共查询到20条相似文献，搜索用时 31 毫秒
1.
Giovanni Foti Antonio Campacci Michele Conati Mirko Trentadue Claudio Zorzi Giovanni Carbognin 《La Radiologia medica》2017,122(10):774-784
Purpose
To compare the diagnostic performance of three-dimensional (3D) intermediate-weighted FSE (IW-3D) and 3D hybrid T1-weighted sequences (Hy-3D) and 2D fast-spin-echo sequences (FSE) in diagnosing chondral and labral lesions at 1.5 Tesla hip MR arthrography (MRA).Materials and methods
Institutional review board approval was obtained and informed consent was waived. Ninety-two consecutive patients were evaluated. Chondral and labral lesions were retrospectively and independently evaluated by two radiologists. Intra-operative findings were used as the reference standard (arthroscopy = 73, open surgery = 19). Sensitivity (Se), specificity (Sp), and accuracy (Acc) values that obtained were compared using McNemar test. A value of p < 0.05 was considered statistically significant. Inter-observer agreement was calculated using kappa statistics.Results
Surgeons revealed 81 labrum and 44 chondral lesions, respectively. The highest Se, Sp, and Acc for Reader 1 were 96.3, 90.9, and 95.6%, respectively, in evaluating labral lesions (by reading 2D data set) and 90.9, 100, and 95.7% in evaluating chondral lesions (by reading IW-3D images). The highest Se, Sp, and Acc for Reader 2 were 93.8, 81.8, and 92.4% in evaluating labral lesions (using 2D images) and 88.6, 97.9, and 93.5%, respectively, in evaluating chondral lesions (using Hy-3D). The difference of diagnostic accuracy achieved was not significant (p > 0.05). A near-perfect inter-observer agreement was achieved by reading 2D data set (k = 0.88) and Hy-3D (k = 0.83) and IW-3D (k = 0.85).Conclusions
At 1.5 Tesla hip MRA, the accuracy of IW-3D and Hy-3D images was not significantly higher than the 2D sequences in evaluating acetabular labrum and chondral lesions.2.
Andrea Lazik Jens M. Theysohn Christina Geis Sören Johst Mark E. Ladd Harald H. Quick Oliver Kraff 《European radiology》2016,26(5):1245-1253
Objectives
To evaluate the technical feasibility and applicability of quantitative MR techniques (delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T2 mapping, T2* mapping) at 7 T MRI for assessing hip cartilage.Methods
Hips of 11 healthy volunteers were examined at 7 T MRI with an 8-channel radiofrequency transmit/receive body coil using multi-echo sequences for T2 and T2* mapping and a dual flip angle gradient-echo sequence before (T10) and after intravenous contrast agent administration (T1Gd; 0.2 mmol/kg Gd-DTPA2? followed by 0.5 h of walking and 0.5 h of rest) for dGEMRIC. Relaxation times of cartilage were measured manually in 10 regions of interest. Pearson’s correlations between R1delta?=?1/T1Gd???1/T10 and T1Gd and between T2 and T2* were calculated. Image quality and the delineation of acetabular and femoral cartilage in the relaxation time maps were evaluated using discrete rating scales.Results
High correlations were found between R1delta and T1Gd and between T2 and T2* relaxation times (all p?<?0.01). All techniques delivered diagnostic image quality, with best delineation of femoral and acetabular cartilage in the T2* maps (mean 3.2 out of a maximum of 4 points).Conclusions
T1, T2 and T2* mapping of hip cartilage with diagnostic image quality is feasible at 7 T. To perform dGEMRIC at 7 T, pre-contrast T1 mapping can be omitted.Key Points
? dGEMRIC of hip cartilage with diagnostic image quality is feasible at 7 T. ? To perform dGEMRIC at 7 T, pre-contrast T1 mapping can be omitted. ? T2(*) mapping of hip cartilage with diagnostic image quality is feasible at 7 T. ? T2 and T2* relaxation times of cartilage were highly correlated at 7 T. ? Best delineation of femoral and acetabular cartilage was found in T2* maps.3.
Purpose
To evaluate image quality of non-contrast-enhanced magnetic resonance angiography (MRA) and compare transplant renal artery stenosis (TRAS) seen by non-contrast-enhanced MRA with digital subtraction angiography (DSA) as the gold standard.Materials and methods
330 patients receiving 369 non-contrast-enhanced MRA examinations from July 2014 to June 2017 were included. Thirty patients received at least two MRA examinations. Image quality was independently assessed by two radiologists. Inter-observer agreement was analyzed. Transplant renal artery anatomy and complications were evaluated and compared with DSA. If possible, accuracy was calculated on a per-artery basis.Results
Good or excellent image quality was found in 95.4 % (352/369) of examinations with good inter-observer agreement (K=0.760). Twenty-two patients with DSA had 28 non-contrast-enhanced MRA examinations within a 2-month period. Of these, 19 patients had TRAS, two patients had pseudoaneurysms, and one patient had a normal transplant renal artery but an occluded external iliac artery. Non-contrast-enhanced MRA correctly detected 19 TRAS and nine normal arteries, giving 96.6 % accuracy on a per-artery basis.Conclusions
Non-contrast-enhanced MRA demonstrates a good depiction of the transplanted renal artery and shows good correlation with DSA in cases where there was TRAS.Key Points
? Good or excellent image quality was found in 95.4 % of examinations. ? Non-contrast-enhanced MRA can clearly map transplant renal artery anatomy. ? Non-contrast-enhanced MRA is a reliable tool to detect TRAS.4.
Li H Hosseini A Li JS Gill TJ Li G 《Knee surgery, sports traumatology, arthroscopy》2012,20(8):1496-1502
Purpose
To analyze the morphological change in the cartilage of the knee after anterior cruciate ligament (ACL) injury by comparing with that of the intact contralateral knee.Methods
A total of 22 participants (12 male and 10 female patients) who had unilateral ACL injury underwent MRI scan of both the injured and intact contralateral knees. Sagittal plane images were segmented using a modeling software to determine cartilage volume and cartilage thickness in each part of the knee cartilage that were compared between the ACL-injured and the intact contralateral knees. Furthermore, the male and female patients’ data were analyzed in subgroups.Results
The ACL-injured knees had statistically significant lower total knee cartilage volume than the intact contralateral knees (P = 0.0020), but had similar mean thickness of total knee cartilage (not significant: n.s.). In the male subgroup, there was no significant difference in cartilage volume and thickness between normal and ACL-injured knees. In the female subgroup, the ACL-injured knees demonstrated statistically significant difference in total knee cartilage volume (P = 0.0004) and thickness (P = 0.0024) compared with the normal knees. The percentage change in the cartilage thickness in women was significantly greater than that in men.Conclusion
Cartilage volume was significantly smaller in the ACL-injured knees than in the contralateral intact knees in this cohort. Women tended to display greater cartilage volume and thickness change after ACL injury than men. These findings indicated that women might be more susceptible to cartilage alteration after ACL injuries.Level of evidence
III.5.
Toshinori Matsushige Bixia Chen Philipp Dammann Sören Johst Harald H. Quick Mark E. Ladd Michael Forsting Ulrich Sure Karsten H. Wrede 《European radiology》2016,26(9):2908-2914
Objectives
To investigate in-vivo microanatomy of the subcallosal artery branching from the anterior communicating artery (ACoA) using time-of-flight (TOF) magnetic resonance angiography (MRA) at 7 Tesla.Methods
Seventy-five subjects, including 15 healthy volunteers and 60 patients, were included in this prospective study. Three raters characterized branches from ACoA in maximum intensity projections of TOF MRA at 7 Tesla acquired with 0.22?×?0.22?×?0.41 mm3 resolution. Furthermore, course patterns and anatomical features of the subcallosal artery (maximum diameter, length, and branching angle from ACoA) were measured.Results
Branches from the anterior communicating artery were visualized in 63 of 74 (85.1 %) subjects and were identified as the subcallosal artery (93.7 %) and the accessory anterior cerebral artery (6.3 %). The course of the subcallosal artery was classified into 3 groups; C-shaped (55.9 %), straight (16.9 %), and S-shaped (27.2 %). There was a significant difference between the branching angles of C-shaped and straight (p?<?0.0001), between C-shaped and S-shaped (p?<?0.0001), as well as between straight and S-shaped (p?=?0.0113) course patterns.Conclusions
High-resolution in-vivo 7 T TOF MRA can delineate the microanatomy of the subcallosal artery. Three main variants of course patterns and branching angles from ACoA could be identified.Key Points
? In-vivo 7 Tesla TOF MRA can delineate the subcallosal artery microanatomy ? Three distinct course patterns of the subcallosal artery were identified ? Branching angles from ACoA significantly differed between subcallosal artery course patterns6.
Objectives
To compare automated breast volume scanner (ABVS), ultrasound (US) and MRI in measuring breast cancer size, and evaluate the agreement between ABVS and US in assessing lesion location and sonographic features.Methods
We retrospectively included 98 women with 100 index cancers who had undergone US and ABVS followed by 1.5T MRI. Images were interpreted by a pool of readers reporting lesion size, location and breast imaging reporting and data system (BI-RADS) features. Bland-Altman analysis (with logarithmic data transformation), intraclass correlation coefficient (ICC) and Cohen’s kappa statistic were used for statistical analysis.Results
MRI showed the best absolute agreement with histology in measuring cancer size (ICC 0.93), with LOA comparable to those of ABVS (0.63–1.99 vs. 0.52–1.73, respectively). Though ABVS and US had highly concordant measurements (ICC 0.95), ABVS showed better agreement with histology (LOA 0.52–1.73 vs. 0.45–1.86, respectively), corresponding to a higher ICC (0.85 vs. 0.75, respectively). Except for posterior features (k=0.39), the agreement between US and ABVS in attributing site and BI-RADS features ranged from substantial to almost perfect (k=0.68–0.85).Conclusions
ABVS performs better than US and approaches MRI in predicting breast cancer size. ABVS performs comparably to US in sonographic assessment of lesions.Key Points
? ABVS approaches MRI in predicting breast cancer size. ? ABVS is equivalent to US in localising and characterising breast cancer. ? ABVS is more accurate than US in assessing breast cancer size. ? ABVS has the potential to replace US in breast cancer staging.7.
Background
Computed tomography (CT) for evaluation of occult and suspect hip fractures has been proposed as a good second-line investigation. The diagnostic precision compared to magnetic resonance imaging (MRI) is unclear.Purpose
To compare the diagnostic performance of CT and MRI in a retrospective study on patients with suspect and occult hip fractures.Material and methods
Forty-four elderly consecutive patients with low-energy trauma to the hip were identified where negative or suspect CT was followed by MRI. Primary reporting and review by two observers as well as the diagnostic performance of the two modalities were compared. Surgical treatment and clinical course were used as outcomes.Results
Compared to the primary reports, the CT reviewers found fewer normal and no suspect cases. MRI changed the primary diagnoses in 27 cases, and in 14 and 15 cases, respectively, at review. There was no disagreement on MRI diagnoses.Conclusion
In our patient population, MRI was deemed a more reliable modality for hip fracture diagnosis in comparison to CT. For clinical decision making, MRI seems to have a higher accuracy than CT. A negative CT finding cannot completely rule out a hip fracture in patients where clinical findings of hip fracture persevere.Key Points
? Experience is highly influential in diagnosing occult or suspect hip fractures at CT ? Inconclusive hip CT shows high inter-rater reliability at experienced review ? There was low diagnostic accuracy via CT compared to MRI for all interpreters ? Hip fractures can readily be diagnosed at MRI regardless of radiological experience8.
Objectives
To clarify the relevance of the bony fusion of the distal femoral and the proximal tibial epiphyses by means of magnetic resonance imaging (MRI), a prospective cross-sectional cohort study was performed with a special focus on a reliable determination of the 14th, 16th and 18th years of life.Methods
We scanned 658 German volunteers in the age bracket 12–24 years using a 3.0 T MR-scanner and utilising a T1 turbo spin-echo sequence representing true bone anatomy. Minimum, maximum, mean?±?standard deviation and median with lower and upper quartiles were defined. Intra- and interobserver agreements were determined (Cohen’s kappa). The statistical relevance of sex-related differences was analysed (Mann-Whitney U test, p?<?0.05, exact, two-sided).Results
The bony fusion took place before the 18th year of life in both epiphyses. The Mann-Whitney U test results imply significant sex-related differences for most stages. For both epiphyses, the intra observer (κ femur 0.961; tibia 0.971) and interobserver (κ femur 0.941; tibia 0.951) agreement levels were very good.Conclusion
The 14th and the 16th years of life can be determined in both sexes, but the completion of the 18th year of life cannot solely be determined by the bony fusion, as depicted by closest-to-bone MRI.Key Points
? Forensic age estimation by means of MRI of the knee is feasible. ? MRI provides data about the ossification process without using ionising radiation. ? The method allows the determination of the 14th and 16th years of life. ? The bony fusion is not suitable as the sole indicator of majority. ? The chosen classification is easy to use for specially trained professional personnel.9.
Andrea Lazik-Palm Oliver Kraff Christina Geis Sören Johst Juliane Goebel Mark E. Ladd Harald H. Quick Jens M. Theysohn 《European radiology》2016,26(11):3923-3931
Objectives
To investigate the influence of intravenous gadolinium on cartilage T2 and T2* relaxation times and on morphological image quality at 7-T hip MRI.Methods
Hips of 11 healthy volunteers were examined at 7 T. Multi-echo sequences for T2 and T2* mapping, 3D T1 volumetric interpolated breath-hold examination (VIBE) and double-echo steady-state (DESS) sequences were acquired before and after intravenous application of gadolinium according to a delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) protocol. Cartilage relaxation times were measured in both scans. Morphological sequences were assessed quantitatively using contrast ratios and qualitatively using a 4-point Likert scale. Student’s t-test, Pearson’s correlation (ρ) and Wilcoxon sign-rank test were used for statistical comparisons.Results
Pre- and post-contrast T2 and T2* values were highly correlated (T2: acetabular: ρ?=?0.76, femoral: ρ?=?0.77; T2*: acetabular: ρ?=?0.80, femoral: ρ?=?0.72). Gadolinium enhanced contrasts between cartilage and joint fluid in DESS and T1 VIBE according to the qualitative (p?=?0.01) and quantitative (p?<?0.001) analysis. The delineation of acetabular and femoral cartilage and the labrum predominantly improved with gadolinium.Conclusions
Gadolinium showed no relevant influence on T2 or T2* relaxation times and improved morphological image quality at 7 T. Therefore, morphological and quantitative sequences including dGEMRIC can be conducted in a one-stop-shop examination.Key Points
? Hip cartilage T2 values correlate highly before and after gadolinium at 7 T ? Hip cartilage T2* values correlate highly before and after enhancement at 7 T ? Morphological hip cartilage imaging benefits from intravenous gadolinium at 7 T ? The delineation of acetabular and femoral cartilage can be improved by gadolinium ? Morphological and quantitative sequences including dGEMRIC can be combined as a one-stop-shop examination10.
Purpose
Computed tomography angiography (CTA) and magnetic resonance imaging/angiography (MRI/MRA) are used for the diagnosis of intracranial dural arteriovenous fistulas (DAVFs). The purpose of this study was to compare the diagnostic accuracy of CTA and magnetic resonance imaging/angiography (MRI/MRA) for detection of cortical venous reflux (CVR) in intracranial DAVFs.Methods
The records of patients with angiography-confirmed intracranial DAVFs who also received CTA and MRI/MRA from January 2008 to July 2016 were reviewed. CTA and MRI/MRA were reviewed for signs of CVR, and the diagnostic accuracy of individual signs was evaluated by receiver operating curve (ROC) analysis.Results
A total 108 patients were included in this study. CTA signs of CVR included abnormal dilatation, early enhancement, and the presence of a medullary or pial vein. MRI/MRA signs of CVR included abnormal dilatation, early enhancement, flow-related enhancement, flow void, and medullary or pial venous collaterals. The sensitivity of individual CTA signs ranged from 62 to 96%, and specificities from 79 to 94%. The sensitivities of individual MRI/MRA signs ranged from 58 to 83%, and specificities from 77 to 93%. The area under ROC curve (AUC) of CTA and MRI/MRA were 0.91 and 0.87, respectively (P?=?0.04 in direct comparison). In subgroup analysis, CTA had better diagnostic accuracy for higher grade disease (P?=?0.05) and non-aggressive manifestation (P?=?0.04).Conclusions
Both CTA and MRI/MRA have good diagnostic accuracy for detection of CVR in patients with intracranial DAVFs. There is modest evidence that CTA is better than MRI/MRA.11.
Objectives
To investigate optimised isotropic 3D turbo spin echo (TSE) and gradient echo (GRE)-based pulse sequences for visualisation of articular cartilage lesions within the knee joint.Methods
Optimisation of experimental imaging sequences was completed using healthy volunteers (n=16) with a 3-Tesla (3T) MRI scanner. Imaging of patients with knee cartilage abnormalities (n=57) was then performed. Acquired sequences included 3D proton density-weighted (PDW) TSE (SPACE) with and without fat-suppression (FS), and T2*W GRE (TrueFISP) sequences, with acquisition times of 6:51, 6:32 and 5:35 min, respectively.Results
One hundred sixty-one confirmed cartilage lesions were detected and categorised (Grade II n=90, Grade III n=71). The highest sensitivity and specificity for detecting cartilage lesions were obtained with TrueFISP with values of 84.7% and 92%, respectively. Cartilage SNR mean for PDW SPACE-FS was the highest at 72.2. TrueFISP attained the highest CNR means for joint fluid/cartilage (101.5) and joint fluid/ligament (156.5), and the lowest CNR for cartilage/meniscus (48.5). Significant differences were identified across the three sequences for all anatomical structures with respect to SNR and CNR findings (p-value <0.05).Conclusion
Isotropic TrueFISP at 3T, optimised for acquisition time, accurately detects cartilage defects, although it demonstrated the lowest contrast between cartilage and meniscus.Key points
? Cartilage is better visualised with 3D TrueFISP than 3D SPACE sequences. ? 3D TrueFISP is a reliable sequence for detecting low- and high-grade cartilage defects. ? 3D TrueFISP at 3T provides excellent contrast between cartilage and joint fluid.12.
Objectives
To determine the feasibility of MRI texture analysis as a method of quantifying subchondral bone architecture in knee osteoarthritis (OA).Methods
Asymptomatic subjects aged 20–30 (group 1, n = 10), symptomatic patients aged 40–50 (group 2, n = 10) and patients scheduled for knee replacement aged 55–85 (group 3, n = 10) underwent high spatial resolution T1-weighted coronal 3T knee MRI.Regions of interest were created in the medial (MT) and lateral (LT) tibial subchondral bone from which 20 texture parameters were calculated. T2 mapping of the tibial cartilage was performed in groups 1 and 2. Mean parameter values were compared between groups using ANOVA. Linear discriminant analysis (LDA) was used to evaluate the ability of texture analysis to classify subjects correctly.Results
Significant differences in 18/20 and 12/20 subchondral bone texture parameters were demonstrated between groups at the MT and LT respectively. There was no significant difference in mean MT or LT cartilage T2 values between group 1 and group 2.LDA demonstrated subject classification accuracy of 97 % (95 % CI 91–100 %).Conclusion
MRI texture analysis of tibial subchondral bone may allow detection of alteration in subchondral bone architecture in OA. This has potential applications in understanding OA pathogenesis and assessing response to treatment.Key Points
? Improved techniques to monitor OA disease progression and treatment response are desirable ? Subchondral bone (SB) may play significant role in the development of OA ? MRI texture analysis is a method of quantifying changes in SB architecture ? Pilot study showed that this technique is feasible and reliable ? Significant differences in SB texture were demonstrated between individuals with/without OA13.
Objective
To evaluate the clinical feasibility and image quality of breath-hold (BH) three-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) using a gradient and spin-echo (GRASE) technique compared to the conventional 3D respiratory-triggered (RT)-MRCP using a turbo spin-echo (TSE) sequence at 3 T.Methods
Sixty-six patients underwent both 3D RT-TSE-MRCP and 3D BH-GRASE-MRCP at 3 T. Three radiologists independently reviewed the visualisation of biliary and pancreatic ducts, image blurring, and overall image quality of the two data sets using four- or five-point scales. The numbers of scans with non-diagnostic or poor image quality were compared between the two scans.Results
The 3D BH-GRASE-MRCP had a significantly better image quality (3.69 ± 0.77 vs. 3.30 ± 1.18, p = 0.005) and less image blurring (3.23 ± 0.94 vs. 3.65 ± 0.57, p = 0.0003) than the 3D RT-TSE-MRCP. In detail, 3D BH-GRASE-MRCP better depicted the common bile duct, cystic duct, and bilateral first intrahepatic duct (all ps < 0.05). The number of scans with non-diagnostic or poor image quality significantly decreased with 3D BH-GRASE-MRCP compared with 3D RT-TSE-MRCP [19.7% (13/66) vs. 1.5% (1/66), p = 0.002].Conclusion
The 3D BH-GRASE-MRCP provided better image quality and a reduced number of non-diagnostic images compared to 3D RT-TSE-MRCP.Key points
? The GRASE technique enabled 3D MRCP acquisition within a single breath-hold. ? The short acquisition time of 3D BH-GRASE-MRCP significantly reduced image blurring. ? The 3D BH-GRASE-MRCP had a better image quality than 3D RT-TSE-MRCP. ? The number of non-diagnostic scans was reduced with 3D BH-GRASE-MRCP.14.
Objective
Treatment response assessment in high-grade gliomas uses contrast enhanced T1-weighted MRI, but is unreliable. Novel advanced MRI techniques have been studied, but the accuracy is not well known. Therefore, we performed a systematic meta-analysis to assess the diagnostic accuracy of anatomical and advanced MRI for treatment response in high-grade gliomas.Methods
Databases were searched systematically. Study selection and data extraction were done by two authors independently. Meta-analysis was performed using a bivariate random effects model when ≥5 studies were included.Results
Anatomical MRI (five studies, 166 patients) showed a pooled sensitivity and specificity of 68% (95%CI 51–81) and 77% (45–93), respectively. Pooled apparent diffusion coefficients (seven studies, 204 patients) demonstrated a sensitivity of 71% (60–80) and specificity of 87% (77–93). DSC-perfusion (18 studies, 708 patients) sensitivity was 87% (82–91) with a specificity of 86% (77–91). DCE-perfusion (five studies, 207 patients) sensitivity was 92% (73–98) and specificity was 85% (76–92). The sensitivity of spectroscopy (nine studies, 203 patients) was 91% (79–97) and specificity was 95% (65–99).Conclusion
Advanced techniques showed higher diagnostic accuracy than anatomical MRI, the highest for spectroscopy, supporting the use in treatment response assessment in high-grade gliomas.Key points
? Treatment response assessment in high-grade gliomas with anatomical MRI is unreliable ? Novel advanced MRI techniques have been studied, but diagnostic accuracy is unknown ? Meta-analysis demonstrates that advanced MRI showed higher diagnostic accuracy than anatomical MRI ? Highest diagnostic accuracy for spectroscopy and perfusion MRI ? Supports the incorporation of advanced MRI in high-grade glioma treatment response assessment15.
Purpose
To evaluate the difference between T2 relaxation values of the subtalar cartilage in lateral ankle instability patients and healthy volunteers.Materials and Methods
This institutional review board-approved study included 27 preoperative magnetic resonance imaging (MRI) examinations of 26 patients who underwent Broström operations. Data of previously enrolled healthy volunteers (12 volunteers, 13 MRIs) were used as controls. Two radiologists independently measured T2 values in eight posterior subtalar joint cartilage compartments: central calcaneus anterior (CCA) and posterior (CCP), central talus anterior (CTA) and posterior (CTP), lateral calcaneus anterior (LCA) and posterior (LCP), and lateral talus anterior (LTA) and posterior (LTP). Patient and control values were compared using linear regression analysis. Inter- and intraobserver agreement was calculated.Results
Mean T2 values were significantly higher in the patient group in all measurements of subtalar joint cartilage compartments (p < 0.05) except that in LTP (p = 0.085) measured by reviewer 1. Both inter- and intraobserver agreements were excellent.Conclusions
The T2 relaxation values of the subtalar cartilage were significantly higher in lateral ankle instability patients compared with those of controls.Key Points
? Subtalar cartilage T2 values are increased in patients with lateral ankle instability. ? This trend was demonstrated regardless of the presence of talar dome cartilage lesions. ? Inter-and intraobserver agreements were excellent (intraclass coefficient range, 0.765-0.951) in subtalar cartilage T2 mapping.16.
Objectives
Traditional contrast-enhanced methods for scanning blood vessels using magnetic resonance imaging (MRI) or CT carry potential risks for patients with advanced kidney disease. Ferumoxytol is a superparamagnetic iron oxide nanoparticle preparation that has potential as an MRI contrast agent in assessing the vasculature.Methods
Twenty patients with advanced kidney disease requiring aorto-iliac vascular imaging as part of pre-operative kidney transplant candidacy assessment underwent ferumoxytol-enhanced magnetic resonance angiography (FeMRA) between December 2015 and August 2016. All scans were performed for clinical indications where standard imaging techniques were deemed potentially harmful or inconclusive. Image quality was evaluated for both arterial and venous compartments.Results
First-pass and steady-state FeMRA using incremental doses of up to 4 mg/kg body weight of ferumoxytol as intravenous contrast agent for vascular enhancement was performed. Good arterial and venous enhancements were achieved, and FeMRA was not limited by calcification in assessing the arterial lumen. The scans were diagnostic and all patients completed their studies without adverse events.Conclusions
Our preliminary experience supports the feasibility and utility of FeMRA for vascular imaging in patients with advanced kidney disease due for transplant listing, which has the advantages of obtaining both arteriography and venography using a single test without nephrotoxicity.Key Points
? Evaluation of vascular disease is important in planning kidney transplantation. ? Standard vascular imaging methods are often problematic in kidney disease patients. ? FeMRA has the advantage of arteriography and venography in a single test. ? FeMRA is safe and non-nephrotoxic. ? FeMRA is not limited by arterial calcification.17.
Grazia Pozzi Ezio Lanza Cleber Garcia Parra Ilaria Merli Luca Maria Sconfienza Alberto Zerbi 《La Radiologia medica》2017,122(3):208-214
Objectives:
We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome.Methods:
Hip MRA performed at our institution (3/2012–1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed.Results:
N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen.Conclusions:
GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.18.
Objectives
Secretin-stimulated magnetic resonance imaging (s-MRI) is the best validated radiological modality assessing pancreatic secretion. The purpose of this study was to compare volume output measures from secretin-stimulated transabdominal ultrasonography (s-US) to s-MRI for the diagnosis of exocrine pancreatic failure in cystic fibrosis (CF).Methods
We performed transabdominal ultrasonography and MRI before and at timed intervals during 15 minutes after secretin stimulation in 21 CF patients and 13 healthy controls. To clearly identify the subjects with reduced exocrine pancreatic function, we classified CF patients as pancreas-sufficient or -insufficient by secretin-stimulated endoscopic short test and faecal elastase.Results
Pancreas-insufficient CF patients had reduced pancreatic secretions compared to pancreas-sufficient subjects based on both imaging modalities (p < 0.001). Volume output estimates assessed by s-US correlated to that of s-MRI (r = 0.56–0.62; p < 0.001). Both s-US (AUC: 0.88) and s-MRI (AUC: 0.99) demonstrated good diagnostic accuracy for exocrine pancreatic failure.Conclusions
Pancreatic volume-output estimated by s-US corresponds well to exocrine pancreatic function in CF patients and yields comparable results to that of s-MRI. s-US provides a simple and feasible tool in the assessment of pancreatic secretion.Key points
? Cystic fibrosis patients with affected pancreas have reduced pancreatic secretions. ? Secretin-stimulated sonography is a simple and feasible method to assess pancreatic output. ? Secretin-simulated MRI is a more precise method to assess pancreatic secretions. ? The sonographic and MRI methods yielded comparable pancreatic secretory output estimates.19.
Objectives
We used T2 mapping to quantify the effect of intra-articular hyaluronic acid administration (IAHAA) on cartilage with correlation to clinical symptoms.Methods
One hundred two patients with clinical and MRI diagnosis of hip or knee grade I-III chondropathy were prospectively included. All patients received a standard MRI examination of the affected hip/knee (one joint/patient) and T2-mapping multiecho sequence for cartilage evaluation. T2 values of all slices were averaged and used for analysis. One month after MR evaluation 72 patients (38 males; mean age 51±10 years) underwent IAHAA. As a control group, 30 subjects (15 males; 51 ± 9 years) were not treated. MR and WOMAC evaluation was performed at baseline and after 3, 9, and 15 months in all patients.Results
T2 mapping in hyaluronic acid (HA) patients showed a significant increase in T2 relaxation times from baseline to the first time point after therapy in knees (40.7 ± 9.8 ms vs. 45.8 ± 8.6 ms) and hips (40.9 ± 9.7 ms; 45.9 ± 9.5 ms) (p < 0.001). At the 9- and 15-month evaluations, T2 relaxation dropped to values similar to the baseline ones (p < 0.001 vs. 3 month). The correlation between T2 increase and pain reduction after IAHAA was statistically significant (r = 0.54, p < 0.01) in patients with grade III chondropathy.Conclusions
T2 mapping can be used to evaluate the effect over time of IAHAA in patients with hip and knee chondropathy.Key points
? T2 relaxation times change over time after hyaluronic acid intra-articular administration? T2 relaxation times of the medial femoral condyle correlate with WOMAC variation? T2 relaxation times are different between Outerbridge I and II-III20.