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1.
3-T breast magnetic resonance imaging in patients with suspicious microcalcifications on mammography
B. L. Stehouwer L. G. Merckel H. M. Verkooijen N. H. G. M. Peters R. M. Mann K. M. Duvivier W. P. Th. M. Mali P. H. M. Peeters W. B. Veldhuis M. A. A. J. van den Bosch 《European radiology》2014,24(3):603-609
Objective
To investigate the diagnostic value of 3-Tesla (T) breast MRI in patients presenting with microcalcifications on mammography.Methods
Between January 2006 and May 2009, 123 patients with mammographically detected BI-RADS 3–5 microcalcifications underwent 3-T breast MRI before undergoing breast biopsy. All MRIs of the histopathologically confirmed index lesions were reviewed by two breast radiologists. The detection rate of invasive carcinoma and ductal carcinoma in situ (DCIS) was evaluated, as well as the added diagnostic value of MRI over mammography and breast ultrasound.Results
At pathology, 40/123 (33 %) lesions proved malignant; 28 (70 %) DCIS and 12 (30 %) invasive carcinoma. Both observers detected all invasive malignancies at MRI, as well as 79 % (observer 1) and 86 % (observer 2) of in situ lesions. MRI in addition to conventional imaging led to a significant increase in area under the receiver operating characteristic (ROC) curve from 0.67 (95 % CI 0.56–0.79) to 0.79 (95 % CI 0.70–0.88, observer 1) and to 0.80 (95 % CI 0.71–0.89, observer 2), respectively.Conclusions
3-T breast MRI was shown to add significant value to conventional imaging in patients presenting with suspicious microcalcifications on mammography.Key points
? 3-T MRI is increasingly used for breast imaging in clinical practice. ? On 3-T breast MRI up to 86 % of DCIS lesions are detected. ? 3-T MRI increases the diagnostic value in patients with mammographically detected microcalcifications. 相似文献2.
Michael A. Fischer Olivio F. Donati Natalie Chuck Iris N. Blume Roger Hunziker Hatem Alkadhi Daniel Nanz 《European radiology》2013,23(2):408-416
Objective
To compare 2D spoiled dual gradient-echo (SPGR-DE) and 3D SPGR-DE with fat and water separation for the assessment of focal and diffuse fatty infiltration of the liver.Methods
A total of 227 consecutive patients (141 men; 56?±?14 years) underwent clinically indicated liver MRI at 1.5 T including multiple-breath-hold 2D SPGR-DE and single-breath-hold 3D SPGR-DE with automatic reconstruction of fat-only images. Two readers assessed the image quality and number of fat-containing liver lesions on 2D and 3D in- and opposed-phase (IP/OP) images. Liver fat content (LFC) was quantified in 138 patients without chronic liver disease from 2D, 3D IP/OP, and 3D fat-only images.Results
Mean durations of 3D and 2D SPGR-DE acquisitions were 23.7?±?2.9 and 97.2?±?9.1 s respectively. The quality of all 2D and 3D images was rated diagnostically. Three-dimensional SPGR-DE revealed significantly more breathing artefacts resulting in lower image quality (P?<?0.001); 2D and 3D IP/OP showed a similar detection rate of fat-containing lesions (P?=?0.334) and similar LFC estimations (mean: +0.4 %; P?=?0.048). LFC estimations based on 3D fat-only images showed significantly higher values (mean: 2.7 % + 3.5 %) than those from 2D and 3D IP/OP images (P?<?0.001).Conclusion
Three dimensional SPGR-DE performs as well as 2D SPGR-DE for the assessment of focal and diffuse fatty infiltration of liver parenchyma. The 3D SPGR-DE sequence used was quicker but more susceptible to breathing artefacts. Significantly higher LFC values are derived from 3D fat-only images than from 2D or 3D IP/OP images.Key Points
? Magnetic resonance imaging can assess focal and diffuse hepatic fatty infiltration ? Both 2D and 3D dual-echo MRI techniques can be used for chemical shift imaging of the liver. ? The single breath-hold 3D dual-echo technique is faster but more susceptible to breathing artefacts. ? Three-dimensional fat-only images show higher fat estimates than in- and out-of-phase images. 相似文献3.
Yoshiko Ueno Kazuhiro Kitajima Fumi Kawakami Tetsuo Maeda Yuko Suenaga Satoru Takahashi Shozo Matsuoka Kenji Tanimura Hideto Yamada Yoshiharu Ohno Kazuro Sugimura 《European radiology》2014,24(4):881-888
Objective
To review established magnetic resonance (MR) criteria and describe a new MR finding for the diagnosis of invasive placenta praevia.Methods
A retrospective review of prenatal MRI examinations of 65 patients (median age: 35 years) who underwent MR for the screening of invasive placenta praevia. All MRIs were performed on a 1.5-T unit, including axial, coronal and sagittal T2-weighted half-Fourier single-shot turbo spin echo imaging. Fifteen patients were diagnosed with invasive placenta praevia. Two experienced radiologists reviewed the MR images and evaluated a total of six MRI features of the placenta, including our novel finding of the placental protrusion into the internal os (placental protrusion sign). Inter-rater reliability was assessed by using kappa statistics. Features with a kappa statistic >0.40 were evaluated using Fisher’s two-sided exact test for comparison of their capabilities for placental invasion assessment.Results
Interobserver reliability was moderate or better for the intraplacental T2 dark band, intraplacental abnormal vascularity, uterine bulging, heterogeneous placenta and placental protrusion sign. Fisher’s two-sided exact test results showed all these features were significantly associated with invasive placenta praevia.Conclusion
The novel MRI finding of a placental protrusion sign is a useful addition to the established MRI findings for the diagnosis of invasive placenta praevia.Key Points
? Prenatal diagnosis for an invasive placenta is essential for perinatal planning. ? Magnetic resonance imaging provides useful information for the diagnosis of invasive placenta. ? The placental protrusion sign is a useful novel MRI finding for predicting invasive placenta. 相似文献4.
Jeroen A. W. Tielbeek Shandra Bipat Thierry N. Boellaard C. Yung Nio Jaap Stoker 《European radiology》2014,24(5):1059-1067
Objectives
To prospectively evaluate if training with direct feedback improves grading accuracy of inexperienced readers for Crohn’s disease activity on magnetic resonance imaging (MRI).Methods
Thirty-one inexperienced readers assessed 25 cases as a baseline set. Subsequently, all readers received training and assessed 100 cases with direct feedback per case, randomly assigned to four sets of 25 cases. The cases in set 4 were identical to the baseline set. Grading accuracy, understaging, overstaging, mean reading times and confidence scores (scale 0-10) were compared between baseline and set 4, and between the four consecutive sets with feedback. Proportions of grading accuracy, understaging and overstaging per set were compared using logistic regression analyses. Mean reading times and confidence scores were compared by t-tests.Results
Grading accuracy increased from 66 % (95 % CI, 56-74 %) at baseline to 75 % (95 % CI, 66-81 %) in set 4 (P = 0.003). Understaging decreased from 15 % (95 % CI, 9-23 %) to 7 % (95 % CI, 3-14 %) (P < 0.001). Overstaging did not change significantly (20 % vs 19 %). Mean reading time decreased from 6 min 37 s to 4 min 35 s (P < 0.001). Mean confidence increased from 6.90 to 7.65 (P < 0.001). During training, overall grading accuracy, understaging, mean reading times and confidence scores improved gradually.Conclusions
Inexperienced readers need training with at least 100 cases to achieve the literature reported grading accuracy of 75 %.Key points
? Most radiologists have limited experience of grading Crohn’s disease activity on MRI. ? Inexperienced readers need training in the MRI assessment of Crohn’s disease. ? Grading accuracy, understaging, reading time and confidence scores improved during training. ? Radiologists and residents show similar accuracy in grading Crohn’s disease. ? After 100 cases, grading accuracy can be reached as reported in the literature. 相似文献5.
Objectives
MRI of bone marrow of the axial skeleton is recommended for evaluation of multiple myeloma. The impact of bone marrow involvement pattern on MRI for determining progression-free survival (PFS) and overall survival (OS) is not yet clear.Methods
We performed a meta-analysis of research on the prognostic significance of MRI patterns for OS and PFS using a random effects model. Databases searched without language restriction were MEDLINE, EMBASE, and the Cochrane Library (January 1976 to April 2014). Manual searches were also conducted.Results
Of 10,953 citations identified in the original search, 10 cohort studies for a total of 2015 patients met the inclusion criteria. Nine of the 10 included studies are from three research groups. Pooled hazard ratios were 1.80 (95 % confidence interval [CI] 1.32–2.46; P?<?0.001) for OS and 2.30 (95 % CI 1.65–3.20; P?<?0.001) for PFS for focal lesions on MRI; and 1.70 (95 % CI 1.30–2.21; P?<?0.001) for OS and 1.74 (95 % CI 1.07–2.85; P?=?0.03) for PFS for diffuse infiltration on MRI. No significant heterogeneity was observed among studies.Conclusions
This meta-analysis demonstrated an association between focal lesions and diffuse infiltration and poor prognosis in this population.Key Points
? MRI findings of multiple myeloma include normal, focal, variegated and diffuse infiltration ? Focal lesions and diffuse infiltration on MRI were poor prognostic factors ? Bone marrow involvement pattern on MRI can help physicians assess prognosis6.
Hugo J. A. Adams Thomas C. Kwee Malou A. Vermoolen Bart de Keizer John M. H. de Klerk Judit A. Adam Rob Fijnheer Marie José Kersten Jaap Stoker Rutger A. J. Nievelstein 《European radiology》2013,23(8):2271-2278
Objective
To assess and compare the value of whole-body MRI with FDG-PET for detecting bone marrow involvement in lymphoma.Methods
A total of 116 patients with newly diagnosed lymphoma prospectively underwent whole-body MRI and blind bone marrow biopsy (BMB) of the posterior iliac crest. Of 116 patients, 80 also underwent FDG-PET. Patient-based sensitivities of whole-body MRI for detecting bone marrow involvement were calculated using BMB as reference standard and compared with FDG-PET in aggressive and indolent lymphomas separately.Results
Sensitivity of whole-body MRI in all lymphomas was 45.5 % [95 % confidence interval (CI): 29.8–62.0 %]. Sensitivity of whole-body MRI in aggressive lymphoma [88.9 % (95 % CI: 54.3–100 %)] was significantly higher (P?=?0.0029) than that in indolent lymphoma [23.5 % (95 % CI: 9.1–47.8 %)]. Sensitivity of FDG-PET in aggressive lymphoma [83.3 % (95 % CI: 41.8–98.9 %)] was also significantly higher (P?=?0.026) than that in indolent lymphoma [12.5 % (95 % CI: 0–49.2 %)]. There were no significant differences in sensitivity between whole-body MRI and FDG-PET (P?=?1.00)Conclusion
Sensitivity of whole-body MRI for detecting lymphomatous bone marrow involvement is too low to (partially) replace BMB. Sensitivity of whole-body MRI is significantly higher in aggressive lymphoma than in indolent lymphoma and is equal to FDG-PET in both entities.Key Points
? Bone marrow involvement in lymphoma has prognostic and therapeutic implications. ? Blind bone marrow biopsy (BMB) is standard for bone marrow assessment. ? Neither whole-body MRI nor FDG-PET can yet replace BMB. ? Both techniques have higher sensitivity in aggressive than in indolent lymphoma. ? Both imaging techniques are complementary to BMB. 相似文献7.
Anthony Dohan Clarisse Eveno Raluca Oprea Karine Pautrat Vinciane Placé Marc Pocard Christine Hoeffel Mourad Boudiaf Philippe Soyer 《European radiology》2014,24(11):2906-2915
Objective
To investigate the role of diffusion-weighted magnetic resonance imaging (DWMRI) in the diagnosis of abscess-complicating fistula-in-ano.Methods
This retrospective study was approved by our Institutional Review Board and informed consent was waived. MRI examinations, including fat-suppressed T2-weighted turbo spin-echo (T2-TSE) MRI and DWMRI, of 24 patients with a fistula-in-ano, were reviewed by two independent readers for the presence and number of visible fistulas, conspicuity and apparent diffusion coefficient (ADC) measurement of suspected fistula tracks and pelvic collections. The reference standard was surgical with follow-up findings.Results
Sensitivity was 91.2 % [95 % CI: 76 %-98 %] for T2-weighted TSE MRI and 100 % [95 % CI: 90 %-100 %] for DWMRI detecting fistulas. ADC values were lower in abscesses than in inflammatory masses (P?=?0.714.10-6). The area under the ROC curve was 0.971 and the optimal cut-off ADC value was 1.186?×?10-3 mm2/s, yielding a sensitivity of 100 % [95 % CI: 77 %-100 %], a specificity of 90 % [95 % CI: 66 %-100 %], a positive predictive value of 93 % [95 % CI: 82.8 %-100 %] and a negative predictive value of 90 % [95 % CI: 78 %-100 %] for an abscess diagnosis. Fistula conspicuity was greater with DWMRI than with T2-TSE MRI for the two observers (P?=?0.0034 and P?=?0.0007).Conclusion
DWMRI shows high sensitivity and specificity for the diagnosis of perianal abscesses and helps discriminate between an abscess and inflammatory mass. Conspicuity of fistulas-in-ano is greater with DWMRI than with T2-weighted TSE MRI.Key Points
? DWMRI can differentiate between pelvic abscess and inflammatory mass. ? DWMRI helps avoid gadolinium-chelate administration in patients with a suspected fistula-in-ano. ? DWMRI provides high degrees of conspicuity for fistula-in-ano. ? Conspicuity of fistulas is better with DWMRI imaging than with T2-TSE-weighted MRI. 相似文献8.
Flavie Bratan Emilie Niaf Christelle Melodelima Anne Laure Chesnais Rémi Souchon Florence Mège-Lechevallier Marc Colombel Olivier Rouvière 《European radiology》2013,23(7):2019-2029
Objectives
To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.Methods
One hundred and seventy-five patients who underwent radical prostatectomy were included. Pre-operative MRI performed at 1.5 T (n?=?71) or 3 T (n?=?104), with (n?=?58) or without (n?=?117) an endorectal coil were independently interpreted by two radiologists. A five-point subjective suspicion score (SSS) was assigned to all focal abnormalities (FAs). MR findings were then compared with whole-mount sections.Results
Readers identified 192–214/362 cancers, with 130–155 false positives. Detection rates for tumours of <0.5 cc (cm3), 0.5–2 cc and >2 cc were 33–45/155 (21–29 %), 15–19/35 (43–54 %) and 8–9/12 (67–75 %) for Gleason ≤6, 17/27 (63 %), 42–45/51 (82–88 %) and 34/35 (97 %) for Gleason 7 and 4/5 (80 %), 13/14 (93 %) and 28/28 (100 %) for Gleason ≥8 cancers respectively. At multivariate analysis, detection rates were influenced by tumour Gleason score, histological volume, histological architecture and location (P?<?0.0001), but neither by field strength nor coils used for imaging. The SSS was a significant predictor of both malignancy of FAs (P?<?0.005) and aggressiveness of tumours (P?<?0.00001).Conclusions
Detection rates were significantly influenced by tumour characteristics, but neither by field strength nor coils used for imaging. The SSS significantly stratified the risk of malignancy of FAs and aggressiveness of detected tumours.Key Points
? Prostate cancer volume, Gleason score, architecture and location are MRI predictors of detection. ? Field strength and coils used do not influence the tumour detection rate. ? Multiparametric MRI is accurate for detecting aggressive tumours. ? A subjective suspicion score can stratify the risk of malignancy and tumour aggressiveness. 相似文献9.
Kenneth E. Pengel Bas B. Koolen Claudette E. Loo Wouter V. Vogel Jelle Wesseling Esther H. Lips Emiel J. Th. Rutgers Renato A. Valdés Olmos Marie Jeanne T. F. D. Vrancken Peeters Sjoerd Rodenhuis Kenneth G. A. Gilhuijs 《European journal of nuclear medicine and molecular imaging》2014,41(8):1515-1524
Purpose
To explore the potential complementary value of PET/CT and dynamic contrast-enhanced MRI in predicting pathological response to neoadjuvant chemotherapy (NAC) of breast cancer and the dependency on breast cancer subtype.Methods
We performed 18F-FDG PET/CT and MRI examinations before and during NAC. The imaging features evaluated on both examinations included baseline and changes in 18F-FDG maximum standardized uptake value (SUVmax) on PET/CT, and tumour morphology and contrast uptake kinetics on MRI. The outcome measure was a (near) pathological complete response ((near-)pCR) after surgery. Receiver operating characteristic curves with area under the curve (AUC) were used to evaluate the relationships between patient, tumour and imaging characteristics and tumour responses.Results
Of 93 patients, 43 achieved a (near-)pCR. The responses varied among the different breast cancer subtypes. On univariate analysis the following variables were significantly associated with (near-)pCR: age (p?=?0.033), breast cancer subtype (p?<?0.001), relative change in SUVmax on PET/CT (p?<?0.001) and relative change in largest tumour diameter on MRI (p?<?0.001). The AUC for the relative reduction in SUVmax on PET/CT was 0.78 (95 % CI 0.68–0.88), and for the relative reduction in tumour diameter at late enhancement on MRI was 0.79 (95 % CI 0.70–0.89). The AUC increased to 0.90 (95 % CI 0.83–0.96) in the final multivariate model with PET/CT, MRI and breast cancer subtype combined (p?=?0.012).Conclusion
PET/CT and MRI showed comparable value for monitoring response during NAC. Combined use of PET/CT and MRI had complementary potential. Research with more patients is required to further elucidate the dependency on breast cancer subtype. 相似文献10.
Gilbert Deray Olivier Rouviere Lorenzo Bacigalupo Bart Maes Thierry Hannedouche François Vrtovsnik Claire Rigothier Jean-Marie Billiouw Paolo Campioni Joaquin Ferreiros Daniel Devos Daniel Alison François Glowacki Jean-Jacques Boffa Luis Marti-Bonmati 《European radiology》2013,23(5):1250-1259
Objective
To prospectively compare the renal safety of meglumine gadoterate (Gd-DOTA)-enhanced magnetic resonance imaging (MRI) to a control group (unenhanced MRI) in high-risk patients.Methods
Patients with chronic kidney disease (CKD) scheduled for MRI procedures were screened. The primary endpoint was the percentage of patients with an elevation of serum creatinine levels, measured 72?±?24 h after the MRI procedure, by at least 25 % or 44.2 μmol/l (0.5 mg/dl) from baseline. A non-inferiority margin of the between-group difference was set at ?15 % for statistical analysis of the primary endpoint. Main secondary endpoints were the variation in serum creatinine and eGFR values between baseline and 72?±?24 h after MRI and the percentage of patients with a decrease in eGFR of at least 25 % from baseline. Patients were screened for signs of nephrogenic systemic fibrosis (NSF) at 3-month follow-up.Results
Among the 114 evaluable patients, one (1.4 %) in the Gd-DOTA-MRI group and none in the control group met the criteria of the primary endpoint [Δ?=??1.4 %, 95%CI = (?7.9 %; 6.7 %)]. Non-inferiority was therefore demonstrated (P?=?0.001). No clinically significant differences were observed between groups for the secondary endpoints. No serious safety events (including NSF) were noted.Conclusion
Meglumine gadoterate did not affect renal function and was a safe contrast agent in patients with CKD.Key points
? Contrast-induced nephropathy (CIN) is a potential problem following gadolinium administration for MRI. ? Meglumine gadoterate (Gd-DOTA) appears safe, even in patients with chronic kidney disease. ? Gd-DOTA only caused a temporary creatinine level increase in 1/70 such patients. ? No case or sign of NSF was detected at 3-month follow-up. 相似文献11.
E. M. Coppenrath N. Lummel J. Linn O. Lenz M. Habs K. Nikolaou M. F. Reiser M. Dichgans T. Pfefferkorn T. Saam 《European radiology》2013,23(10):2784-2792
Objectives
To compare the use of an unenhanced high-resolution time-of-flight MR angiography sequence (Hr-TOF MRA) with fat-suppressed axial/coronal T1-weighted images and contrast-enhanced angiography (standard MRI) for the diagnosis of cervical artery dissection (cDISS).Methods
Twenty consecutive patients (9 women, 11 men, aged 24–66 years) with proven cDISS on standard MRI underwent Hr-TOF MRA at 3.0 T using dedicated surface coils. Sensitivity (SE), specificity (SP), positive and negative predictive values (PPV, NPV), Cohen’s kappa (к) and accuracy of Hr-TOF MRA were calculated using the standard protocol as the gold standard. Image quality and diagnostic confidence were assessed on a four-point scale.Results
Image quality was rated better for standard MRI (P?=?0.02), whereas diagnostic confidence did not differ significantly (P?=?0.27). There was good agreement between Hr-TOF images and the standard protocol for the presence/absence of cDISS, with к?=?0.95 for reader 1 and к?=?0.89 for reader 2 (P?<?0.001). This resulted in SE, SP, PPV, NPV and accuracy of 97 %, 98 %, 97 %, 98 % and 97 % for reader 1 and 93 %, 96 %, 93 %, 96 % and 95 % for reader 2.Conclusions
Hr-TOF MRA can be used to diagnose cDISS with excellent agreement compared with the standard protocol. This might be useful in patients with renal insufficiency or if contrast-enhanced MR angiography is of insufficient image quality.Key Points
? New magnetic resonance angiography sequences are increasingly used for vertebral artery assessment. ? A high-resolution time-of-flight sequence allows the diagnosis of cervical artery dissection. ? This technique allows the diagnosis without intravenous contrast medium. ? It could help in renal insufficiency or when contrast-enhanced MRA fails. 相似文献12.
Philippe Soyer Marc Sirol Yann Fargeaudou Laurence Bour Olivier Morel Anthony Dohan Mourad Boudiaf Etienne Gayat Delphine Hequet Emmanuel Barranger Olivier le Dref 《European radiology》2013,23(1):262-271
Objectives
To assess the potential of magnetic resonance (MR) imaging in evaluating placental vascularity and predicting placental resorption delay after conservative management of invasive placenta.Methods
MR examinations of 23 women with conservative management of invasive placenta were reviewed. Twelve women had pelvic embolisation because of postpartum haemorrhage (Group 1) and 11 had no embolisation (Group 2). Comparisons between the two groups were made with respect to the delay for complete placental resorption at follow-up MR imaging and degree of placental vascularity 24 h after delivery on early (30s) and late (180 s) phase of dynamic gadolinium chelate-enhanced MR imaging.Results
The median delay for complete placental resorption in the cohort study was 21.1 weeks (range, 1-111 weeks). In Group 1, the median delay for complete placental resorption was shorter than in Group 2 (17 vs 32 weeks) (P?=?0.036). Decreased placental vascularity on the early phase was observed in Group 1 by comparison with Group 2 (P?=?0.003). Significant correlation was found between the degree of vascularity on early phase of dynamic MR imaging and the delay for complete placental resorption (r?=?0.693; P?<?0.001).Conclusions
MR imaging provides useful information after conservative management of invasive placenta and may help predict delay for complete placental resorption.Key Points
? MR imaging is useful after conservative management of invasive placenta. ? MR imaging may help predict delay regarding complete placental resorption. ? Early decreased vascularity correlates with reduced delay of placental resorption. 相似文献13.
Marica Cutajar David L. Thomas Patrick W. Hales T. Banks Christopher A. Clark Isky Gordon 《European radiology》2014,24(6):1300-1308
Objectives
To investigate the reproducibility of arterial spin labelling (ASL) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and quantitatively compare these techniques for the measurement of renal blood flow (RBF).Methods
Sixteen healthy volunteers were examined on two different occasions. ASL was performed using a multi-TI FAIR labelling scheme with a segmented 3D-GRASE imaging module. DCE MRI was performed using a 3D-FLASH pulse sequence. A Bland-Altman analysis was used to assess repeatability of each technique, and determine the degree of correspondence between the two methods.Results
The overall mean cortical renal blood flow (RBF) of the ASL group was 263?±?41 ml min?1 [100 ml tissue]?1, and using DCE MRI was 287?±?70 ml min?1 [100 ml tissue]?1. The group coefficient of variation (CVg) was 18 % for ASL and 28 % for DCE-MRI. Repeatability studies showed that ASL was more reproducible than DCE with CVgs of 16 % and 25 % for ASL and DCE respectively. Bland-Altman analysis comparing the two techniques showed a good agreement.Conclusions
The repeated measures analysis shows that the ASL technique has better reproducibility than DCE-MRI. Difference analysis shows no significant difference between the RBF values of the two techniques.Key Points
? Reliable non-invasive monitoring of renal blood flow is currently clinically unavailable. ? Renal arterial spin labelling MRI is robust and repeatable. ? Renal dynamic contrast-enhanced MRI is robust and repeatable. ? ASL blood flow values are similar to those obtained using DCE-MRI. 相似文献14.
L. Jans C. van Langenhove L. Van Praet P. Carron D. Elewaut F. Van Den Bosch V. Lambrecht J. L. Jaremko K. Verstraete 《European radiology》2014,24(4):866-871
Objective
To determine the prevalence and diagnostic value of pelvic enthesitis on MRI of the sacroiliac (SI) joints in spondyloarthritis (SpA).Materials and methods
A retrospective study in 444 patients aged 17–45 years old with MRI of the SI joints and with clinically suspected sacroiliitis was performed. Patients were classified as having SpA if they fulfilled the Assessment of Spondyloarthritis International Society (ASAS) criteria. Pelvic enthesitis on MRI was correlated with the final diagnosis. Sensitivity, specificity, positive and negative likelihood ratio (LR) and predictive values (PV) of pelvic enthesitis for the diagnosis of SpA were calculated.Results
MRI showed pelvic enthesitis in 24.4 % of patients with SpA and in 7.1 % of patients without SpA. Presence of any enthesitis had sensitivity, specificity, LR+, LR?, PPV and NPV of 24.4 %, 92.9 %, 3.45, 0.81, 69.4 % and 65.2 % for the diagnosis of SpA, respectively. The most commonly affected entheses were the longitudinal ligament insertion (4.5 %), the retroarticular ligaments (4.1 %) and the pubic symphysis (4.1 %). The sites of enthesitis with the highest PPV for SpA were the iliac crest/wing (85.7 %) and the retroarticular ligaments (81.3 %).Conclusion
Nearly one fourth of SpA patients with suspected sacroiliitis showed pelvic enthesitis on MRI. Such pelvic enthesitis has a high specificity for the diagnosis of spondyloarthritis.Key Points
? Enthesitis is the primary clinical feature of spondyloarthritis. ? Magnetic resonance imaging of the sacroiliac joints can demonstrate pelvic enthesitis. ? Pelvic enthesitis has a high specificity for the diagnosis of spondyloarthritis. 相似文献15.
Hyun Jeong Park Seong Hyun Kim Kyung Mi Jang Seo-youn Choi Soon Jin Lee Dongil Choi 《European radiology》2014,24(4):947-958
Objectives
To assess the added value of diffusion-weighted imaging (DWI) to conventional magnetic resonance imaging (MRI) for differentiating benign from malignant bile duct strictures.Methods
Twenty-seven patients with a benign stricture and 42 patients with a malignant stricture who had undergone gadoxetic acid-enhanced MRI with DWI were enrolled. Qualitative (signal intensity, dynamic enhancement pattern) and quantitative (wall thickness and length) analyses were performed. Two observers independently reviewed a set of conventional MRI and a combined set of conventional MRI and DWI, and receiver operating characteristic (ROC) curve analysis was assessed.Results
Benign strictures showed isointensity (18.5–70.4 %) and a similar enhancement pattern (22.2 %) to that of normal bile duct more frequently than malignant strictures (0–40.5 % and 0 %) on conventional MRI (P?<?0.05). Malignant strictures (90.5–92.9 %) showed hypervascularity on arterial and portal venous phase images more frequently than benign strictures (37.0–70.4 %) (P?<?0.01) On DWI, all malignant strictures showed hyperintensity compared with benign cases (70.4 %) (P?<?0.001). Malignant strictures were significantly thicker and longer than benign strictures (P?<?0.001). The diagnostic performance of both observers improved significantly after additional review of DWI.Conclusions
Adding DWI to conventional MRI is more helpful for differentiating benign from malignant bile duct strictures than conventional MRI alone.Key points
? Accurate diagnosis and exclusion of benign strictures of bile duct are important. ? Diffusion-weighted MRI helps to distinguish benign from malignant bile duct strictures. ? DWI plus conventional MRI provides superior diagnostic accuracy to conventional MRI alone. 相似文献16.
Annalisa Macera Chiara Lario Massimo Petracchini Teresa Gallo Daniele Regge Irene Floriani Dario Ribero Lorenzo Capussotti Stefano Cirillo 《European radiology》2013,23(3):739-747
Objectives
To compare the diagnostic accuracy and sensitivity of Gd-EOB-DTPA MRI and diffusion-weighted (DWI) imaging alone and in combination for detecting colorectal liver metastases in patients who had undergone preoperative chemotherapy.Methods
Thirty-two consecutive patients with a total of 166 liver lesions were retrospectively enrolled. Of the lesions, 144 (86.8 %) were metastatic at pathology. Three image sets (1, Gd-EOB-DTPA; 2, DWI; 3, combined Gd-EOB-DTPA and DWI) were independently reviewed by two observers. Statistical analysis was performed on a per-lesion basis.Results
Evaluation of image set 1 correctly identified 127/166 lesions (accuracy 76.5 %; 95 % CI 69.3–82.7) and 106/144 metastases (sensitivity 73.6 %, 95 % CI 65.6–80.6). Evaluation of image set 2 correctly identified 108/166 (accuracy 65.1 %, 95 % CI 57.3–72.3) and 87/144 metastases (sensitivity of 60.4 %, 95 % CI 51.9–68.5). Evaluation of image set 3 correctly identified 148/166 (accuracy 89.2 %, 95 % CI 83.4–93.4) and 131/144 metastases (sensitivity 91 %, 95 % CI 85.1–95.1). Differences were statistically significant (P?<?0.001). Notably, similar results were obtained analysing only small lesions (<1 cm).Conclusions
The combination of DWI with Gd-EOB-DTPA-enhanced MRI imaging significantly increases the diagnostic accuracy and sensitivity in patients with colorectal liver metastases treated with preoperative chemotherapy, and it is particularly effective in the detection of small lesions.Key Points
? Accurate detection of colorectal liver metastases is essential to determine resectability. ? Almost 80 % of patients are candidates for neoadjuvant chemotherapic treatment at diagnosis. After chemotherapy, metastases usually decrease, and drug-induced liver steatosis may be present. ? The sensitivity of imaging is significantly inferior to that in chemotherapy-naïve patients. ? DWI combined with Gd-EOB-DTPA increases sensitivity in detecting small metastases after chemotherapy. 相似文献17.
18.
Alasdair R. Dempsey Yuanyuan Wang Jonas B. Thorlund Peter M. Mills Tim V. Wrigley Kim L. Bennell Ben R. Metcalf Fahad Hanna Flavia M. Cicuttini David G. Lloyd 《Knee surgery, sports traumatology, arthroscopy》2013,21(5):1097-1103
Purpose
To examine the relationship between tibiofemoral and patellofemoral joint articular cartilage and subchondral bone in the medial and gait biomechanics following partial medial meniscectomy.Methods
For this cross-sectional study, 122 patients aged 30–55 years, without evidence of knee osteoarthritis at arthroscopic partial medial meniscectomy, underwent gait analysis and MRI on the operated knee once for each sub-cohort of 3 months, 2 years, or 4 years post-surgery. Cartilage volume, cartilage defects, and bone size were assessed from the MRI using validated methods. The 1st peak in the knee adduction moment, knee adduction moment impulse, 1st peak in the knee flexion moment, knee extension range of motion, and the heel strike transient from the vertical ground reaction force trace were identified from the gait data.Results
Increased knee stance phase range of motion was associated with decreased patella cartilage volume (B = ?17.9 (95 % CI ?35.4, ?0.4) p = 0.045) while knee adduction moment impulse was associated with increased medial tibial plateau area (B = 7.7 (95 % CI 0.9, 13.3) p = 0.025). A number of other variables approached significance.Conclusions
Knee joint biomechanics exhibited by persons who had undergone arthroscopic partial meniscectomy gait may go some way to explaining the morphological degeneration observed at the patellofemoral and tibiofemoral compartments of the knee as patients progress from surgery.Level of evidence
III. 相似文献19.
Sébastien Soize Coralie Barbe Krzysztof Kadziolka Laurent Estrade Isabelle Serre Laurent Pierot 《Neuroradiology》2013,55(8):977-987
Introduction
The study attempts to identify notable factors predicting poor outcome, death, and intracranial hemorrhage in patients with acute ischemic stroke undergoing mechanical thrombectomy with stent retriever. These data could be useful to improve the selection of patients for thrombectomy.Methods
Patients with acute ischemic stroke treated with the Solitaire FR device were retrospectively analyzed from a prospectively collected database. We assessed the effect of selected demographic characteristics, clinical and imaging factors on poor outcome at 3 months (modified Rankin score 3–6), mortality at 3 months, and hemorrhage at day 1 (symptomatic and asymptomatic).Results
From May 2010 to April 2012, 59 consecutive patients with an acute ischemic stroke underwent mechanical thrombectomy. At 3 months, 57.6 % of the patients were functionally independent (modified Rankin Scale 0–2) and mortality was 20.4 %. Multivariate analyses revealed that a thrombus length?>?14 mm (p?=?0.02; OR 7.55; 95 % CI 1.35–42.31) and longer endovascular procedure duration (p?=?0.01; OR 1.04; 95 % CI 1.01–1.07) were independently associated with poor outcome. A higher baseline Alberta Stroke Program Early CT (ASPECT) score (p?=?0.04; OR 0.79 per point; 95 % CI 0.63–0.99) and successful recanalization (p?=?0.02; OR 0.07; 95 % CI 0.01–0.72) were independent predictors of good functional outcome. Baseline ASPECT score (p?<?0.01; OR 0.65; 95 % CI 0.54–0.78) independently predicted symptomatic intracranial hemorrhage at day 1.Conclusion
Absolute baseline ASPECT score reflects early symptomatic hemorrhage risk and functional outcome at 3 months. Thrombus length measured on MRI play an important role on functional outcome at 3 months after thrombectomy. Further analyses are needed to determine its importance in the selection of patients for mechanical thrombectomy. 相似文献20.
Cyrille Naim Guy Cloutier Elizabeth Mercure François Destrempes Zhao Qin Walid El-Abyad Sylvain Lanthier Marie-France Giroux Gilles Soulez 《European radiology》2013,23(7):2030-2041