Fat-saturated T1 Research Articles

Prevalence of Rathke Cleft and Other Incidental Pituitary Gland Findings on Contrast-Enhanced 3D Fat-Saturated T1 MPRAGE at 7T MRI.

A cleftlike nonenhancing hypointensity was observed repeatedly in the pituitary gland at the adenohypophysis/neurohypophysis border on contrast-enhanced 3D fat-saturated T1-MPRAGE using clinical 7T MRI. Our primary goal was to assess the prevalence of this finding. The secondary goals were to evaluate the frequency of other incidental pituitary lesions, MRI artifacts, and their effect on pituitary imaging on the contrast-enhanced 3D fat-saturated T1 MPRAGE at 7T. One hundred patients who underwent 7T neuroimaging between October 27, 2021, and August 10, 2023, were included. Each case was evaluated for cleftlike pituitary hypointensity, pituitary masses, and artifacts on contrast-enhanced 3D fat-saturated T1 MPRAGE. Follow-up examinations were evaluated if present. The average prevalence for each finding was calculated, as were descriptive statistics for age and sex. A cleftlike hypointensity was present in 66% of 7T MRIs. There were no significant differences between the "cleftlike present" and "cleftlike absent" groups regarding sex (P = .39) and age (P = .32). The cleftlike hypointensity was demonstrated on follow-up MRIs in 3/3 patients with 7T, 1/12 with 3T, and 1/5 with 1.5T. A mass was found in 22%, while 75% had no mass and 3% were indeterminate. A mass was found in 18 (27%) of the cleftlike present and 4 (13%) of the cleftlike absent groups. The most common mass types were Rathke cleft cyst in 7 (31.8%) patients, "Rathke cleft cyst versus entrapped CSF" in 6 (27.3%), and microadenoma in 6 (22.2%) in the cleftlike present group. There were no significant differences in the mass types between the cleftlike present and cleftlike absent groups (P = .23). Susceptibility and/or motion artifacts were frequent using contrast-enhanced 3D fat-saturated T1 MPRAGE (54%). Artifact-free scans were significantly more frequent in the cleftlike present group (P = .03). A cleftlike nonenhancing hypointensity was frequently seen on the contrast-enhanced 3D fat-saturated T1 MPRAGE images at 7T MRI, which most likely represents a normal embryologic Rathke cleft remnant and cannot be seen in lower-field-strength MRIs. Susceptibility and motion artifacts are common in the sella. They may affect image quality, and the artifacts at 7T may lead to an underestimation of the prevalence of the Rathke cleft and other incidental findings.

Time-efficient combined morphologic and quantitative joint MRI: an in situ study of standardized knee cartilage defects in human cadaveric specimens

BackgroundQuantitative techniques such as T2 and T1ρ mapping allow evaluating the cartilage and meniscus. We evaluated multi-interleaved X-prepared turbo-spin echo with intuitive relaxometry (MIXTURE) sequences with turbo spin-echo (TSE) contrast and additional parameter maps versus reference TSE sequences in an in situ model of human cartilage defects.MethodsStandardized cartilage defects of 8, 5, and 3 mm in diameter were created in the lateral femora of ten human cadaveric knee specimens (81 ± 10 years old; nine males, one female). MIXTURE sequences providing proton density-weighted fat-saturated images and T2 maps or T1-weighted images and T1ρ maps as well as the corresponding two- and three-dimensional TSE reference sequences were acquired before and after defect creation (3-T scanner; knee coil). Defect delineability, bone texture, and cartilage relaxation times were quantified. Appropriate parametric or non-parametric tests were used.ResultsOverall, defect delineability and texture features were not significantly different between the MIXTURE and reference sequences (p ≤ 0.47). After defect creation, relaxation times significantly increased in the central femur (T2pre = 51 ± 4 ms [mean ± standard deviation] versus T2post = 56 ± 4 ms; p = 0.002) and all regions combined (T1ρpre = 40 ± 4 ms versus T1ρpost = 43 ± 4 ms; p = 0.004).ConclusionsMIXTURE permitted time-efficient simultaneous morphologic and quantitative joint assessment based on clinical image contrasts. While providing T2 or T1ρ maps in clinically feasible scan time, morphologic image features, i.e., cartilage defects and bone texture, were comparable between MIXTURE and reference sequences.Relevance statementEqually time-efficient and versatile, the MIXTURE sequence platform combines morphologic imaging using familiar contrasts, excellent image correspondence versus corresponding reference sequences and quantitative mapping information, thereby increasing the diagnostic value beyond mere morphology.Key points• Combined morphologic and quantitative MIXTURE sequences are based on three-dimensional TSE contrasts.• MIXTURE sequences were studied in an in situ human cartilage defect model.• Morphologic image features, i.e., defect delineabilty and bone texture, were investigated.• Morphologic image features were similar between MIXTURE and reference sequences.• MIXTURE allowed time-efficient simultaneous morphologic and quantitative knee joint assessment.Graphical

Two for One-Combined Morphologic and Quantitative Knee Joint MRI Using a Versatile Turbo Spin-Echo Platform.

Quantitative MRI techniques such as T2 and T1ρ mapping are beneficial in evaluating knee joint pathologies; however, long acquisition times limit their clinical adoption. MIXTURE (Multi-Interleaved X-prepared Turbo Spin-Echo with IntUitive RElaxometry) provides a versatile turbo spin-echo (TSE) platform for simultaneous morphologic and quantitative joint imaging. Two MIXTURE sequences were designed along clinical requirements: "MIX1", combining proton density (PD)-weighted fat-saturated (FS) images and T2 mapping (acquisition time: 4:59 min), and "MIX2", combining T1-weighted images and T1ρ mapping (6:38 min). MIXTURE sequences and their reference 2D and 3D TSE counterparts were acquired from ten human cadaveric knee joints at 3.0 T. Contrast, contrast-to-noise ratios, and coefficients of variation were comparatively evaluated using parametric tests. Clinical radiologists (n = 3) assessed diagnostic quality as a function of sequence and anatomic structure using five-point Likert scales and ordinal regression, with a significance level of α = 0.01. MIX1 and MIX2 had at least equal diagnostic quality compared to reference sequences of the same image weighting. Contrast, contrast-to-noise ratios, and coefficients of variation were largely similar for the PD-weighted FS and T1-weighted images. In clinically feasible scan times, MIXTURE sequences yield morphologic, TSE-based images of diagnostic quality and quantitative parameter maps with additional insights on soft tissue composition and ultrastructure.

Convolutional neural network denoising technique on MRI examination using parallel imaging grappa (Generalized autocalibrating partial parallel acquisition): A study on axial brain MRI T2 fat saturation flair

Convolutional neural network denoising technique on MRI examination using parallel imaging grappa (Generalized autocalibrating partial parallel acquisition): A study on axial brain MRI T2 fat saturation flair

Prevalence of Scarpa's ganglion enhancement on high-resolution MRI imaging.

The vestibular ganglion, or Scarpa's ganglion, is a cluster of afferent vestibular neurons within the internal auditory canal (IAC). There is minimal literature describing enhancement of this region on magnetic resonance imaging (MRI) and its correlation to clinical symptoms. Here, we sought to find the prevalence of enhancement at Scarpa's ganglion, and determine whether such enhancement correlates with demographics or clinical symptoms. A retrospective review was performed of consecutive patients with an MRI of the IAC between 3/1/2021 and 5/20/2021. Two neuroradiologists independently reviewed for T1 and FLAIR enhancement of the Scarpa's ganglion on post-contrast fat-saturated T1 and post-contrast FLAIR images. Discrepancies were agreed upon by consensus. Clinical variables (hearing loss, vestibular symptoms, tinnitus, and MRI indication) were gathered from a retrospective chart review. Eighty-nine patients were included (51 female); the mean age was 58 (range 19-85). The most common MRI indication was hearing loss (n = 53). FLAIR enhancement was present on the right in 7 patients, on the left in 7 patients, and bilaterally in 6 patients. No enhancement was seen on post-contrast T1 images. There was no statistically significant correlation between consensus FLAIR on at least one side and age (p = .74), gender (p = .29), hearing loss (p = .32), hearing loss side (p = .39), type of hearing loss (p = .87), vestibular symptoms (p = .71), or tinnitus (p = .81). Enhancement is present in the minority of patients on post-contrast FLAIR images. If seen, it should be considered an uncommon but not unexpected finding with no clinical significance.

Penatalaksanaan Pemeriksaan Magnetic Resonance Imaging (MRI) Lumbal Dengan Kasus Hernia Nukleus Pulposus

Magnetic Resonance Imaging (MRI) is the gold standard for diagnosing Hernia Nucleus Pulposus. Hernia of the Nucleus Pulposus (HNP) is a condition in which there is bulging of the nucleus pulposus. This study aims to determine the management of lumbar MRI examinations in cases of Nucleus Pulposus Hernia and the role of the Dixon sequence in cases of lumbar HNP. The Dixon sequence is an MRI method used for fat suppression and produces 4 contrasts in one scanning, including in phase, opposed phase, water and fat. The research method used is descriptive research with a case study approach. Data collection was carried out in January 2023 – February 2023 using a Philips 3 Tesla MRI aircraft. Subjects consisted of ten patients with clinical HNP. Data collection was carried out through observation, interviews and documentation. The research results were obtained according to theory using the sequence T1 SE/TSE sagittal, T2 SE/TSE axial, SE/TSE T1 axial, Short Inversion Recovery (STIR) while in the field using the sequence Survey, Myelo Radial, T2 Weighted Dixon Sagittal (T2 Fat Saturation Sagittal, T2 Sagittal), T1 Weighted TSE Sagittal, STIR TSE PSS Coronal, T1 Weighted TSE Axial, T2 Weighted TSE Axial.

MRI Criteria for Healing at 1 Year After Repair of a Traumatic Meniscal Tear

Background: Meniscal repair for a traumatic meniscal tear is increasingly used to preserve the meniscus. Interpreting postoperative magnetic resonance imaging (MRI) scans remains challenging, especially in symptomatic patients. There is a lack of reliable MRI criteria to affirm the healed character of a traumatic meniscal injury repair. Purpose: To identify relevant MRI criteria for meniscal healing after meniscal repair. Study Design: Case series; Level of evidence, 4. Methods: We prospectively included all patients with a traumatic meniscal injury who underwent either an isolated meniscal repair or a repair during a concomitant anterior cruciate ligament reconstruction. A standardized preoperative and postoperative clinical evaluation was performed, along with collection of functional scores—Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee, Lysholm Score, and 36-Item Short Form Health Survey. An MRI scan was performed 1 year postoperatively and compared with the preoperative MRI scan. The following MRI aspects were analyzed: variation of morphology and fat-saturated (FS) T2 intensity signal and pre- and postoperative tear diastasis measurement. Results: Fifty patients (age, mean ± SD, 28.7 ± 8.5 years [range, 16-45 years]) who were 1 year postoperative were included. All patients were considered clinically healed had the same MRI characteristics. A signal change (FS T2) was observed from a high signal intensity fluid to a nonfluid moderate signal intensity. The morphology of the lesion was more complex: from the initial lesion, line ramifications appeared, creating the appearance of tree branches. The tear diastasis decreased (from 2.3 ± 0.5 mm [range, 1.3-3.5] to 1.1 ± 0.28 mm [range, 0.5-1.5]). Conclusion: MRI criteria confirming meniscal healing after traumatic meniscal repair at 1 year were identified: a change in the intrameniscal signal becoming nonfluid and moderate in intensity; a reduction in tear diastasis to <1.5 mm; and a change in the signal morphology of the repaired meniscus.

Clinical outcomes of 3T magnetic resonance imaging-guided lumbar and sacral foraminal injections

PurposeThis article evaluates the feasibility, safety, and efficacy of MRI-guided lumbar or sacral nerve root infiltration for chronic back pain. We compared the outcomes of our MRI-guided infiltrations with data from CT-guided infiltrations reported in the literature and explored the potential advantages of MRI guidance.MethodForty-eight MRI-guided nerve root infiltrations were performed using a 3 T MRI machine. The optimal needle path was determined using breathhold T2-weighted sequences, and the needle was advanced under interleaved guidance based on breathhold PD-weighted images. Pain levels were assessed using a numeric rating scale (NRS) before the procedure and up to 5 months after, during follow-up. Procedure success was evaluated by comparing patients’ pain levels before and after the infiltration.ResultsThe MRI-guided infiltrations yielded pain reduction 1 week after the infiltration in 92% of cases, with an average NRS substantial change of 3.9 points. Pain reduction persisted after 5 months for 51% of procedures. No procedure-related complications occurred. The use of a 22G needle and reconstructed subtraction images from T2 FatSat sequences improved the workflow.ConclusionOur study showed that MRI-guided nerve root infiltration is a feasible, safe, and effective treatment option for chronic back pain. Precise positioning of the needle tip and accurate distribution of the injected solution contributed to the effectiveness of MRI-guided infiltration, which appeared to be as accurate as CT-guided procedures. Further research is needed to explore the potential benefits of metal artifact reduction sequences to optimize chronic back pain management.

Comparison between T2 Turbo Inversion Recovery Magnitude and T2 Frequency Selective Fat Saturation Turbo Spin Echo MRI Sequences in Detection of Perianal Fistula

Fat suppression magnetic resonance imaging (MRI) sequences are routinely included in the MRI protocol for patients with perianal fistula to improve the visibility of the abnormal tracts and abscesses against the background of hypo-signal intensity on the image. The objective of this study is to compare the turbo inversion recovery magnitude (TIRM) and frequency selective fat saturation turbo spin echo (FSTSE) MRI sequences in detecting perianal fistulas in terms of time and clarity. The MRI protocol included a coronal T2 turbo inversion recovery magnitude sequence, a T2 fat saturation turbo spin echo, and T2 turbo inversion recovery magnitude sequences in the axial plane. The evaluation of sequence image quality involved calculating the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Additionally three radiologists assessed the best image using a questionnaire designed to align with the study’s objectives. The T2 TIRM sequence was found to have the highest number of ticked images. The inter-rater kappa agreement showed fair agreement (k = 0.370) between the raters. However, the SNR and CNR values for the T2 FSTSE were higher than those of the T2 TIRM sequence, with a p-value less than 0.001. There is a significant difference in the meantime in that the T2 TIRM sequence has less time than the T2 FSTSE with a p-value &lt; 0.001. Due to its uniform fat suppression in the MR image and shorter acquisition time, the turbo inversion recovery magnitude sequence exhibited superior performance compared to the T2 frequency-selective turbo spin echo sequence.

Penggunaan T2 STIR dan Fat Saturation pada Pemeriksaan MRI Lumbal Kasus Hernia Nucleus Pulposus (HNP)

Background: Signal to noise ratio (SNR) is defined as the ratio of the amplitude of the signal received by the coil to the amplitude of the noise. Methods: This research was quantitative alongside an observational approach conducted at the Radiology Installation of Satya Negara Hospital, North Jakarta. Alongside a research population of Lumbar MRI patients with HNP clinical indication from October to November 2022. The research sample was ten patients aged around 25-50 years with a diagnosis of HNP. Furthermore, an MRI examination was carried out using T2 STIR and T2 Fat Saturation sequences. Hence, the results of the Lumbar MRI image were ROI performed on common areas alongside the Corpus, Discus, CSF, Spinal Cord, and HNP area. Results: This research showed there was a significant difference in SNR values in the T2 STIR and T2 Fat Saturation sequences in common areas with a p-value of 0.05. There was no significant difference in SNR values in the HNP-experienced area with a p-value of 0.05. Conclusions: After a statistical test using the Paired Sample T Test, the test results obtained were p value 0.05, namely 0.692 for the SNR value on the results of the MRI Lumbar sagittal section of the sequence T2 STIR and T2 Fat saturation in the Lumbar area experiencing HNP, which means that Ho was accepted, which means that there was no significant difference in SNR values between the T2 STIR and T2 Fat saturation sequences in the lumbar tissue that experienced HNP. 2. The SNR value of MRI images of the lumbar sagittal section of the sequence T2 STIR and T2 Fat saturation in normal lumbar tissue including Corpus, Discus, CSF, the test results obtained are p-value 0.05. This means that Ho was rejected, which means there was a significant difference in SNR values between the T2 STIR and T2 Fat saturation sequences. In the spinal cord area, the test results obtained were p value 0.05. This meant that Ho was accepted, which meant there was no significant difference in SNR values between the T2 STIR and T2 Fat saturation sequences.

Teknik Pemeriksaan MRI Genu Dengan Penambahan Sequence Axial 3D Spoiled Gradient Recalled Echo

Magnetic Resonance Imaging (MRI) is a medical diagnostic imaging technique that works on the principle of nuclear magnetic resonance. MRI aircraft can produce diagnostic images of the inside of the human body in both sagittal, coronal, and transverse cuts, Magnetic resonance imaging (MRI) is a widely accepted non-invasive technique for the evaluation of cartilage lesions. The femur, tibia, fibula, and patella are united into one complex group by ligaments. According to Moeller, Genu Examination uses STIR Sequence, Sagital T2 Weighted Fat saturated, Sagittal 3D GRE, Proton Density weighted fat saturated T1 Coronal. The author's purpose in conducting this study is because Genu Examination at one of the Jakarta Hospital in the Case of Soft Tissue Tumor, Meniscus Tear and Oesteoarthritis added the Axial 3D SPGR sequence. The research method used is descriptive research with an observational approach. Data collection was carried out on June 5 to August 31 using Mri GE aircraft with a power of 1.5 Tesla. The patient samples used in this study were three patients with clinical Soft Tissue Tumor, Meniscus Tear, and Osteoarthritis. Data collection was carried out through observation, interviews and Genu Examination Documentation with the addition of Axial 3D SPGR. The examination is carried out using Quad Knee Coil, the patient's position is supine, feet first. The sequences used in the examination at one of the Jakarta hospitals are Axial Proton Density Fat saturated, Sagital Proton Density Fat saturated, Sagital T2, Coronal Proton Density Fat saturated, Coronal STIR. The role of the Axial 3D SPGR sequence is to evaluate articular cartilage due to its clear depiction of cartilage morphology and high signal to noise ratio (SNR) images.

Hysteroscopic management of uterine diverticulum after myomectomy: a case report

BackgroundA uterine diverticulum is defined as the presence of a niche within the inner contour of the uterine myometrial wall. Although secondary uterine diverticula can occur after hysterotomy such as cesarean section, reports of diverticula after myomectomy are extremely rare.Case presentationA 45-year-old nulliparous woman undergoing infertility treatment was referred to our hospital because of abnormal postmenstrual bleeding after myomectomy. Transvaginal sonography and magnetic resonance imaging revealed a diverticulum in the isthmus. Fat-saturated T1 image showed a blood reservoir in the diverticulum. Hysteroscopic surgery was performed to remove the lowed edge of the defect and coagulate the hypervascularized area. Two months after surgery, the abnormal postmenstrual bleeding and chronic endometritis improved.Discussion and conclusionsThis report highlights the similarities of the patient’s diverticulum to cesarean scar defects in terms of symptoms and pathophysiology. First, this patient developed a diverticulum with hypervascularity after myomectomy and persistent abnormal bleeding. Second, after hysteroscopic surgery, the symptoms of irregular bleeding disappeared. Third, endometrial glands were identified within the resected scar tissue. Fourth, preoperatively identified CD138-positive cells in endometrial tissue spontaneously disappeared after hysteroscopic resection. To the best of our knowledge, this is the first report of symptomatic improvement following hysteroscopic surgery in a patient with an iatrogenic uterine diverticulum with persistent irregular bleeding after myomectomy.

Peran Sequence Paracoronal T2FSE Pada Informasi Citra Magnetic Resonance Imaging (MRI) Pelvis Pada Kasus Fistula

The Role Of The T2FSE Paracoronal Sequence On Pelvic Magnetic Resonance Imaging (MRI) Image Information In Fistula Pelvic MRI is the most ideal part to be examined using Magnetic Resonance Imaging because it is very suitable for detecting abnormalities in the pelvis which most of the organs consist of soft tissue can be seen using MRI techniques . A fistula is an abnormal connection between two epithelial sites. A fistula is one that connects the anus with the skin around the anus or with other organs such as the vagina. One or more fistula bones are visible on the surface of the skin, which can become pus or feces during bowel movements. This study aims to determine the role of pelvic MRI examination with clinical fistula and to find out paracoronal sequence information can establish the clinical diagnosis of fistula. This study uses qualitative descriptive with a case study approach, the subject consists of one patient who will indeed perform a pelvic MRI examination with clinical fistula, the subject is carried out a 1.5 Tesla MRI examination to find out the sequence and procedure and sequence information used. The results of the study were obtained according to theory using sagittal sequences SE / FSE T2, axial SE / FSE T2, axial SE / FSE T1, coronal SE / FSE T2, and coronal GRE / SE / FSE T1, while in the field using sequences axial T2, axial Fat Sat, coronal T1, coronal T2, coronal T2 Fat Sat, sagittal T1 and sagittal T2 Fat Sat.

Penatalaksanaan Pemeriksaan MRI Cervical Pada Kasus Syringomyelia Pada Medulla Spinalis Di Rumah Sakit Primaya Tangerang

Management of Cervical MRI Examination in Cases of Syringomyelia in the Spinal Medulla at Primaya Hospital Tangerang. Magnetic Resonance Imaging (MRI) is a state-of-the-art diagnostic tool for examining and detecting the body using a large magnetic field and radio frequency waves, without the use of X-rays or radioactive materials, which produces cross-sectional images of the human body/organs using a magnetic field. strength between 0.064 – 1.5 tesla (1 tesla = 1000 Gauss) and vibrational resonance of the hydrogen atom nucleus. MRI can produce images of the vertebral column, spinal cord, and also the CSF. The MRI screening procedure is ideal for the differential diagnosis of structural disorders that can affect the spinal roots and spinal cord. This examination is used in carrying out a vertebral examination at once, namely scanning starting directly from the cervical vertebrae and also up to the sacrum. So this examination can directly diagnose the cervical, thoracic, lumbar, sacral vertebrae and also includes the coccyx. The purpose of this study was to determine the management of cervical MRI examination with clinical syringomyelia. This research is descriptive qualitative with a case study approach. The subject is a patient with clinical syringomyelia. All subjects underwent Cervical MRI examination at 1.5 tesla to find out the sequence and procedure and sequence information used. From the research results obtained according to the theory using T1-weighted imaging with administration of contrast agent. While in the field using the cervical MRI protocol without contrast, it is sufficient to establish a diagnosis using an examination procedure with a localizer sequence design, sagittal T1, Axial T1 FSE, Axial T2, Axial 2D marge, sagittal T2 fat sat, Axial T2 thoracic 2-3, myelo 2D. The T2 fat sat sagittal sequence section makes it possible to see the anatomy, namely syringomyelia.

Septic arthritis and transient synovitis of the hip

Differentiating between septic arthritis and transient synovitis can be challenging but is very important as alate diagnosis of septic arthritis can lead to sepsis and joint damage. For correct diagnosis and prediction of complications, the right combination of physical examination, laboratory and radiological studies is needed. Hip ultrasound is easy to learn and has ahigh sensitivity for joint effusion. Faster diagnosis and therapy are possible due to increasing use of ultrasound. Magnetic resonance imaging (MRI) is primarily used to rule out co-infections (osteomyelitis, pyomyositis) and differential diagnoses. X‑ray is typically nonremarkable in septic arthritis. Routine use of ultrasound in nontraumatic pediatric hip pain. Generous use of MRI in case of elevated inflammatory markers or inconclusive clinical findings. Using only few sequences may be appropriate to avoid sedation, primarily fluid sensitive sequences (fat-saturated T2, TIRM, STIR), in case of positive findings, accompanied by T1-weighted images.

The efficacy of abbreviated breast MRI protocols using 1.5 T MRI in the preoperative staging of newly diagnosed breast cancers

PurposeTo determine the efficacy of abbreviated breast magnetic resonance imaging (MRI) protocols using 1.5 T MRI in the preoperative staging of newly diagnosed breast cancers. MethodsEighty patients who underwent 1.5 T MRI between August 2014 and January 2018 for the preoperative staging of breast cancer were evaluated retrospectively. Three separate abbreviated breast MRI protocols (AP) were created from a full protocol, and the images were evaluated independently by two radiologists. AP1 included axial fat-saturated T2 weighted and diffusion-weighted (DW) images, while subtracted axial fat-saturated T1 weighted images were obtained 2 min after contrast administration in AP2. Finally, AP2 and DW images were evaluated in AP3. Lesion location, number, and size, and presence of axillary lymphadenopathy were evaluated in each protocol. Pathological data (lesion quadrant, lesion size, and presence of axillary metastases) from the 80 patients were compared with the abbreviated protocols and full diagnostic protocol. ResultsThe best correlation with the full protocol for detecting the lesion quadrant, number of lesions, and presence of axillary lymphadenopathy was achieved with AP3 for both readers (κ = 0.954, 0.954 for the lesion quadrant, κ = 0.971, 0.910 for the number of lesions, and κ = 0.973, 0.865 for the axillary lymphadenopathy). The evaluation time in all abbreviated protocols was shorter than for the full protocol (p < 0.05). Comparing the abbreviated protocols with pathological data for both readers, the best correlation for detecting the lesion quadrant, number of lesions, and presence of axillary lymphadenopathy was achieved with AP3 (κ = 0.939, 0.954 for the lesion quadrant, κ = 0.941, 0.879 for the number of lesions, and κ = 0.842, 0.740 for axillary lymphadenopathy, respectively). ConclusionAbbreviated breast MRI protocols can provide sufficient diagnostic accuracy in the preoperative staging of breast cancer, with shorter imaging and evaluation times.

Comparing bone shape models from deep learning processing of magnetic resonance imaging to computed tomography-based models

The purpose of this study was to develop a deep learning approach to automatically segment the scapular bone on magnetic resonance imaging (MRI) images and to compare the accuracy of these three-dimensional (3D) models with that of 3D computed tomography (CT). Fifty-five patients with high-resolution 3D fat-saturated T2 MRI were retrospectively identified. The underlying pathology included rotator cuff tendinopathy and tears, shoulder instability, and impingement. Two experienced musculoskeletal researchers manually segmented the scapular bone. Five cross-validation training and validation splits were generated to independently train two-dimensional (2D) and 3D models using a convolutional neural network approach. Model performance was evaluated using the Dice similarity coefficient (DSC). All models with DSC > 0.70 were ensembled and used for the test set, which consisted of four patients with matching high-resolution MRI and CT scans. Clinically relevant glenoid measurements, including glenoid height, width, and retroversion, were calculated for two of the patients. Paired t-tests and Wilcoxon signed-rank tests were used to compare the DSC of the models. The 2D and 3D models achieved a best DSC of 0.86 and 0.82, respectively, with no significant difference observed. Augmentation of imaging data significantly improved 3D but not 2D model performance. In comparing clinical measurements of 3D MRI and CT, there was a mean difference ranging from 1.29 mm to 3.46 mm and 0.05° to 7.47°. We have presented a fully automatic, deep learning-based strategy for extracting scapular shape from a high-resolution MRI scan. Further developments of this technology have the potential to allow for surgeons to obtain all clinically relevant information from MRI scans and reduce the need for multiple imaging studies for patients with shoulder pathology.

The magnetic resonance imaging characteristics of radicular cysts and granulomas.

Limited studies have differentiated radicular cysts and granulomas with MRI. Therefore, we investigated the MRI characteristics of the two lesions and clarified features for distinguishing between them. We collected data of 27 radicular cysts and 9 granulomas definitively diagnosed by histopathology and reviewed the fat-saturated T2 weighted, T1 weighted, and contrast-enhanced fat-saturated T1 weighted images. We measured the maximum diameter and apparent diffusion coefficient values of the lesions. We employed Fisher's exact test, the Mann-Whitney U test, and independent t-tests to compare the two lesions and created a decision tree for discriminating between them. There were significant differences between radicular cysts and granulomas with respect to five imaging characteristics-signal intensity of the lesion centre on fat-saturated T2 weighted images; signal intensity, texture, and contrast enhancement of the lesion centre on contrast-enhanced fat-saturated T1 weighted images; and maximum diameter of the lesion. The cut-off diameter for radicular cysts was 15.9 mm. The area under the receiver operating characteristic curve, sensitivity, and specificity were 0.971, 85.2%, and 100%, respectively. From the decision tree analysis, maximum diameter, lesion centre contrast enhancement on contrast-enhanced fat-saturated T1 weighted images, and lesion centre signal intensity on fat-saturated T2 weighted images were important for discriminating between radicular cysts and granulomas.

Efficacy of MRI for detection of frozen pelvis

A 26- year old female presented to us with severe pelvic pain. She was adviced follicular study and MRI pelvis. There was a large, multilobulated cyst in her pelvic region appearing hyperintense on both T1 and T2 fat sat sequences. There was also presence of multiple, hypointense peritoneal deposits seen on both T1 and T2 fat sat sequences. The findings concluded the diagnosis of frozen pelvis.

The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head

This study aimed to investigate the influence of bone marrow edema (BME) for the assessment of the boundaries of necrotic lesions using unenhanced and contrast-enhanced (CE) magnetic resonance (MR) images in patients with osteonecrosis of the femoral head (ONFH). We retrospectively reviewed 72 consecutive hips in 55 patients of ONFH that were Association Research Circulation Osseous (ARCO) stage III or higher and underwent both unenhanced and contrast-enhanced MR imaging between January 2005 and February 2016. The degree of extension of BMEs, and the boundaries of the necrotic lesions were compared using unenhanced and CE MR images on both mid coronal and mid oblique-axial slices. Forty-two percent of the coronal T1 images, 40% of the coronal fat-saturated T2 images, and 48% of the oblique-axial T1 images showed differences in the boundaries of necrotic lesion, by comparison with those of CET1-weighted MR images. The boundaries of necrotic lesions were clearly detected in all hips on CE coronal slices and 97% of all hips on CE oblique-axial slices. The BME grade in the difference group was significantly higher than in the non-difference group on the coronal plane (P = 0.0058). There were significant differences between the BME grade and duration from the onset of hip pain to MR imaging examination. Multivariate analyses revealed that the duration from the onset to MR imaging examination in both coronal (P = 0.0008) and oblique-axial slices (P = 0.0143) were independently associated with differences in the boundary of necrotic lesion between T1 and CET1-weighted MR images. Our findings suggest that unenhanced MR image may be insufficient for a precise assessment of the boundaries of the necrotic lesions for ONFH cases in the early phase of subchondral collapse due to the diffuse BME.