's rank sum test, and receiver operating characteristic curves were used to identify whether MRI parameters could differentiate between high and low expressions of hypoxia biomarkers. The IVIM/DKI parameters showed varying degrees of correlation with HIF-1α, CAIX, and PIMO expression. Among them, the D, f, and MK values could confirm HIF-1α expression, while D, f, and MK values could assess CAIX expression. Finally, standard D and MK values could evaluate PIMO expression levels. IVIM and DKI parameters can be used to reflect hypoxic biomarkers of FS and have the potential to detect tumor hypoxia.

The relationship between the degeneration and asymmetry of the lumbar multifidus and erector spinae muscles in patients with lumbar disc herniation with and without root compression

BackgroundThe determination of muscle pathologies in lumbar disc herniation (LDH) and other conditions with low back pain is important for understanding low back problems and determining appropriate treatment methods. In patients with lumbar disc herniation with radiculopathy, elucidating the effect of root compression on the severity of muscle degeneration may predict the importance of alleviating root compression. For this purpose, magnetic resonance imaging (MRI) was used to compare the degeneration and asymmetries of the lumbar musculus multifidus (MF) and lumbar musculus erector spinae (ES) muscles in patients with lumbar discopathy without root compression (radiculopathy) and in patients with lumbar discopathy with root compression (radiculopathy).MethodsThe patients were examined in two groups: 56 patients with lumbar discopathy and no radiculopathy (Non-rad group) and 51 patients with lumbar discopathy and radiculopathy (Rad group). On axial MRI sections passing through the centre of the disc at the L3-S1 level, the asymmetry, cross-sectional area (CSA), fat infiltration, and total CSA (TCSA = MF + ES) of the MF and ES muscles were measured and compared.ResultsNo difference was seen between the groups with respect to the CSA values of the right and left MF and left ES, but a significant difference was found in the right ES CSA (p = 0.021). The CSA and TCSA of the MF and ES showed no asymmetry according to group. Severe fat infiltration of > 50% in the right and left MF and left ES was found in the Rad group at a higher rate than in the Non-rad group. Fat infiltration was significantly positively correlated with age, body mass index, and the duration of pain (p < 0.001, p < 0.001, p = 0.004, respectively).ConclusionsThe study results showed a correlation between LDH and paraspinal muscle degeneration, while no correlation was found with asymmetry. Severe (> 50%) fat infiltration is associated with root compression, and the severity of fat filtration increases in the presence of root compression. The development of more severe degeneration due to denervation associated with root compression plays a role in the emergence of this situation. Therefore, in patients with lumbar disc herniation with radiculopathy, it can be foreseen that to stop and correct severe fat infiltration and muscle degeneration, first, nerve root compression should be corrected with appropriate medical treatment methods, and in patients in whom there is no response, the pressure should be alleviated with appropriate surgical methods.

Bone Bruise Patterns in Ligamentous Injuries of the Knee With Focus on Anterior Cruciate Ligament.

Introduction After sustaining an anterior cruciate ligament (ACL) injury, the bone bruises seen on magnetic resonance imaging (MRI) could reveal plenty of information regarding the loading mechanisms causing injury to the ACL. The current study was conducted to evaluate the common distribution patterns of bone bruises following an ACL injury and understand the loading mechanisms. Methods The knee MRI sequences of the patients operated arthroscopically for an injured ACL between August 2016 to August 2018 were selected for the study. The distribution pattern of the bone bruises was determined using the sagittal and coronal sections of MRI. The pattern of distribution of the bone bruises was categorized and analyzed by two independent observers. Results Twenty-two patients were found to have bone bruises diagnosed in the MRI scans. The mean age of the patients was 27.8 ± 8.7 years. The pattern of a bone bruises in only the lateral femoral and tibial compartments was the most typical pattern observed in this study. The study pattern has a significant anterior distribution of bone bruises on the outer (lateral) compartment of both the femur and tibia as compared to the inner (medial) compartment (p< .05 and p > .05, respectively). The inter-rater reliability between the two observers by Cronbach's Alpha was 93.2%. Conclusion Having the appropriate information regarding the pattern distribution of bone bruises and the concomitant injuries associated with it furthers our knowledge and helps us understand the loading mechanisms of ACL tears. A combination of coup forces acting on the lateral compartment and the contrecoup varus force on the medial compartment of the knee during the primary pivot-shift injury suggests an an involvement of multiplanar loading patterns at the point of sustaining ACL tear.

Relationship Between Diagnostic Anatomic Shoulder Parameters and Degenerative Rotator Cuff Tears: An MRI Study.

Numerous radiographic measurement methods related to rotator cuff tears (RCTs) have been described. The most widely used of these parameters is the critical shoulder angle (CSA) as measured via radiography. However, magnetic resonance imaging (MRI) measurements provide more accurate results than direct radiography. To determine the relationship between anatomic shoulder parameters and RCT type via MRI scans. Cross-sectional study; Level of evidence, 3. The data and physical examination notes of 389 patients were retrospectively analyzed, and 242 patients were included in the study. Patients were divided into 2 groups: those with RCT (n = 127) and those without RCT (control group; n = 115). Using suitable MRI sections, the CSA, lateral acromial angle, acromial index, superior glenoid inclination, acromion-greater tuberosity impingement index, and acromiohumeral distance were compared between the RCT and control groups. The correlation of these shoulder parameters with the presence of RCT was investigated, and the predictive value of each parameter was examined using receiver operating characteristic (ROC) analysis. There were significant positive relationships between the presence of RCT and CSA, acromial index, acromion-greater tuberosity impingement index, and superior glenoid inclination, with the strongest correlation belonging to CSA (r = 0.716). There were also significant negative relationships between presence of RCT and lateral acromial angle (r = -0.510) and acromiohumeral distance (r = -0.222). The ROC analysis revealed CSA to be the best predictor for the presence of RCT (area under the ROC curve = 0.899). The study outcomes showed that CSA as measured on MRI is the best predictor for determining the presence of RCTs. In patients with shoulder pain attributed to RCT, it may be helpful to examine the CSA on MRI.

Differences between spinal cord injury and cervical compressive myelopathy in intramedullary high-intensity lesions on T2-weighted magnetic resonance imaging: A retrospective study.

Increases in aging populations have raised the number of patients with cervical spinal cord injury (SCI) without fractures due to compression of the cervical spinal cord. In such patients, it is necessary to clarify whether SCI or cervical compressive myelopathy (CCM) is the cause of disability after trauma. This study aimed to clarify the differences in magnetic resonance imaging (MRI) features between SCI and CCM.Overall, 60 SCI patients and 60 CCM patients with intramedullary high-intensity lesions on T2-weighted MRI were included in this study. The longitudinal lengths of the intramedullary T2 high-intensity lesions were measured using sagittal MRI sections. Snake-eye appearance on axial sections was assessed as a characteristic finding of CCM. The T2 values of the high-intensity lesions and normal spinal cords at the first thoracic vertebra level were measured, and the contrast ratio was calculated using these values.The longitudinal length of T2 high-intensity lesions was significantly longer in SCI patients than in CCM patients. Snake-eye appearance was found in 26 of the 60 CCM patients, but not in SCI patients. On both the sagittal and axial images, the contrast ratio was significantly higher in the SCI group than in the CCM group. Based on these results, a diagnostic scale was created. This scale made it possible to distinguish between SCI and CCM with approximately 90% accuracy.

EVALUATION OF COCCYX MORPHOLOGY WITH MAGNETIC RESONANCE IMAGING IN CHILDHOOD AGE

AMAÇ: Koksiks, vertebral kolonun distalinde yer alan, sakrum alt ucu ile eklem yapan ve sıklıkla 3 veya 4 vertebral segmentten oluşan üçgen şeklinde bir kemiktir. Bu çalışmanın amacı çocukluk çağı yaş grubunda koksiks morfolojisinin ve morfometrisinin manyetik rezonans görüntüleme (MRG) ile değerlendirilmesidir.GEREÇ VE YÖNTEM: Bu retrospektif çalışmada, Ocak 2020- Ocak 2021 tarihleri arasında hastanemizde lumbosakral veya pelvik MRG ile tetkik edilmiş olan çocuk hastalar çalışmaya dahil edildi. Sakral ve koksigeal vertebraların en iyi şekilde görüntülendiği mid-sagittal, T1 ağırlıklı MRG kesitlerinde vertebraların dizilimleri, listezis varlığı/yokluğu ve koksiks vertebra sayısı kaydedildi. Ayrıca aynı kesitte morfometrik değerlendirmede doğrusal koksiks uzunluğu, sakrokoksigeal açı, sakrokoksigeal eklem açısı ve interkoksigeal açı ölçüldü.BULGULAR: Toplam 47 hasta (36 kız, 11 erkek) çalışmaya dahil edildi. Hastaların yaş ortalaması 13.7±2.1 idi. Kız ve erkek hasta-lar arasında ve farklı yaş grupları arasında (grup 1: 7-10 yaş, grup 2: 11-13 yaş, grup 3: 14-16 yaş); koksiks uzunluğu, sakrokoksi-geal açı, sakrokoksigeal eklem açısı, interkoksigeal açı arasında anlamlı fark saptanmadı (sırasıyla; p= 0,728, p=0,262, p=0,105 ve p=0.191, p= 0.684, p=0.927).SONUÇ: Bu çalışmaya göre çocukluk çağı yaş grubunda sakrokoksigeal açı, sakrokoksigeal eklem açısı ve interkoksigeal açılar değerlendirildiğinde kız ve erkek hastalar arasında ve farklı yaş grupları arasında farklılık saptanmamıştır. Çocukluk çağı yaş grubunda koksikse ait morfolojik özelliklerin bilinmesi, hastalıkların değerlendirilmesinde kolaylık sağlayacaktır.

Prevalence and clinical potential of extraspinal incidental findings in lumbosacral spine MRI of patients with suspected disc diseases

BACKGROUND Incidental findings could be observed in organs close to the spine while reporting lumbosacral spine magnetic resonance imaging (MRI). This study aimed to report the prevalence and clinical potential of extraspinal incidental findings in lumbosacral MRI of patients with suspected disc diseases.&#x0D; METHODS This single-centered cross-sectional study was carried out on 420 consecutive adult patients who underwent lumbar spine MRI for suspected disc disease from January to July 2019. The MRI was checked for the presence of extraspinal incidental findings, and each finding was categorized according to the body organ and its clinical significance. Each MRI plane that best displayed the findings was recorded, and the association between the findings and patient's age and sex was determined.&#x0D; RESULTS Of 420 samples, 135 cases showed extraspinal findings (32.1%), and 7.6% of the patients displayed suspicious lesions. The urinary tract was the most common system (18.6%) to display both clinically significant (5.0%) and benign findings (13.6%), and the axial MRI section was the plane which showed most of the incidental findings. Incidental findings in any body system were rarely found in the younger patients. Females had significantly higher benign findings than males (p = 0.002).&#x0D; CONCLUSIONS The prevalence of extraspinal findings in lumbosacral spine MRI is high, and some are significant. Most findings are related to the urinary tract and best displayed in the axial plane.

Effects of Platelet-Rich Plasma and Bone Marrow Mesenchymal Stem Cells on Meniscal Repair in the White-White Zone of the Meniscus.

ObjectiveTo investigate the role of autologous platelet‐rich plasma (PRP) on the repair of meniscal white‐white zone injury through promoting the proliferation of canine bone marrow‐derived mesenchymal stem cells (BMSCs).MethodsA total of 24 beagle dogs were selected to construct meniscal white‐white zone injury models in both lateral knee joints. All subjects were divided into four groups: control, BMSCs, PRP, and PRP + BMSCs. Immunohistochemistry was applied in the expression detection of type I and type II collagens. HE staining and methylene blue staining were performed to observe the injury of cartilage of lateral femoral condyle in each group. ELISA was used to detect the osteopontin (OPN) content in cartilage of lateral femoral condyle. HE staining and magnetic resonance imaging (MRI) were used to observe the healing of meniscus in each group. Outcome measures include the expression of OPN in the synovial fluid of knee joint, the expression of type I collagen and type II collagen, the healing of meniscus injury, and the damage degree of lateral femoral condyle cartilage.ResultsCompared with the control group, the expressions of type I and type II collagens were enhanced in the PRP group and the PRP + BMSCs group. Compared with 1 week before modeling, the expression of OPN was elevated in the control group and the BMSCs group at 3 weeks after modeling. There were no significant differences in the above indicators between the PRP group and the PRP + BMSCs group. According to MRI and pathological section after HE staining, meniscal healing in the PRP group and the PRP + BMSCs group was significantly improved as compared to that of the control group and the BMSCs group (all P < 0.05), and there was no significant difference between the PRP group and the PRP + BMSCs group (P > 0.05). All subjects were divided into the non‐healing group and the healing group in accordance with the HE staining results in previous experiment. The injury of cartilage of lateral femoral condyle was significantly heavier in the non‐healing group than that in the healing group.ConclusionThe application of PRP alone or in combination with BMSCs could promote the clinical healing rate of meniscal white‐white zone injury.

Computer simulation of tumour resection-induced brain deformation by a meshless approach.

Tumour resection requires precise planning and navigation to maximise tumour removal while simultaneously protecting nearby healthy tissues. Neurosurgeons need to know the location of the remaining tumour after partial tumour removal before continuing with the resection. Our approach to the problem uses biomechanical modelling and computer simulation to compute the brain deformations after the tumour is resected. In this study, we use meshless Total Lagrangian explicit dynamics as the solver. The problem geometry is extracted from the patient-specific magnetic resonance imaging (MRI) data and includes the parenchyma, tumour, cerebrospinal fluid and skull. The appropriate non-linear material formulation is used. Loading is performed by imposing intra-operative conditions of gravity and reaction forces between the tumour and surrounding healthy parenchyma tissues. A finite frictionless sliding contact is enforced between the skull (rigid) and parenchyma. The meshless simulation results are compared to intra-operative MRI sections. We also calculate Hausdorff distances between the computed deformed surfaces (ventricles and tumour cavities) and surfaces observed intra-operatively. Over 80% of points on the ventricle surface and 95% of points on the tumour cavity surface were successfully registered (results within the limits of two times the original in-plane resolution of the intra-operative image). Computed results demonstrate the potential for our method in estimating the tissue deformation and tumour boundary during the resection.

Analysis of intercondylar notch size and shape in patients with cyclops syndrome after anterior cruciate ligament reconstruction

BackgroundCyclops lesion is the second most common cause of extension loss after anterior cruciate ligament reconstruction. This study focused on the correlation between the anatomy of the intercondylar notch and the incidence of cyclops lesion. To determine whether the size and shape of the intercondylar notch are related to cyclops lesion formation following anterior cruciate ligament reconstruction according to magnetic resonance imaging (MRI) findings.MethodsOne hundred twenty-five (125) patients were retrospectively evaluated. The notch width index (NWI) and notch shape index (NSI) were measured based on coronal and axial MRI sections in patients diagnosed with cyclops syndrome (n = 25), diagnosed with complete anterior cruciate ligament (ACL) tears (n = 50), and without cyclops lesions or ACL ruptures (n = 50).ResultsImaging analysis results showed that the cyclops and ACL groups had lower mean NWI and NSI values than the control group. Significant between-group differences were found in NSI (p = 0.0140) based on coronal cross-sections and in NWI (p = 0.0026) and NSI (p < 0.0001) based on axial sections.ConclusionsThe geometry of the intercondylar notch was found to be associated with the risk of cyclops lesion formation and ACL rupture.

Accuracy of Magnetic Resonance Imaging in Evaluating the Depth and Level of Invasion of Buccal Carcinoma: A Prospective Cohort Study

This study evaluated the accuracy of magnetic resonance imaging (MRI) in determining the depth and level of invasion of buccal carcinoma. Patients with buccal squamous cell carcinoma diagnosed pathologically from July 2016 to December 2019 were included. The depth of invasion (DOI) and level of invasion (LOI) were evaluated by MRI, intraoperative specimens and pathological sections. Statistical analyses were performed using IBM SPSS software version 25.0 (IBM Corp., Armonk, NY). Forty-nine patients were ultimately included. The overall difference in DOI between MRI and pathological sections (DMP) was 5.55 ± 2.40 mm, and T category correlated with the differences in DOI measurement and LOI assessment. The threshold value of DOI by MRI to identify lymph node metastasis was 8.5 mm, and that for overall survival (OS) and disease-specific survival (DSS) was 14.1 mm for both. Buccinator invasion on MRI correlated with OS and DSS. Tumors with MRI-derived DOI larger than 8.5 mm deserve simultaneous neck dissection at initial surgery. Buccinator invasion was found to be an independent prognostic factor for buccal carcinoma patients.

A novel approach for computerized quantitative image analysis of proximal femur bone shape deformities based on the hip joint symmetry

As a result of most of the bone disorders seen in hip joints, shape deformities occur in the structural form of the hip joint components. Image-based quantitative analysis and assessment of these deformities in bone shapes are very important for the evaluation, treatment, and prognosis of the various hip joint bone disorders. In this article, a novel approach for the image-based computerized quantitative analysis of proximal femur shape deformities is presented. In the proposed approach, shape deformities of the pathological proximal femurs were quantified over the contralateral healthy proximal femur shape structure of the same patient in 2D by taking the hip joint symmetry property of human anatomy into consideration. It is based on the idea that if the right and left proximal femurs in bilateral hip joints are highly symmetrical and also if one of the proximal femurs is healthy and the contralateral one is pathological, the non-overlapping bone shape regions can represent the deformities in pathological proximal femurs when both proximal femurs are registered to overlap each other. In the methodological process of the proposed study, a set of image preprocessing operations was primarily performed on the raw magnetic resonance imaging (MRI) data. Then, the segmented proximal femurs in bilateral hip joint images were automatically aligned with the Iterative Closest Point (ICP) rigid registration method. Following the registration, a set of image postprocessing operations was performed on the images of proximal femurs aligned. In the quantification phase, the bone shape deformities in pathological proximal femurs were quantified simply in terms of the mismatching area in 2D by measuring a shape variation index representing the total bone shape deformity ratio. To evaluate the proposed quantitative shape analysis approach, bilateral hip joints in a total of 13 coronal MRI sections of 13 patients with Legg-Calve-Perthes disease (LCPD) were used. Experimental studies have shown that the proposed approach has quite promising results in the quantitative representation of the pathological proximal femur shape deformities. Furthermore, consistent results have been observed for the Waldenström classification stages of the disease. The shape deformity ratios in pathological proximal femurs were quantified as 9.44% (±1.40), 18.38% (±6.30), 24.73% (±12.42), and 27.66% (±10.41), respectively for the Initial, Fragmentation, Reossification, and Remodelling stages of LCPD with the quantification error rates of 0.29% (±0.16), 0.58% (±0.71), 1.12% (±0.82), and 0.80% (±0.98). Additionally, a mean error rate of 0.65% (±0.68) was observed for the quantified shape deformity ratios of all samples.

Value of intravoxel incoherent motion and diffusion kurtosis imaging in predicting peritumoural infiltration of soft-tissue sarcoma: a prospective study based on MRI–histopathology comparisons

To investigate the performance of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in the identification of peritumoural infiltration of soft-tissue sarcoma (STS). From July 2018 to January 2020, 34 STS patients who underwent 3-T magnetic resonance imaging (MRI), including IVIM and DKI, were reviewed. The standard apparent diffusion coefficient (ADC), true diffusion (D), pseudo-diffusion coefficient (D∗), perfusion fraction (f), mean kurtosis (MK), and mean diffusion (MD) of each lesion were analysed independently by two observers. An MRI-histopathology control method was used to ensure the correspondence of MRI sections with histopathological sections. Differences in STS with and without infiltration were evaluated. The area under the curve (AUC) was used to determine the best cut-off point for different parameters. Interobserver agreement was assessed using the intraclass correlation coefficient. Standard ADC, D, MK, and MD values reliably distinguished STS that had positive and negative infiltration. The MD value had the best diagnostic performance. Use of an MD cut-off value of 2.35×10-3 mm2/s to distinguish positive and negative infiltration had an AUC of 0.85, accuracy of 88.2%, sensitivity of 94.4%, and specificity of 81.3%. The two independent observers had nearly perfect agreement for all parameters. The standard ADC and D value of IVIM, and the MK and MD values of DKI reliably identify the presence of peritumoural infiltration of STS.

Prognostic value of serum HE4 level in the management of endometrial cancer: A pilot study.

Human epididymis protein 4 (HE4) has shown promising utility as a prognostic biomarker in endometrial cancer. Increased serum HE4 levels may be associated with deeper myometrial invasion, extrauterine disease and poorer prognosis. To evaluate the use of serum HE4 level, compared to and alongside other investigations, to accurately guide management in apparent early-stage endometrial cancer. This is a single-site prospective study of 100 patients with histologically confirmed endometrial cancer. All patients underwent preoperative measurements of HE4 and CA125 levels and a preoperative magnetic resonance imaging (MRI) to assess the depth of invasion, nodal status and tumour size. Correlation was sought between serum HE4 level, CA125 level, MRI findings and intra-operative frozen section with tumour type, grade and stage. While both median HE4 and CA125 levels were higher with worsening clinicopathological features, serum HE4 level showed a more consistent association with high-risk features. Patients with a low-grade biopsy preoperatively and a low HE4 level (<70pmol/L) demonstrated an 86.8% likelihood of having low-risk disease on final histopathology. In comparison, preoperative MRI or intraoperative frozen section alongside a low-grade biopsy demonstrated a similar likelihood of 86.2 and 87.7%, respectively. When used in conjunction with an initial low-grade endometrial biopsy, serum HE4 level demonstrated a similar likelihood to both preoperative MRI and intraoperative frozen section in identifying low-risk disease on final histopathology. As a triaging tool this may be significant given that a preoperative, serum-based assay would likely be the least invasive, least resource-intensive and most cost-effective approach.

A basic MRI anatomy of the rat brain in coronal sections for practical guidance to neuroscientists

Identification of the brain structures in the magnetic resonance imaging (MRI) of the rat is very important for the experimental work of many neuroscientists. Our intention was to recognize most of the structures without overlapping the MRI sections with the histological templates. Three live rats were used for this study who were examined in a micro-MRI apparatus by performing T2-weighted sequences in serial brain sections. Most of the white matter structures were easily identified, e.g. the anterior commissure, corpus callosum with forceps minor and major, cingulum, external and internal capsules, fornix, stria medullaris and terminalis, cranial nerves, mammillothalamic tract, fasciculus retroflexus, medial and lateral lemniscus, posterior commissure, commissures of the superior and inferior colliculi, medial longitudinal fasciculus, and the cerebral peduncle. Large and small gray matter structures were recognized as well, for example, the anterior olfactory structures, nucleus accumbens, caudate putamen, claustrum, bed nucleus of the stria terminalis, pituitary gland, globus pallidus, amygdala, some midline and intralaminar thalamic nuclei, certain hypothalamic nuclei, hippocampal formation, pineal body, periaqueductal gray matter, lateral and medial geniculate bodies, superior and inferior colliculi, and cranial nerves nuclei. All in all, of the total 160 recognized brain structures, 77 were identified without using the corresponding histological atlases. We believe that our labeled MRI pictures could be an important way for quick orientation for evaluating the effects of the experimental work regarding the rat brain.