Underwent Magnetic Resonance Imaging Examination Research Articles

The predictive value of conventional magnetic resonance imaging combined with intravoxel incoherent motion parameters for evaluating maternal and neonatal clinical outcomes in patients with placenta accreta spectrum disorders

IntroductionWe aimed to identify factors predictive of adverse maternal and neonatal outcomes in patients with placenta accreta spectrum (PAS) disorders using magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) parameters. MethodFifty-six normal singleton pregnancies at 33-39 weeks of gestation underwent MRI examination at 1.5 T. The IVIM parameters were obtained from the placenta. The correlation between the f value and postpartum hemorrhage (PPH) and between the f value and transfused units of red blood cells (RBCs) was estimated by linear regression. The correlation between various influencing factors (clinical risk factors, MRI features, and IVIM parameters) and poor outcomes was investigated using univariate and multivariate analyses. ResultThe interobserver agreement ranged from fair to excellent (k = 0.30–0.88). Multivariate analyses showed that previous cesarean sections, low signal intensity bands on T2WI and the D value were independent risk factors for adverse outcomes. The combination of three risk factors demonstrated the highest AUC of 0.903, with a sensitivity and specificity of 73.10% and 96.90%, respectively. Last, f was positively correlated with PPH and units of RBCs transfused. DiscussionPreoperative MRI features and IVIM parameters may be used to predict poor outcomes in patients with invasive placental disorders like PAS.

Thoracic Biometry in Patients with Congenital Diaphragmatic Hernia, a Magnetic Resonance Imaging Study.

This is a retrospective study investigating biometric measurements using magnetic resonance imaging (MRI) examinations in congenital diaphragmatic hernia (CDH). CDH is one of the more common causes of pulmonary hypoplasia, with grave consequences for the fetus. Inclusion criteria were patients diagnosed with CDH as the only observed anomaly, who underwent MRI examination after the second-trimester morphology ultrasound. The patients came from three university hospitals in Bucharest, Romania. In total, 19 patients were included in the study after applying exclusion criteria. Comparing the observed values of the thoracic transverse diameter, the thoracic anterior-posterior diameter, the thoracic circumference, the thoracic area, and the thoracic volume with values from the literature, we observed a predictive alteration of these parameters, with most showing Gaussian distribution. We observed statistical significance for most of our correlations, except between the observed and expected thoracic anterior-posterior diameters and the observed and expected thoracic volume values. This is very helpful when complex studies that can calculate the pulmonary volume cannot be obtained, as in the case of movement artifacts, and allows the clinicians to better assess the severity of the disease. MRI follow-up in CDH cases is a necessity, as it offers the most accurate thoracic biometry.

The Success of Deep Learning Modalities in Evaluating Modic Changes

BackgroundModic changes are pathologies that are common in the population and cause low back pain. The aim of the study is to analyze the modic changes detected in magnetic resonance imaging (MRI) using deep learning modalities. MethodsThe sagittal T1, sagittal and axial T2-weighted lumbar MRI images of 307 patients, of which 125 were female and 182 were male, aged 19-86 years, who underwent MRI examination between 2016-2021 were analyzed. Modic changes (MC) were categorized and marked according to signal changes. Our study consists of two independent stages: classification and segmentation. The categorized data was first classified using convolutional neural network (CNN) architectures such as DenseNet-121, DenseNet-169, and VGG-19. In the next stage, masks were removed by segmentation using U-Net, which is the CNN architecture, with image processing programs on the marked images. ResultsDuring the classification stage, the success rates for modic type 1, type 2, and type 3 changes were 98%, 96%, 100% in DenseNet-121, 100%, 94%, 100% in DenseNet-169, and 98%, 92%, 97% in VGG-19, respectively. At the segmentation phase, the success rate was 71% with the U-Net architecture. ConclusionEvaluation of MRI findings of MC in the etiology of lower back pain with deep learning architectures can significantly reduce the workload of the radiologist by providing ease of diagnosis.

Longitudinal changes in magnetic resonance imaging biomarkers of the gluteal muscle groups and functional ability in Duchenne muscular dystrophy: a 12-month cohort study

BackgroundQuantitative magnetic resonance imaging (MRI) is considered an objective biomarker of Duchenne muscular dystrophy (DMD), but the longitudinal progression of MRI biomarkers in gluteal muscle groups and their predictive value for future motor function have not been described.ObjectiveTo explore MRI biomarkers of the gluteal muscle groups as predictors of motor function decline in DMD by characterizing the progression over 12 months.Materials and methodsA total of 112 participants with DMD were enrolled and underwent MRI examination of the gluteal muscles to determine fat fraction and longitudinal relaxation time (T1). Investigations were based on gluteal muscle groups including flexors, extensors, adductors, and abductors. The North Star Ambulatory Assessment and timed functional tests were performed. All participants returned for follow-up at an average of 12 months and were divided into two subgroups (functional stability/decline groups) based on changes in timed functional tests. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with future motor function decline.ResultsFor the functional decline group, all T1 values decreased, while fat fraction values increased significantly over 12 months (P<0.05). For the functional stability group, only the fat fraction of the flexors and abductors increased significantly over 12 months (P<0.05). The baseline T1 value was positively correlated with North Star Ambulatory Assessment and negatively correlated with timed functional tests at the 12-month follow-up (P<0.001), while the baseline fat fraction value was negatively correlated with North Star Ambulatory Assessment and positively correlated with timed functional tests at the 12-month follow-up (P<0.001). Multivariate regression showed that increased fat fraction of the abductors was associated with future motor function decline (model 1: odds ratio [OR]=1.104, 95% confidence interval [CI]: 1.026~1.187, P=0.008; model 2: OR=1.085, 95% CI: 1.013~1.161, P=0.019), with an area under the curve of 0.874.ConclusionFat fraction of the abductors is a powerful predictor of future motor functional decline in DMD patients at 12 months, underscoring the importance of focusing early on this parameter in patients with DMD.

Functional and structural brain reorganization in patients with ischemic stroke: a multimodality MRI fusion study.

Understanding how structural and functional reorganization occurs is crucial for stroke diagnosis and prognosis. Previous magnetic resonance imaging (MRI) studies focused on the analyses of a single modality and demonstrated abnormalities in both lesion regions and their associated distal regions. However, the relationships of multimodality alterations and their associations with poststroke motor deficits are still unclear. In this study, 71 hemiplegia patients and 41 matched healthy controls (HCs) were recruited and underwent MRI examination at baseline and at 2-week follow-up sessions. A multimodal fusion approach (multimodal canonical correlation analysis + joint independent component analysis), with amplitude of low-frequency fluctuation (ALFF) and gray matter volume (GMV) as features, was used to extract the co-altered patterns of brain structure and function. Then compared the changes in patients' brain structure and function between baseline and follow-up sessions. Compared with HCs, the brain structure and function of stroke patients decreased synchronously in the local lesions and their associated distal regions. Damage to structure and function in the local lesion regions was associated with motor function. After 2 weeks, ALFF in the local lesion regions was increased, while GMV did not improve. Taken together, the brain structure and function in the local lesions and their associated distal regions were damaged synchronously after ischemic stroke, while during motor recovery, the 2 modalities were changed separately.

Comparison of Magnetic Resonance Imaging-Based Radiomics Features with Nomogram for Prediction of Prostate Cancer Invasion.

To explore the value of the magnetic resonance imaging (MRI) radiomics model in predicting prostate cancer (PCa) invasion. Clinical data of 86 pathologically confirmed PCa patients in our hospital were collected, including 44 cases in the invasive group and 42 cases in the non-invasive group. All patients underwent MRI examinations, and the same parameters were used. The lesion area was manually delineated and the radiomics features were extracted from T2WI. The radiomics signature based on LASSO regression was established. Besides, logistic regression was used to identify independent clinical predictors, and a combined model incorporating the radiomics signature and independent clinical risk factor was constructed. Finally, the receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) was performed to compare the prediction efficiency and clinical benefit of each model. A total of 867 radiomics features were obtained, and six of them were incorporated into the radiomics model. Multivariate logistic regression analysis exhibited the Gleason score as an independent clinical risk factor for PCa invasion. ROC results showed that the performance of the radiomics model was comparable to that of the clinical-radiomics model in predicting PCa invasion, and it was better than that of the single Gleason score. DCA also confirmed the considerable clinical application value of the radiomics and the clinical-radiomics models. As a simple, non-invasive, and efficient method, the radiomics model has important predictive value for PCa invasion.

Biomarker evidence of neurodegeneration in chronic kidney disease, in a general population

AbstractBackgroundProgressive decline in cognition and renal function are both related to ageing. The estimated global prevalence of dementia was 55 million people in 2019, a number expected to increase to 139 million by 2050. Furthermore, chronic kidney disease (CKD) is the second fastest growing cause of death globally. Few studies have examined the link between these conditions. In this study, we examine CKD and estimated glomerular filtration rate (eGFR) in relation to plasma neurofilament light protein (P‐NfL) and volumetric magnetic resonance imaging (MRI) measures of Alzheimer’s disease‐specific and general neurodegeneration.MethodUsing a cross‐sectional design, 744 participants from the Gothenburg H70 Birth cohort 1944 study, conducted in 2014‐2016, underwent MRI examination and blood draws. Plasma NfL concentration was measured using a Single molecule array (Simoa) assay. eGFR was calculated from creatinine and used for CKD diagnosis. CKD was defined as an estimated glomerular filtration rate below 60 mL/min/1.73 m2. Measurements of biomarker evidence of neurodegeneration were compared between participants with and without CKD. Correlations were also performed against eGFR. A logistic regression model adjusting for known risk factors for CKD was performed.ResultP‐NfL was significantly higher in participants with CKD (p&lt;0.001). No difference was seen in any MRI variables. Only P‐NfL correlated with eGFR (R = ‐0.25, p&lt;0.001), and there was a significant correlation both in participants with and without CKD (R = ‐0.44, p&lt;0.001 and R = ‐0.18, p&lt;0.001 respectively). Furthermore, in a logistic regression model, P‐NfL was a significant predictor of CKD independent of known risk factors including age, sex, education, smoking, hypertension, diabetes, BMI, fasting glucose, LDL‐cholesterol, CRP, and homocysteine (OR (CI); 3.231 (1.743: 5.990), p&lt;0.001).ConclusionOur observations suggest that neurodegeneration measured as P‐NfL is a predictor of CKD, independent of hypertension and diabetes. The origin of NfL, and the potential influence on the utilization of P‐NfL as a marker of neurodegeneration in individuals with CKD, should be assessed in future studies.

Exploration of the influence of early rehabilitation training on circulating endothelial progenitor cell mobilization in patients with acute ischemic stroke and its related mechanism under a lightweight artificial intelligence algorithm.

This work aimed to explore the application of lightweight artificial intelligence algorithms in magnetic resonance imaging (MRI) image processing of patients with acute ischemic stroke (AIS) to clarify the effect and mechanism of early rehabilitation training on the mobilization of circulating endothelial progenitor cells (EPCs) in AIS. A total of 98 AIS patients undergoing MRI examination were selected as the research objects and were randomly divided into a rehabilitation group (early rehabilitation training, 50 cases) and a routine group (conventional treatment, 48 cases) by random number table method and lottery method. In this work, based on the convolutional neural network (CNN) algorithm, a low-rank decomposition algorithm was introduced to optimize it, and a lightweight MRI image computer intelligent segmentation model (LT-RCNN) was established. The LT-RCNN model was used in the MRI image processing of AIS patients, and the role of the model in AIS image segmentation and lesion localization was analyzed. Furthermore, flow cytometry was used to detect the number of peripheral circulating EPCs and CD34+KDR+ cells in the two groups of patients before and after treatment. The serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), interleukin 10 (IL-10), and stromal cell-derived factor-1α (SDF-1α) content were detected by Enzyme-Linked Immunosorbent Assay (ELISA). In addition, the correlation between each factor and CD34+KDR+ was analyzed by Pearson linear correlation. The diffusion-weighted imaging (DWI) signal of MRI images of AIS patients under the LT-RCNN model was high. The location of the lesion could be accurately detected, and the contour of the lesion could be displayed and segmented, and the segmentation accuracy and sensitivity were significantly better than before optimization. The number of EPCs and CD34+KDR+ cells in the rehabilitation group was increased compared with the control group (p<0.01); the expression levels of VEGF, IL-10, and SDF-1α were higher than those of the control group (p<0.001), and TNF-α content was lower than the control group (p<0.001). The number of CD34+KDR+ cells was positively correlated with VEGF, IL-10, and TNF-α contents (p<0.01). The results showed that the computer-intelligent segmentation model LT-RCNN could accurately locate, and segment AIS lesions and the early rehabilitation training could change the expression level of inflammatory factors and further promote the mobilization of AIS circulation EPCs.

Assessing chronic pain in the ankle and foot using Magnetic Resonance Imaging (MRI)

Objectives: Chronic ankle and foot pain is a common and non-specific manifestation of a broad spectrum of osseous and soft tissue pathology in the ankle and foot. MRI can play an important role in the diagnosis of these conditions and help to guide conservative management.&#x0D; Aim: The aim of this study was to assess the normal anatomy and anatomical variations, as well as to examine the MRI features that provide vital clues for the diagnosis of painful conditions of the ankle and foot. Another objective was to differentiate these conditions from one another using MRI imaging.&#x0D; Methodology: This was a descriptive study of 50 patients presenting with pain in the ankle and foot who underwent MRI examinations at the Department of Radiodiagnosis, Pacific Institute of Medical Sciences from November 2022 to February 2023.&#x0D; Results: The most common cause of chronic pain in the ankle and foot in our study was ligament pathology, which was found in 12 (24%) of the 50 patients. Tendon injuries were the next most common cause, present in 10 (20%) patients. Other causes included arthritis, bursitis, osteomyelitis, and ganglion cysts. The most affected age group was 21 to 30 years old.&#x0D; Conclusion: MRI is the modality of choice for the evaluation and characterization of various pathologies of the ankle. Most of the conditions can be managed conservatively. This study highlights the importance of MRI in the diagnosis and management of chronic ankle and foot pain.

Magnetic Resonance Imaging Characteristics of Brain Structure and Neuroendocrine Changes in Patients with First-Episode Schizophrenia

This research was aimed to investigate the magnetic resonance imaging (MRI) features of brain structure and neuroendocrine levels in patients with first-episode schizophrenia. 25 hospitalized patients with first-episode schizophrenia were selected as the observation group, while 25 healthy people were selected as the control group. All the objects underwent MRI examination, and the images as well as gray matter density of the original image data were analyzed under voxel-based morphometry (VBM). The cortisol and prolactin in the observation group were detected, and the levels were compared. The Pearson correlation analysis was adopted to analyze the correlation between cortisol and prolactin levels and the total score of the Positive and Negative Syndrome Scale (PANSS). The results showed that the gray matter volume of the precentral gyrus, superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus, postcentral gyrus, inferior parietal lobule, superior parietal lobule, and anterior cingulate cortex of the observation group decreased, while the volume of cerebellar gray matter increased. The levels of cortisol and prolactin in the observation group (387.54 ± 117.69 μg/L and 804.16 ± 267.13 μIU/mL, respectively) were significantly higher than those in the control group (138.46 ± 62.47 μg/L and 397.54 ± 203.82 μIU/mL, respectively), and the differences were statistically significant ( P &lt; 0.05 ). The results of the Pearson correlation test showed that the higher the cortisol level, the more severe the schizophrenia (r = 0.421 and P = 0.013 ), while the prolactin level was not directly related to the severity of schizophrenia (r = 0.019 and P = 0.568 ). In conclusion, the MRI features based on the VBM technology can accurately assess the changes of gray matter; the levels of cortisol and prolactin in patients with first-episode schizophrenia were significantly higher than those in healthy people; and the higher the cortisol level, the more severe the schizophrenia symptoms. This study provided a certain research basis for MRI features of brain structure and neuroendocrine changes in patients with first-episode schizophrenia.

Clinical utilisation of multimodal quantitative magnetic resonance imaging in investigating muscular damage in Duchenne muscular dystrophy: a study on the association between gluteal muscle groups and motor function

BackgroundDuchennemuscular dystrophy (DMD) is a neuromuscular disease characterised by progressive muscular weakness and atrophy. Currently, studies on DMD muscle function mostly focus on individual muscles; little is known regarding the effect of gluteal muscle group damage on motor function.ObjectiveTo explore potential imaging biomarkers of hip and pelvic muscle groups for measuring muscular fat replacement and inflammatory oedema in DMD with multimodal quantitative magnetic resonance imaging (MRI).Materials and methodsOne hundred fifty-nine DMD boys and 32 healthy male controls were prospectively included. All subjects underwent MRI examination of the hip and pelvic muscles with T1 mapping, T2 mapping and Dixon sequences. Quantitatively measured parameters included longitudinal relaxation time (T1), transverse relaxation time (T2) and fat fraction. Investigations were all based on hip and pelvic muscle groups covering flexors, extensors, adductors and abductors. The North Star Ambulatory Assessment and stair climbing tests were used to measure motor function in DMD.ResultsT1 of the extensors (r = 0.720, P < 0.01), flexors (r = 0.558, P < 0.01) and abductors (r = 0.697, P < 0.001) were positively correlated with the North Star Ambulatory Assessment score. In contrast, T2 of the adductors (r = -0.711, P < 0.01) and fat fraction of the extensors (r = -0.753, P < 0.01) were negatively correlated with the North Star Ambulatory Assessment score. Among them, T1 of the abductors (b = 0.013, t = 2.052, P = 0.042), T2 of the adductors (b = -0.234, t = -2.554, P = 0.012) and fat fraction of the extensors (b = -0.637, t =  − 4.096, P < 0.001) significantly affected the North Star Ambulatory Assessment score. Moreover, T1 of the abductors was highly predictive for identifying motor dysfunction in DMD, with an area under the curve of 0.925.ConclusionMagnetic resonance biomarkers of hip and pelvic muscle groups (particularly T1 values of the abductor muscles) have the potential to be used as independent risk factors for motor dysfunction in DMD.

Monoexponential, biexponential, stretched-exponential and kurtosis models of diffusion-weighted imaging in kidney assessment: comparison between patients with primary aldosteronism and healthy controls.

This study used various diffusion-weighted imaging (DWI) models (including monoexponential, biexponential, stretched-exponential and kurtosis models) in renal magnetic resonance imaging (MRI) to compare whether there were differences in each diffusion parameter between patients with primary aldosteronism (PA) and healthy volunteers. Twenty-two (female:male, 14:8; age, 48 ± 10years) patients with PA and 22 age- and sex-matched healthy controls (HCs) underwent MRI examinations of the kidneys. The independent-sample t test or the Mann‒Whitney U test was used to detect differences in the diffusion metrics of the kidneys between the two groups. Univariable and multivariable linear regression were applied to analyze the correlations between diffusion parameters and the clinical indicators. The mean diffusivity (MD, p < 0.001) and radial diffusivity (Dr, p < 0.001) values in the medulla were lower in the PA group than in the HC group. The medullary fractional anisotropy (FA, p < 0.001) was higher than that of HCs. The FA (p < 0.001) and axial diffusivity (Da, p < 0.001) values in the cortex were lower in the PA group. The cortical α (anomalous exponent term, p = 0.016) was higher in the PA patients than in the HCs. Linear regression analysis showed that log(plasma aldosterone concentration) and the estimated glomerular filtration rate (eGFR) were correlated with medullary FA. The stretched-exponential model (cortical α) and the kurtosis model (FA, MD and Dr in the medulla and FA and Da in the cortex) showed significant differences between PA patients and healthy volunteers and may have potential for noninvasive renal assessment in PA patients.

Association between white matter lesions and Parkinson’s disease: an impact on Postural/Gait difficulty phenotype and cognitive performance

ABSTRACT Background White matter hyperintensities (WMHs) may be observed on Magnetic Resonance Imaging (MRI) in patients with Parkinson disease with or without vascular risk factors. Whether WMHs may influence motor and non-motor aspects of Parkinson disease is a subject of debate. The aim of this study is to evaluate the impact of WMH severity on various aspects of Parkinson disease in combination to the estimation of the impact of cerebrovascular risk factors. Materials and Methods We included a cohort of patients with Parkinson’s disease who underwent MRI examination. The Fazekas visual rating scale was used to assess the severity and location of WMHs, and patient clinical characteristics were correlated with MRI data. Results All vascular risk factors were associated with higher Fazekas score in both periventricular and deep white matter. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were associated with lower scores in the ACE-R cognitive assessment scale (p < 0.001). Furthermore, PWMHs and DWMHs severity was associated with higher UPDRS motor score (p < 0.001), while the Postural Instability Gait Difficulty (PIGD) phenotype was correlated with higher burden of WMHs. Conclusions Comorbid WMHs may contribute to multi-dimension dysfunction in patients with Parkinson disease and consequently the management of vascular risk factors may be crucial to maintain motor and non-motor functions in PD.

Quantitative 7T sodium magnetic resonance imaging of the human brain using a 32-channel phased-array head coil: Application to patients with secondary progressive multiple sclerosis.

Apparent tissue sodium concentrations (aTSCs) determined by 23 Na brain magnetic resonance imaging (MRI) have the potential to serve as a biomarker in pathologies such as multiple sclerosis (MS). However, the quantification is hindered by the intrinsically low signal-to-noise ratio of 23 Na MRI. The purpose of this study was to improve the accuracy and reliability of quantitative 23 Na brain MRI by implementing a dedicated postprocessing pipeline and to evaluate the applicability of the developed approach for the examination of MS patients. 23 Na brain MRI measurements of 13 healthy volunteers and 17 patients with secondary progressive multiple sclerosis (SPMS) were performed at 7T using a dual-tuned 23 Na/1 H birdcage coil with a receive-only 32-channel phased array. The aTSC values were determined for normal appearing white matter (NAWM) and normal appearing gray matter (NAGM) in healthy subjects and SPMS patients. Signal intensities were normalized using the mean cerebrospinal fluid (CSF) sodium concentration determined in 37 separate patients receiving a spinal tap for routine diagnostic purposes. Five volunteers underwent MRI examinations three times in a row to assess repeatability. Coefficients of variation (CoVs) were used to quantify the repeatability of the proposed method. aTSC values were compared regarding brain regions and subject cohort using the paired-samples Wilcoxon rank-sum test. Laboratory CSF sodium concentration did not differ significantly between patients without and with MS (p = 0.42). The proposed quantification workflow for 23 Na MRI was highly repeatable with CoVs averaged over all five volunteers of 1.9% ± 0.9% for NAWM and 2.2% ± 1.6% for NAGM. Average NAWM aTSC was significantly higher in patients with SPMS compared with the control group (p = 0.009). Average NAGM aTSC did not differ significantly between healthy volunteers and MS patients (p = 0.98). The proposed postprocessing pipeline shows high repeatability and the results can serve as a baseline for further studies establishing 23 Na brain MRI as a biomarker in diseases such as MS.

T1rho, T2, and T2* relaxation time based on grading of intervertebral disc degeneration.

Previous studies have explored the biochemical changes of disc degeneration and its relevance in low back pain using various quantitative magnetic resonance imaging (MRI) techniques. However, quantitative evaluation of intervertebral disc (IVD) with MRI such as T1rho, T2, and T2* have not been previously analyzed and compared directly in the same patients. To investigate T1rho, T2, and T2* of IVD degeneration in the same patients, reveal the correlation coefficients of these values, and evaluate which values are more sensitive to detect the degree of IVD degeneration. The participants were 55 patients who underwent MRI examinations which the investigator classified the degree of IVD degeneration according to the Pfirrmann classification. The T1rho, T2, and T2* values of IVD were analyzed for their classification and were compared. T1rho, T2, and T2* values were 74.3 ± 7.1, 61.2 ± 6.7, and 46.5 ± 16.3 ms (grade II); 61.6 ± 11.8, 48.9 ± 8.2, and 34.1 ± 11.8 ms (grade III); 50.8 ± 10.8, 38.9 ± 9.8, and 25.4 ± 8.1 ms, (grade IV); 44.5 ± 13.3, 34.8 ± 9.5, and 11.2 ± 6.6 ms (grade V), respectively. Those values significantly decreased with increasing grades, but T1rho and T2 values for grades IV and V were not different. The T1rho and T2 values were excellent for the evaluation of initial to moderate IVD degeneration with water and proteoglycan content. In contrast, the T2* value was suitable for detailed evaluation of progressive IVD, even with poor water content.

The Necessity of Magnetic Resonance Imaging in Congenital Diaphragmatic Hernia.

This is a retrospective study investigating the relationship between ultrasound and magnetic resonance imaging (MRI) examinations in congenital diaphragmatic hernia (CDH). CDH is a rare cause of pulmonary hypoplasia that increases the mortality and morbidity of patients. Inclusion criteria were: patients diagnosed with CDH who underwent MRI examination after the second-trimester morphology ultrasound confirmed the presence of CDH. The patients came from three university hospitals in Bucharest, Romania. A total of 22 patients were included in the study after applying the exclusion criteria. By analyzing the total lung volume (TLV) using MRI, and the lung to head ratio (LHR) calculated using MRI and ultrasound, we observed that LHR can severely underestimate the severity of the pulmonary hypoplasia, even showing values close to normal in some cases. This also proves to be statistically relevant if we eliminate certain extreme values. We found significant correlations between the LHR percentage and herniated organs, such as the left and right liver lobes and gallbladder. MRI also provided additional insights, indicating the presence of pericarditis or pleurisy. We wish to underline the necessity of MRI follow-up in all cases of CDH, as the accurate measurement of the TLV is important for future treatment and therapeutic strategy.

Magnetic resonance imaging findings in patients with polymyalgia rheumatica.

To describe the prevalence of magnetic resonance imaging (MRI) findings in patients with the clinical diagnosis of polymyalgia rheumatica (PMR). Sixteen consecutive patients with untreated PMR, meeting the American College of Rheumatology criteria, underwent MRI examinations of the shoulder(s), hip(s), or both, depending on clinical complaints. Six patients also underwent MRI of the spine. We evaluated 24 shoulders, among which we identified subacromial-subdeltoid bursitis in 21 (87.5%), glenohumeral joint effusion in 17 (70.8%), and fluid distention of the long head of the biceps tendon sheath in 15 (62.5%). Peritendinitis and capsular edema were observed in 21 (87.5%) and 17 (70.8%) shoulders, respectively. We also evaluated 17 hips, identifying hip joint effusion in 12 (70.6%), trochanteric bursitis in 11 (64.7%), peritendinitis in 17 (100%), and capsular edema in 14 (82.4%). All six of the patients who underwent MRI of the spine were found to have interspinous bursitis. Subacromial-subdeltoid bursitis, glenohumeral joint effusion, and hip joint effusion are common findings in patients with PMR. In addition, such patients appear to be highly susceptible to peritendinitis and capsular edema. There is a need for case-control studies to validate our data and to determine the real impact that these findings have on the diagnosis of PMR by MRI.

Magnetic resonance imaging (MRI) in diagnosis of non-traumatic hip joint pain

Background: The hip is a significant weight bearing, highly mobile, ball-and-socket synovial joint. There are several reasons of hip pain, such as congenital and developmental, viral, arthritic, and malignant conditions. Magnetic resonance imaging is the method of choice for determining the severity of osseous, chondral, and soft-tissue abnormalities of the hip joint, as well as for characterizing numerous illnesses. This study investigate the role of MRI in identifying hip joint discomfort. Methods and Results: Seventy-five both sexes patients with unilateral or bilateral painful hip joint were examined. The patients with age ranged from 10 to 70 years (mean age 54.74 + 10.52years) were 42 males (mean age 51.44 + 11.50) and 33 females (mean age 42.75 + 12.24) with male to female ratio 1.3:1. All our patients subjected to careful history taking, thorough clinical examination, routine laboratory investigations and local examination of the diseased hip. The majority of patients were in the age group 40-50 years followed by the age group of 50-60 years, with a male preponderance. The commonest chief complaint, other than pain of the involved hip joint, was restricted movement. All patients underwent MRI examination of both hips using a TOSHIBA 1.5 Tesla MRI machine scanner. Unilateral hip involvement was more common than bilateral. The commonest hip disorder was osteoarthritis, followed by avascular necrosis (AVN) of femoral head, tendinopathy, bursitis, sacroiliitis, Cam type femoral-acetabular impingement, ischio-femoral- impingement and pertheʹs disease. Conclusion: The MRI is the diagnostic method of choice for evaluating hip issues. It can discover certain features that lead to an accurate diagnosis of the uncomfortable hip joint and play a vital role in treatment and monitoring of sick joint by doctors.

Anxiety relaxation during MRI with a patient-friendly audiovisual system

IntroductionMany patients experience anxiety, not limited to claustrophobia, before magnetic resonance imaging (MRI) examination. We performed a non-randomized controlled trial to evaluate whether a patient-friendly audiovisual (AV) system in the MR scanner room reduces patient anxiety. MethodsWe randomly selected 61 participants from outpatients who required brain MRI examination. Patients were informed that they could choose to undergo an MRI examination with a patient-friendly AV system (Ambient Experience, Philips Healthcare, Best, The Netherlands) or the standard system. To complete the MRI examination without affecting clinical practice, all patients who preferred the patient-friendly AV system were assigned to the preferring AV group. Patients who indicated that either system was acceptable were randomly assigned to the no preference but allocated AV group or control (using the standard system) groups. In both groups, state anxiety using the State-Trait Anxiety Inventory (STAI) was assessed before and after the MRI examination (A-State-before and A-State-after MRI, respectively). The changes in A-State-before and A-State-after MRI were categorized as follows: relieved high-state anxiety, no change in high-state anxiety, stable easiness, and intensified anxiety. ResultsAmong the 61 included patients, 19 were assigned to the preferring AV group, 20 to the no preference but allocated AV group, and 22 to the control group. There were no significant differences between the group. However, in patients with high-state anxiety before MRI, the preferring AV group and the no preference but allocated AV group, which used the patient-friendly AV system, relieved high-state anxiety by 63.6% (7 of 11 patients) and 81.8% (9 of 11 patients), respectively. In contrast, the control group using the standard system relieved high-level anxiety by only 42.9% (three out of seven patients). ConclusionThe patient-friendly AV system may reduce anxiety in patients undergoing MRI examinations. Implications for practiceThe patient-friendly AV system may reduce anxiety in patients undergoing MRI examination by providing a more patient-centered MRI examination environment. These findings may help ameliorate negative perceptions associated with MRI examination.

Significant and nonsignificant findings on magnetic resonance imaging of patients with headache

Aim: The great majority of people suffer from headaches. Neuroimaging has a very limited role in determining the etiology of headache However, neuroimaging, especially magnetic resonance imaging (MRI), is requested for the vast majority of patients with headache. We aimed to determine the frequency of clinically significant and nonsignificant findings on brain MRI in patients with headache, and the factors associated with these findings.&#x0D; Material and Method: A total of 350 patients (231 women and 119 men), who underwent MRI examinations for headache complaints, were included in the study. Based on the evaluation of lesions detected on MRI and headache characteristics together, lesions associated with headache were classified as significant findings, and lesions unrelated to headache were classified as nonsignificant findings. Patients were compared in terms of brain MRI findings on the basis of age, gender, and duration of headache complaints.&#x0D; Results: Assessment of brain MRIs revealed normal findings in 211 (60.3%) patients, nonsignificant findings in 122 (34.8%) patients, and significant findings that could cause headache in 17 (4.9%) patients. The most common significant lesions were acute sinusitis, acute cerebrovascular accident, cerebral venous sinus thrombosis and aneurysm. In patients over 65 years of age, the frequency of significant findings was significantly higher (p:0.001). The frequency of significant findings was higher in male patients and patients with a headache duration of less than one month, but there was no statistical difference (p:0.452 and p:0477). &#x0D; Conclusion: We found significant findings on brain MRI in approximately 5% of patients with headache. Being over 65 years old and acute onset headache increase the probability of detecting significant lesions on MRI. Despite its low diagnostic value, physicians will often refer patients with headaches to neuroimaging for fear of missing a critical underlying lesion and encountering medico-legal issues. Taking into account worrying red flags can increase the likelihood of finding significant lesions.