Magnetic resonance imaging of the proximal tibial epiphysis is suitable for statements as to the question of majority: a validation study in forensic age diagnostics

Determining majority plays a key role for forensic age diagnostics in living individuals. Recent data suggest that magnetic resonance imaging (MRI) of the proximal tibial epiphysis (PTE) may be a suitable alternative or at least an additional tool to clarify whether an individual has reached majority. However, the reference data situation is still sparse. Hence, the present dual center study retrospectively analyzed routine MRI of the knee in 413 cases (214 males and 199 females) of a Western Caucasian population aged between 12 and 25 years. MRI was performed at 1.5 and 3.0 T clinical scanners using T1- and T2-weighted sequences. The classification system by Vieth et al. (Eur Radiol 2018; 28:3255–3262) was applied for determining the ossification stages of the PTE. Intra-observer agreement was “very good” (κ = 0.931), and inter-observer agreement was “good” (κ = 0.798). Minimum ages above the age of 18 years were observed with the final stage (stage 6) in either sex (20.27 years in males and 18.55 years in females). The results are not in contradiction with the previous data and can be considered a strong and valuable support of the so far existing database. Therefore, the investigation of the PTE using routine MRI (either at 1.5 or 3.0 T) could be taken into consideration for application in forensic age estimation practice in near future.

Magnetic resonance imaging diagnostic potential in “idiopathic” ventricular arrhythmias in children

The study aims to assess the role of magnetic resonance tomography (MRI) in identifying the substrate of “idiopathic” ventricular arrhythmias in pediatric patients.Methods. One hundred and seven children with “idiopathic” ventricular arrhythmias were enrolled. All patients underwent MRI on a high-field Magnetom Trio A Tim (Siemens) tomograph with a magnetic field induction of 3.0 T.Results. According to MRI data, dilated ventricles and/or a decreased ejection fraction were found in 55 (51%) patients. Based on structural abnormalities of the myocardium patients were divided into 2 groups: group 1 “normal”, without abnormalities, (69 (64.5%) children); group 2 - “fibrosis”, fibrotic changes were detected on late gadolinium enhancement (38 (35.5%) patients). Significant differences of indexed MR-indicators in these two groups were not found. However, in the “fibrosis” group, biventricular dysfunction occurred significantly more often than in the “normal” group, respectively (14 (37%) and 9 (13%) (p = 0.006)).Conclusion. MRI is important in assessing structural changes in pediatric patients with ventricular arrhythmias, and the combination of MRI results with clinical and electrophysiological data can significantly affect the change in management and treatment strategy in pediatric patients.

Neuroimaging cerebrovascular biomarkers in Parkinson’s disease

Background and Purpose The cardiovascular risk in Parkinson’s disease (PD) remains uncertain and controversial. Some studies suggest PD patients present an increased risk of cerebrovascular disease. We aimed to study the prevalence of neuroimaging cerebrovascular biomarkers in PD patients compared to controls, using an accurate and complete magnetic resonance (MR) imaging evaluation. Material and Methods Neuroimaging sub-study within a larger cross-sectional case–control study. An enriched subgroup of PD patients (≤10 years since diagnosis) with at least a moderate cardiovascular mortality risk based on a Systematic COronary Risk Evaluation (SCORE) was compared to community-based controls regarding neuroimaging biomarkers. Patients underwent a high-resolution T1-weighted MR imaging sequence at 3.0 T to visualize neuromelanin. A 3D SWI FFE, sagittal 3D T1-weighted, axial FLAIR and diffusion-weighted image sequences were obtained. Results The study included 47 patients, 24 with PD and 23 controls. PD patients presented a reduced area and signal intensity of the substantia nigra and locus coeruleus on neuromelanin-sensitive MR. The median SCORE was 5% in both groups. No significant differences regarding white matter hyperintensities (OR 4.84, 95% CI 0.50, 47.06), lacunes (OR 0.43, 95% CI 0.07, 2.63), microbleeds (OR 0.64, 95% CI 0.13, 3.26), or infarcts (0.95, 95% CI 0.12, 7.41) was found. The frequency of these neuroimaging biomarkers was very low in both groups. Conclusion The present study does not support an increased prevalence of neuroimaging cerebrovascular biomarkers in PD patients.

Soybean in Indonesia: Current Status, Challenges and Opportunities to Achieve Self-Sufficiency

Soybean is the third important food crop in Indonesia after rice and maize, particularly as a good source of protein. The demand for soybean consumption tends to increase annually. In 2020, the figure was about 3.28 million tons, while the domestic production was 0.63 million tons, thus around 81% of the soybean needed was imported. Efforts to increase the domestic soybean production have been conducted since the last decade, which is concerned with increasing the current productivity (1.5 t/ha) through introducing the high-yielding improved varieties and extending the harvested area, particularly to outside of Java. The potential planting area is focused on the irrigated lowland after rice (optimal land) and suboptimal lands (dry, acid, tidal, and shaded lands). The series of the study showed that the yield potential of soybean grown in such lands varied from 1.8 t/ha to 3.0 t/ha. A number of soybeans improved varieties adapted to different land types or agro-ecological conditions also have been released and supported with advanced cultivation technology. The results, challenges, and opportunities to achieve soybean self-sufficiency are discussed in this paper.

Development of a Proton-Frequency-Transparent Birdcage Radiofrequency Coil for In Vivo 13C MRS/MRSI Study in a 3.0 T MRI System

A proton-frequency-transparent (PFT) birdcage RF coil that contains carbon-proton switching circuits (CPSCs) is presented to acquire 13C MR signals, which, in turn, enable 1H imaging with existing 1H RF coils without being affected by a transparent 13C birdcage RF coil. CPSCs were installed in the PFT 13C birdcage RF coil to cut the RF coil circuits during 1H MR imaging. Finite-difference time-domain (FDTD) electromagnetic (EM) simulations were performed to verify the performance of the proposed CPSCs. The performance of the PFT 13C birdcage RF coil with CPSCs was verified via phantom and in vivo MR studies. In the phantom MR studies, 1H MR images and 13C MR spectra were acquired and compared with each other using the 13C birdcage RF coil with and without the CPSCs. For the in vivo MR studies, hyperpolarized 13C cardiac MRS and MRSI of swine were performed. The proposed PFT 13C birdcage RF coil with CPSCs led to a percent image uniformity (PIU) reduction of 1.53% in the proton MR images when compared with the case without it. FDTD EM simulations revealed PIU reduction of 0.06% under the same conditions as the phantom MR studies. Furthermore, an SNR reduction of 5.5% was observed at 13C MR spectra of corn-oil phantom using the PFT 13C birdcage RF coil with CPSCs compared with that of the 13C birdcage RF coil without CPSCs. Utilizing the PFT 13C birdcage RF coil, 13C-enriched compounds were successfully acquired via in vivo hyperpolarized 13C MRS/MRSI experiments. In conclusion, the applicability and utility of the proposed 16-leg low-pass PFT 13C birdcage RF coil with CPSCs were verified via 1H MR imaging and hyperpolarized 13C MRS/MRSI studies using a 3.0 T MRI system.

Prognosis in patients with coronary heart disease and breath-holding limitations: a free-breathing cardiac magnetic resonance protocol at 3.0 T

Background and purpose Conventional cardiac magnetic resonance (CCMR) imaging is usually performed with breath-holding (BH), which is adverse in patients with BH limitations. We explored the ability of a free-breathing CMR (fCMR) protocol to prognosticate in patients with coronary heart diseases (CHD) and limited BH ability. Methods Sixty-seven patients with CHD and limited BH abilities were prospectively enrolled in this study. All patients underwent comprehensive fCMR imaging at 3.0 T. The fCMR protocols included compressed sensing (CS) single-shot cine acceleration imaging, and motion-corrected (MOCO), single-shot late gadolinium enhancement (LGE) imaging. Image quality (IQ) of the cine and LGE images was evaluated based on the 5-point Likert scale. The value of fMRI in providing a prognosis in patients with CHD was assessed. Statistical methods included the T test, Mann–Whitney test, Kappa test, Kaplan–Meier curve, Log-rank test, Cox proportional hazard regression analysis, and receiver operating characteristic curves. Results All IQ scores of the short axis CS-cine and both the short and long axes MOCO LGE images were ≥ 3 points. Over a median follow-up of 31 months (range 3.8–38.2), 25 major adverse cardiovascular events (MACE) occurred. In the univariate analysis, infarction size (IS), left ventricular ejection fraction (LVEF), 3D-Global peak longitudinal strain (3D-GPLS), heart failure classification were significantly associated with MACE. When the significantly univariate MACE predictors, added to the multivariate analysis, which showed IS (HR 1.02; 95% CI 1.00–1.05; p = 0.048) and heart failure with preserved EF (HR 0.20; 95% CI 0.04–0.98; p = 0.048) correlated positively with MACE. The optimal cutoff value for LVEF, 3D-GPLS, and IS in predicting MACE was 34.2%, − 5.7%, and 26.1% respectively, with a sensitivity of 90.5%, 64%, and 96.0% and specificity of 72%, 95.2%, and 85.7% respectively. Conclusions The fCMR protocol can be used to make prognostic assessments in patients with CHD and BH limitations by calculating IS and LVEF.

Technology Updates in Male Infertility Management

Background: Technologies are replacing manpower many fields including medical field. Several devices have been marketed for replacing/reducing manpower in the medical field including male infertility. Here we reviewed several technologies that developed in male infertility. Review: Computer assisted sperm analysis (CASA), Automatic assessment of biochemical marker of seminal plasma, B-mode ultrasound, and automatic sperm cryopreservation can be applied routinely. Several updates i.e. automatic histopathology assessment, ultrasound strain elastography, magnetic resonance imaging (MRI) stronger than 3.0 T, Artificial intelligence for predicting the presence of sperm in azoospermia cases, automatic sperm selection, and automatic intracytoplasmic sperm injection (ICSI) need more studies before their application. Summary: Prudent choice based on valid studies is needed in order to give a comprehensive management to patient with male infertility without using useless technology.

Comparison of different ROI analysis methods for liver lesion characterization with simplified intravoxel incoherent motion (IVIM)

This study investigated the impact of different ROI placement and analysis methods on the diagnostic performance of simplified IVIM-DWI for differentiating liver lesions. 1.5/3.0-T DWI data from a respiratory-gated MRI sequence (b = 0, 50, 250, 800 s/mm2) were analyzed in patients with malignant (n = 74/54) and benign (n = 35/19) lesions. Apparent diffusion coefficient ADC = ADC(0,800) and IVIM parameters D1′ = ADC(50,800), D2′ = ADC(250,800), f1′ = f(0,50,800), f2′ = f(0,250,800), and D*' = D*(0,50,250,800) were calculated voxel-wise. For each lesion, a representative 2D-ROI, a 3D-ROI whole lesion, and a 3D-ROI from “good” slices were placed, including and excluding centrally deviating areas (CDA) if present, and analyzed with various histogram metrics. The diagnostic performance of 2D- and 3D-ROIs was not significantly different; e.g. AUC (ADC/D1′/f1′) were 0.958/0.902/0.622 for 2D- and 0.942/0.892/0.712 for whole lesion 3D-ROIs excluding CDA at 1.5 T (p > 0.05). For 2D- and 3D-ROIs, AUC (ADC/D1′/D2′) were significantly higher, when CDA were excluded. With CDA included, AUC (ADC/D1′/D2′/f1′/D*') improved when low percentiles were used instead of averages, and was then comparable to the results of average ROI analysis excluding CDA. For lesion differentiation the use of a representative 2D-ROI is sufficient. CDA should be excluded from ROIs by hand or automatically using low percentiles of diffusion coefficients.

Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study

Purpose The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and inferoplantar longitudinal ligament (IPL). Methods We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen’s kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p < 0.05 was considered as significant. The final decision was made by consensus. Results Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of ligaments, the presence of bifid ligaments and side or gender (p > 0.05). Conclusion. More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament.