Sensitivity Of Magnetic Resonance Imaging Research Articles

Contribution of Imaging in the Hydatid Cyst of Soft Tissues in the Thigh: A Case Report and Literature Review

Hydatid cysts in soft tissues remain a rare occurrence, even in endemic regions. This study underscores the crucial importance of imaging modalities for positive diagnosis and topography, providing optimal guidance for effective management strategies. In this article, we present a case of soft tissue hydatidosis in the thigh, directly explored through magnetic resonance imaging (MRI), complemented by soft tissue ultrasound. The observed mass contained vesicles, localized in the thigh. The diagnosis of hydatidosis suggested by ultrasound was confirmed by MRI. A curative surgical intervention was performed on our patient. The diagnosis of soft tissue hydatidosis can be established when ultrasound and/or MRI reveal a multivesicular appearance. MRI proves to be the most useful imaging modality in cases of atypical or pseudo-solid lesions. The peri-cystic enhancement serves as an indicative feature of soft tissue hydatidosis compared to other locations. The study emphasizes the rarity of muscular localization of hydatid cysts and highlights the crucial importance of radiological, surgical, and preventive diagnostic approaches in managing this pathology. The heightened sensitivity of MRI in cases of atypical ultrasound features underscores its central role in the contemporary management of this complex condition, enhancing both diagnostic precision and treatment planning.

Visualization of Reissner's membrane in the mouse inner ear using highly sensitive magnetic resonance imaging analysis

Although research on hearing loss, including the identification of causative genes, has become increasingly active, the pathogenic mechanism of hearing loss remains unclear. One of the reasons for this is that the structure of the inner ear of mice, which is commonly used as a genetically modified animal model, is too small and complex, making it difficult to accurately capture abnormalities and dynamic changes in vivo. Especially, Reissner's membrane is a very important structure that separates the perilymph and endolymph of the inner ear. This malformation or damage induces abnormalities in hearing and balance. Until now, imaging analyses, such as magnetic resonance imaging (MRI) and computed tomography, are performed to investigate the inner ear structure in vivo; however, it has been difficult to analyze the small inner ear structure of mice owing to resolution. Therefore, there is an urgent need to develop an image analysis method that can accurately capture the structure of the inner ear of mice including Reissner's membrane, both dynamically and statically.This study aimed to investigate whether it is possible to accurately capture the structure (e.g., Reissner's membrane) and abnormalities of the inner ear of mice using an 11.7T MRI. By combining two types of MRI methods, in vivo and ex vivo, we succeeded for the first time in capturing the fine structure of the normal mouse inner ear, such as the Reissner’s membrane, and inflammatory lesions of otitis media mouse models in detail and accurately. In the future, we believe that understanding the state of Reissner's membrane during living conditions will greatly contribute to the development of research on inner ear issues, such as hearing loss.

DIAGNOSTIC PERFORMANCE OF CONTRAST-ENHANCED SPECTRAL MAMMOGRAPHY: COMPARISON WITH CONTRAST-ENHANCED DYNAMIC MR IMAGING IN PATIENTS WITH SUSPECTED BREAST CANCER

OBJECTIVE: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with dynamic contrast-enhanced magnetic resonance (MR) imaging in terms of the detection of BI-RADS 4 and 5 lesions suspected of breast cancer. MATERIAL AND METHODS: 92 patients with ACR BI-RADS 4 and 5 lesions underwent CESM, MR Imaging, and consequent core biopsy. Two readers assessed the index lesions which were classified as mass lesions, non-mass lesions, and microcalcifications, and scored using a 7-point scoring system. RESULTS: A total of 98 index lesions were detected, including bilateral lesions in six patients. In histopathological analysis, 56 of the lesions were benign (56/98, 57%,) and 42 of the lesions were malignant (42/98, 43%). 55 of the lesions were classified as mass lesions, 18 as non-mass lesions, and 25 as microcalcifications. CESM scored 28 of the lesions (28,6%) as benign, and 70 (71,4%) of the lesions were malignant whereas these results were 30 (30,6%) and 68 (69,4%) for MR Imaging examinations, respectively. The sensitivity of both CESM and MR imaging for depicting the index cancer was 95 % for both modalities. In ROC (Receiver Operating Characteristic) analysis, AUC (Area Under the Curve) was 0.93 (%95 CI:0.870-0.977) for CESM and 0.94 (%95 CI:0.882-0.982) for MR Imaging. There was no statistically significant difference in AUC values between CESM and MR Imaging (p=0.332; p>0.05). CONCLUSIONS: The diagnostic performance of CESM is similar when compared to MR imaging in the detection of index cancers in patients with BI-RADS 4 and 5 lesions. CESM may be used as a confidential diagnostic tool in this regard.

Comparison of Ultrasound and MRI in Detecting Breast Cancer: A Retrospective Study in Mumbai Hospitals, India

Introduction: Breast cancer is the most common cancer in women throughout the world. Early detection of breast cancer is very important to increase the chances of cure. Ultrasonography (USG) and magnetic resonance imaging (MRI) are two imaging methods commonly used to detect breast cancer. The aim of this study was to compare the accuracy of ultrasound and MRI in detecting breast cancer in female patients at Mumbai Hospital, India.
 Methods: A retrospective study was conducted on 2435 female patients who underwent ultrasound and MRI examinations at Mumbai Hospital, India between 2018 and 2023. Patient data was collected from electronic medical records and analyzed to compare the accuracy of ultrasound and MRI in detecting breast cancer.
 Results: The research results show that MRI is more accurate than ultrasound in detecting breast cancer. MRI sensitivity was 95.2%, while ultrasound sensitivity was 78.3%. The specificity of MRI was 98.7%, while the specificity of USG was 94.3%. The positive predictive value of MRI was 95.2%, while the positive predictive value of USG was 87.5%. The negative predictive value of MRI was 98.7%, while the negative predictive value of USG was 94.3%.
 Conclusion: MRI is recommended as the primary imaging method for detecting breast cancer in female patients. Ultrasound can be used as a complementary method to MRI.

Magnetic Resonance Imaging Indirect Signs for Anterior Instability of the Lateral Meniscus in Pediatric and Adolescent Patients.

Anterior instability (AI) of the LM is potentially debilitating in young patients. The use of magnetic resonance imaging (MRI) to diagnose AI is limited due to the lack of reliable and accurate MRI findings. The ability to identify AI preoperatively would potentially improve the diagnosis and treatment of this pathology. This study presents a novel MRI finding ("phantom sign") for the detection of AI of the LM and demonstrates its reliability and accuracy. Three independent blinded reviewers performed retrospective review of preoperative MRI for all patients who underwent LM repair between July 1, 2019, and March 31, 2022, at a single center. Positive phantom sign was defined as abnormal signal intensity on MRI of the anterior horn of the LM on the coronal sequence at the anterior tibial insertion of the anterior cruciate ligament (ACL). Preoperative MRI was also evaluated for other signs of LM anterior instability. Intrarater and inter-rater reliability was assessed for rater scoring of presence of pathology on MRI. Predictive ability of each imaging finding with at least good (ICC 0.6 or above) reliability was also evaluated based on documented intraoperative findings. Fifty-five preoperative MRIs of arthroscopically treated LM tears were reviewed. Median age was 15 years (range 6 to 20), and 21 patients (38.2%) were female. Twenty-seven patients (49.1%) had a discoid meniscus. LM AI was present on arthroscopy for 25 knees (45.45%), and among these, 21 had discoid morphology. Interrater reliability was substantial for phantom sign (ICC 0.71, 97.5% CI: 0.55-0.82), posterior displacement (ICC 0.71, 97.5% CI: 0.55-0.82), and posterior "megahorn" (ICC 0.76, 97.5% CI: 0.62-0.85). On predictive analysis, phantom signs were 98% sensitive and 76.7% specific for LM AI. Posterior displacement and posterior megahorn were specific for AI (both 93.34%), though with limited sensitivity (32% and 28.6%, respectively). Phantom sign is a reliable and sensitive MRI finding for anterior instability, even in the absence of frank displacement on preoperative MRI. A positive finding should prompt a thorough arthroscopic evaluation of the anterior horn of the LM. Level III-case control study.

Contrast Agents Based on Human Serum Albumin and Nitroxides for 1H-MRI and Overhauser-Enhanced MRI.

In cancer diagnostics, magnetic resonance imaging (MRI) uses contrast agents to enhance the distinction between the target tissue and background. Several promising approaches have been developed to increase MRI sensitivity, one of which is Overhauser dynamic nuclear polarization (ODNP)-enhanced MRI (OMRI). In this study, a macromolecular construct based on human serum albumin and nitroxyl radicals (HSA-NIT) was developed using a new synthesis method that significantly increased the modification to 21 nitroxide residues per protein. This was confirmed by electron paramagnetic resonance (EPR) spectroscopy and matrix-assisted laser desorption/ionization time-of-flight (MALDI ToF) mass spectrometry. Gel electrophoresis and circular dichroism showed no significant changes in the structure of HSA-NITs, and no oligomers were formed during modification. The cytotoxicity of HSA-NITs was comparable to that of native albumin. HSA-NITs were evaluated as potential "metal-free" organic radical relaxation-based contrast agents for 1H-MRI and as hyperpolarizing contrast agents for OMRI. Relaxivities (longitudinal and transversal relaxation rates r1 and r2) for HSA-NITs were measured at different magnetic field strengths (1.88, 3, 7, and 14 T). Phantoms were used to demonstrate the potential use of HSA-NIT as a T1- and T2-weighted relaxation-based contrast agent at 3 T and 14 T. The efficacy of 1H Overhauser dynamic nuclear polarization (ODNP) in liquids at an ultralow magnetic field (ULF, B0 = 92 ± 0.8 μT) was investigated for HSA-NIT conjugates. The HSA-NITs themselves did not show ODNP enhancement; however, under the proteolysis conditions simulating cancer tissue, HSA-NIT conjugates were cleaved into lower-molecular-weight (MW) protein fragments that activate ODNP capabilities, resulting in a maximum achievable enhancement |Emax| of 40-50 and a radiofrequency power required to achieve half of Emax, P1/2, of 21-27 W. The HSA-NIT with a higher degree of modification released increased the number of spin probes upon biodegradation, which significantly enhanced the Overhauser effect. Thus, HSA-NITs may represent a new class of MRI relaxation-based contrast agents as well as novel cleavable conjugates for use as hyperpolarizing contrast agents (HCAs) in OMRI.

Does sacroiliitis is a mandatory criterion for enthesitis-related arthritis diagnosis?

Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA). We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients. We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype. ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1=16 versus G2=3, p=0.005). Sacroiliac joints MRI's sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68-28.09; p=0.006). Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.

IMJENSE: Scan-Specific Implicit Representation for Joint Coil Sensitivity and Image Estimation in Parallel MRI.

Parallel imaging is a commonly used technique to accelerate magnetic resonance imaging (MRI) data acquisition. Mathematically, parallel MRI reconstruction can be formulated as an inverse problem relating the sparsely sampled k-space measurements to the desired MRI image. Despite the success of many existing reconstruction algorithms, it remains a challenge to reliably reconstruct a high-quality image from highly reduced k-space measurements. Recently, implicit neural representation has emerged as a powerful paradigm to exploit the internal information and the physics of partially acquired data to generate the desired object. In this study, we introduced IMJENSE, a scan-specific implicit neural representation-based method for improving parallel MRI reconstruction. Specifically, the underlying MRI image and coil sensitivities were modeled as continuous functions of spatial coordinates, parameterized by neural networks and polynomials, respectively. The weights in the networks and coefficients in the polynomials were simultaneously learned directly from sparsely acquired k-space measurements, without fully sampled ground truth data for training. Benefiting from the powerful continuous representation and joint estimation of the MRI image and coil sensitivities, IMJENSE outperforms conventional image or k-space domain reconstruction algorithms. With extremely limited calibration data, IMJENSE is more stable than supervised calibrationless and calibration-based deep-learning methods. Results show that IMJENSE robustly reconstructs the images acquired at 5× and 6× accelerations with only 4 or 8 calibration lines in 2D Cartesian acquisitions, corresponding to 22.0% and 19.5% undersampling rates. The high-quality results and scanning specificity make the proposed method hold the potential for further accelerating the data acquisition of parallel MRI.

Preoperative Imaging in Cochlear Implants.

To determine the utility of computed tomography (CT) and magnetic resonance imaging (MRI) in cochlear implant candidates. Retrospective case review. Tertiary referral hospital. A total of 207 cochlear implanted patients with CT and/or MRI. N/A. Age versus abnormal radiologic findings, imaging abnormality versus postoperative outcomes, postoperative outcomes versus electrode design, Cambridge Cochlear Implant Protocol (CCIP) status for imaging abnormalities, sensitivity and specificity of CT and MRI for round-window/cochlear occlusion, and MRI for incomplete partitions. A total of 207 patients with CT, MRI, or both were reviewed retrospectively. Less than half (15.5%) of CT scans had findings that might affect surgical intervention compared with 5.9% of MRI. No significant difference was found between children and adults for relevant imaging abnormalities (grade 4 or higher) with either CT (p = 0.931) or MRI (p = 0.606). CCIP status correlated with cochlear abnormalities (p = 0.040); however, only 46.2% of radiographic abnormalities on CT would be identified by these criteria. For detecting cochlear occlusion requiring surgical intervention, the sensitivity and specificity for CT were 40% (4 of 10; 95% confidence interval [CI], 12.16-73.76) and 95.73% (95% CI, 91.40-98.27), respectively. For MRI, the sensitivity and specificity were 33.33% (1 of 3; 95% CI, 0.84-90.57) and 96.97% (63 of 65; 95% CI, 89.32-99.63), respectively. There was no difference for postoperative AzBio scores for higher-grade imaging abnormalities (p = 0.6012) or for electrode designs (p = 0.3699). Significant radiographic abnormalities were relatively uncommon in cochlear implant patients on either CT or MRI at our single-center institution. If present, abnormal imaging findings rarely translated to management changes. CCIP status does not reliably predict which patients are likely to have abnormalities. Both MRI and CT have low sensitivity for round-window or cochlear occlusion, but detection likely leads to changes in surgical management.

The Sensitivity of Limited-Sequence MRI in Identifying Pediatric Cervical Spine Injury: A Western Pediatric Surgery Research Consortium Multicenter Retrospective Cohort Study.

Clinical clearance of a child's cervical spine after trauma is often challenging due to impaired mental status or an unreliable neurologic examination. Magnetic resonance imaging (MRI) is the gold standard for excluding ligamentous injury in children but is constrained by long image acquisition times and frequent need for anesthesia. Limited-sequence MRI (LSMRI) is used in evaluating the evolution of traumatic brain injury and may also be useful for cervical spine clearance while potentially avoiding the need for anesthesia. The purpose of this study was to assess the sensitivity and negative predictive value of LSMRI as compared to gold standard full-sequence MRI as a screening tool to rule out clinically significant ligamentous cervical spine injury. We conducted a ten-center, five-year retrospective cohort study (2017-2021) of all children (0-18y) with a cervical spine MRI after blunt trauma. MRI images were re-reviewed by a study pediatric radiologist at each site to determine if the presence of an injury could be identified on limited sequences alone. Unstable cervical spine injury was determined by study neurosurgeon review at each site. We identified 2,663 children less than 18 years of age who underwent an MRI of the cervical spine with 1,008 injuries detected on full-sequence studies. The sensitivity and negative predictive value of LSMRI were both >99% for detecting any injury and 100% for detecting any unstable injury. Young children (age < 5 years) were more likely to be electively intubated or sedated for cervical spine MRI. LSMRI is reliably detects clinically significant ligamentous injury in children after blunt trauma. To decrease anesthesia use and minimize MRI time, trauma centers should develop LSMRI screening protocols for children without a reliable neurologic exam. 2 (Diagnostic Tests or Criteria).

Diagnostic Accuracy of MRI in Detecting Orbital Masses Keeping Histopathology as Gold Standard

Background: Orbital masses, encompassing a spectrum of benign and malignant lesions, pose significant diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI) has been pivotal in the non-invasive evaluation of these lesions, owing to its superior soft tissue contrast and detailed anatomical resolution. The correlation between MRI findings and histopathological diagnosis remains crucial for accurate clinical decision-making. Objective: The study aimed to evaluate the diagnostic accuracy of MRI in identifying orbital masses, with a focus on differentiating between benign and malignant lesions, using histopathology as the gold standard. Methods: A prospective cross-sectional study was conducted at Jinnah Postgraduate Medical Centre (JPMC), Karachi, from January to December 2023. A total of 145 patients scheduled for surgery or biopsy, presenting with clinical symptoms indicative of orbital masses, were enrolled using a non-probability sequential sampling method. MRI evaluations were performed using a 1.5 Tesla machine. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of MRI in detecting orbital masses were calculated, comparing MRI findings with histopathological results. Results: Of the 145 patients, 55.2% were female, and 44.8% were male, with an age range predominantly between 18-30 years (87.6%). MRI identified 77.2% of cases as malignant and 22.8% as benign, whereas histopathology diagnosed 83.4% as malignant and 16.6% as benign. The diagnostic accuracy of MRI for benign masses showed a sensitivity of 81.82%, specificity of 96.43%, PPV of 87.10%, NPV of 94.74%, and an overall diagnostic accuracy of 93.10%. For malignant masses, MRI demonstrated a sensitivity of 90.16%, specificity of 86.90%, PPV of 83.33%, NPV of 92.41%, and a diagnostic accuracy of 88.28%. Conclusion: MRI exhibits a high diagnostic accuracy in identifying orbital masses, with excellent sensitivity and specificity. It proves to be a reliable diagnostic tool in differentiating between benign and malignant orbital lesions, supporting its integral role in the preoperative assessment and clinical management of patients with suspected orbital masses. Keywords: Orbital Masses, Magnetic Resonance Imaging, Diagnostic Accuracy, Histopathology, Benign Lesions, Malignant Lesions, MRI Sensitivity, MRI Specificity

A Dual-Gene Reporter-Amplifier Architecture for Enhancing the Sensitivity of Molecular MRI by Water Exchange.

The development of genetic reporters for magnetic resonance imaging (MRI) is essential for investigating biological functions in vivo. However, current MRI reporters have low sensitivity, making it challenging to create significant contrast against the tissue background, especially when only a small fraction of cells express the reporter. To overcome this limitation, we developed an approach for amplifying the sensitivity of molecular MRI by combining a chemogenetic contrast mechanism with a biophysical approach to increase water diffusion through the co-expression of a dual-gene construct comprising an organic anion transporting polypeptide, Oatp1b3, and a water channel, Aqp1. We first show that the expression of Aqp1 amplifies MRI contrast in cultured cells engineered to express Oatp1b3. We demonstrate that the contrast amplification is caused by Aqp1-driven increase in water exchange, which provides the gadolinium ions internalized by Oatp1b3-expressing cells with access to a larger water pool compared with exchange-limited conditions. We further show that our methodology allows cells to be detected using approximately 10-fold lower concentrations of gadolinium than that in the Aqp1-free scenario. Finally, we show that our approach enables the imaging of mixed-cell cultures containing a low fraction of Oatp1b3-labeled cells that are undetectable on the basis of Oatp1b3 expression alone.

Polymer/iron oxide nanocomposites as magnetic resonance imaging contrast agents: Polymer modulation and probe property control

AbstractSuperparamagnetic iron oxide nanoparticles (SPIONs) are commonly used as magnetic resonance imaging (MRI) probes/contrast agents in clinical diagnosis because they can significantly improve the sensitivity of MRI. Polymers including natural and synthetic polymers with good biosafety and abundant surface groups are ideal surface coating for SPIONs to overcome their drawbacks such as poor colloidal stability, low relaxivity, and lack of functionality. Several SPIONs' structural properties such as crystal shape and size, charge, shell thickness, and cluster determine their relaxivity, biosafety, and in vivo imaging effect. Therefore, the rational design of SPIONs probes must explore the relationship between polymer structure and SPION properties. In this review, key structural properties of polymers such as surface groups, molecular weight, hydrophilicity, and grafting density are discussed for their effects on key properties of SPIONs. Additionally, some special polysaccharides, polypeptides, and antibodies can be used as targeting molecules to improve the imaging specificity of SPIONs, which is also briefly discussed in this review.

Sensitivity of Magnetic Resonance Imaging in Detection of Choroidal Metastases

Introduction: The objective of this study was to determine the sensitivity of brain magnetic resonance imaging (MRI) in the detection of choroidal metastasis (CM) from systemic primary cancers. Methods: A retrospective chart review identified patients with clinically confirmed CM seen on the Oncology Service (Byers Eye Institute) between January 2018 and March 2022. Patients had an MRI brain and/or orbits performed within 3 months of CM diagnosis. Evaluation of CM detection by MRI was then divided into two parts: an initial “standard read,” where determination of CM detection was based solely on the original radiology report, to reflect real-world performance, and a subsequent “dedicated read,” for which a board-certified neuroradiologist, blinded to the laterality and location of the CM, reevaluated the studies to provide an objective “gold standard” interpretation regarding the radiographic detection of CM. Results: The study included 42 eyes of 40 patients with confirmed CM. On standard read, MRI detection of CM occurred in 21 of 42 eyes (50%), with no significant difference between MRI brain and orbit protocols (p = 0.249). Features associated with improved detection were increased tumor basal diameter (p p = 0.003). On dedicated read, MRI detection of CM improved to 26 of 33 eyes (76%; limited to eyes with full complement of pre- and post-gadolinium sequences). Post-gadolinium 3D fluid-attenuated inversion recovery (FLAIR) sequence with fat suppression was the most sensitive (88%) for CM detection. 42% and 58% of lesions were visualized using conventional pre-gadolinium T1- and T2-weighted imaging, respectively. Conclusions: MRI sensitivity to detect CM improved from 50% to 76% with focused reinterpretation. Increased utilization of the post-gadolinium 3D FLAIR sequence and increased ocular scrutiny in cancer patients undergoing brain imaging may facilitate earlier diagnosis of CM.

Transformable Magnetic Liquid-Metal Nanoplatform for Intracellular Drug Delivery and MR Imaging-Guided Microwave Thermochemotherapy.

Improved techniques for the administration of chemotherapeutic drugs are required to enhance tumor therapy efficacy and reduce the side effects of chemotherapy due to insufficient targeting and limited intratumoral drug release. Controlled drug delivery systems combined with thermotherapy are expected to play an important role in personalized tumor therapy. Herein, a novel microwave-responsive transformable magnetic liquid-metal (MLM) nanoplatform is designed for effective endosomal escape that facilitates intracellular drug delivery and enhanced anticancer therapy. The MLM nanoplatform exhibits a sensitive magnetic resonance imaging function for imaging-guided therapy and brilliant synergistic effects of chemotherapy with microwave thermal therapy to kill tumor cells. Once endocytosed by targeted tumor cells, the deep penetration of microwave energy can be absorbed by the MLM nanoplatform to convert heat and reactive oxygen species, which induces the shape transformation from nanospheres to large rods, resulting in the physical disruption of the endosomal membrane for intracellular drug release. Furthermore, the MLM nanoplatform synergistic therapy could activate immunomodulatory effects by M1 macrophage polarization and T cell infiltration, thus inhibiting tumor growth and lung metastasis. This work based on microwave-driven transformable magnetic liquid-metal nanoplatform provides novel ways to precisely control drug delivery and high-efficiency cancer therapy.

Evaluation of diagnostic value of pelvic MRI in endometriosis in comparison with surgical findings: A cross-sectional study.

Endometriosis is a multifocal gynecologic disorder during the fertility period in women. Magnetic resonance imaging (MRI) is an important diagnostic modality for this disease and can either be used alone or along with transvaginal ultrasonography. This study aims to compare the accuracy of pelvis MRI in pelvic deep endometriosis with laparoscopic findings in women referred to Shahid Sadoughi hospital in one year. This cross-sectional study was conducted on 40 women suspicious of endometriosis who referred to Shahid Sadoughi hospital, Yazd, Iran from November 2020-2021. Based on clinical findings and history, participants were referred to the imaging center for pelvic MRI. Finally, the results of MRI and diagnostic laparoscopy were compared with pathologic findings. The sensitivity and specificity of MRI for pelvic endometriosis were 94.8% and 20%, respectively. Also, the positive predictive value and negative predictive value of MRI were 90.2% and 33.3%, respectively. Laparoscopy is still the gold standard of endometriosis diagnosis, but MRI with susceptibility-weighted imaging sequence is the best noninvasive diagnostic method.

Role of magnetic resonance imaging in differentiating tuberculous spondylitis from pyogenic spondylitis in a TB endemic area

Background: Infectious spondylitis is an infection by a specific organism of one or more components of spine, namely the vertebra, intervertebral discs, paraspinal soft tissues, and epidural space. Magnetic resonance imaging (MRI) of the spine is gold standard in imaging to assess anatomical abnormalities of the spine and surrounding structures. Methods: This cross-sectional observational study was conducted in the Department of Radiology Narayan Medical College and Hospital Sasaram, Bihar (India), where tuberculosis is endemic from July 2022 to September 2023. It included 40 patients, purposively sampled, adhering to strict inclusion and exclusion criteria. Sensitivity, specificity and accuracy of MRI in discriminating tuberculous spondylitis from pyogenic spondylitis were compared against histopathological diagnosis and differences in MRI findings between these conditions were obtained. Results: In this study, 93% patients with tuberculous spondylitis had an enhanced signal with well-defined margins. Meanwhile, pyogenic spondylitis provided an ill-defined margins in 72.7% patients. Most of the patients 82.7% with tuberculous spondylitis showed thin and smooth wall paravertebral abscesses, while pyogenic spondylitis showed an irregular and thick wall paravertebral abscesses in 45% patients. A total of 72.4% patients with tuberculous spondylitis indicated involvement of ≥3 vertebral bodies. 100% patients with pyogenic spondylitis showed an abnormal contrast enhancement of the intervertebral discs. It was identified that tuberculous spondylitis had sensitivity, specificity, and accuracy values of 100%, 84.6%, and 95.2% respectively. For pyogenic spondylitis, the corresponding values were 84.6%, 96.6%, and 93%. Conclusions: MRI was accurate for differentiation of tuberculous spondylitis from pyogenic spondylitis. A well-defined paraspinal abnormal signal, a thin and smooth abscess wall, subligamentous spread to three or more vertebral levels, and less likely involvement of intervertebral discs were more suggestive of tuberculous spondylitis than pyogenic spondylitis.

The Role of Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of the Adherent Placenta: An Observational Study.

Introduction Placenta accreta is an important factor responsible for maternal morbidity and mortality and is commonly associated with emergent postpartum hysterectomy. The precise prenatal diagnosis of affected pregnancies allows optimal obstetric management. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the only diagnostic modalities available for the prenatal diagnosis of placenta accreta. Objective This study aims to evaluate the accuracy of USG and MRI in diagnosing adherent placenta. Methods Thirty females with placenta previa or a history of previous cesarean sections were evaluated with USG at 28-30 weeks, followed by MRI. The findings of USG and MRI were compared with the intra-operative findings (gold standard) as determined at surgery and by pathological examination. Results Abnormal bridging vessel (n = 24; 80%) was the most common finding seen on USG, whereas abnormal bulge (n = 22; 73.3%) and heterogenous placenta (n = 21; 70%) were the most common findings seen on MRI. The sensitivity of USG and MRI was in the range of 86.7%-92.9% and 92.9%-100%, respectively, in diagnosing three types of adherent placenta. The positive predictive values (PPV) of USG and MRI were in the range of 86.7%-86.7%and93.8%-100%, respectively, in diagnosing three types of adherent placenta. The accuracy of USG and MRI was in the range of 86.7%-96.7% and 96.7%-100%, respectively, in diagnosing three types of adherent placenta. Conclusion MRI helps to accurately classify placental invasion according to depth, as can be seen from the results of the present study, where the MRI technique was more accurate in diagnosing three types of adherent placenta.

The Diagnostic Value of CEUS in Assessing Non-Ossified Thyroid Cartilage Invasion in Patients with Laryngeal Squamous Cell Carcinoma

Background: Accurate assessment of thyroid cartilage invasion in squamous cell carcinoma (SCC) of the larynx remains a challenge in clinical practice. The aim of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), and magnetic resonance imaging (MRI) in the detection of non-ossified thyroid cartilage invasion in patients with SCC. Methods: CEUS, CECT, and MRI scans of 27 male patients with histologically proven SCC were evaluated and compared. A total of 31 cases were assessed via CEUS and CECT. The MR images of five patients and six cases were excluded (one patient had two suspected sites), leaving twenty-five cases for analysis via MRI. Results: CEUS showed the highest accuracy and specificity compared with CECT and MRI (87.1% vs. 64.5% and 76.0% as well as 84.0% vs. 64.0% and 72.7%, respectively). The sensitivity and negative predictive value of CEUS and MRI were the same (100%). CEUS yielded four false-positive findings. However, there were no statistically significant differences among the imaging modalities (p &gt; 0.05). Conclusions: CEUS showed better diagnostic performance than CECT and MRI. Therefore, CEUS has the potential to accurately assess non-ossified thyroid cartilage invasion and guide appropriate treatment decisions, hopefully leading to improved patient outcomes.

DWI of the Spine: A Review and Update

The utility of DWI in the spine has been established and continues to grow in clinical practice. DWI raises the MR imaging sensitivity of lesion detection and improves the conspicuity of many spinal pathologies. Applications include evaluation of spinal cord infarction, bone marrow lesions, infection, degenerative disease, trauma, osteoporosis, malignancy, and response to therapy. In this article, we provide a case-based review to illustrate and discuss these uses. We also highlight DWI acquisition techniques and challenges. We provide protocol optimization tips that help to overcome these challenges and permit incorporation of DWI into the workflow.Learning Objective: To emphasize the role of DWI in the spine and discuss technical tips and considerations for protocol optimization