Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated?

2015 ◽  
Vol 25 (5) ◽  
pp. 1520-1527 ◽  
Author(s):  
Wouter Stomp ◽  
Annemarie Krabben ◽  
Désirée van der Heijde ◽  
Tom W. J. Huizinga ◽  
Johan L. Bloem ◽  
...  
Keyword(s):  
Early Arthritis ◽  
Contrast Administration ◽  
Mri Protocol

scholarly journals MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders—Is Gadolinium Contrast Administration Actually Needed?

2021 ◽  
Vol 10 (19) ◽  
pp. 4598
Author(s):  
Marta Michali-Stolarska ◽  
Andrzej Tukiendorf ◽  
Anna Zacharzewska-Gondek ◽  
Jagoda Jacków-Nowicka ◽  
Joanna Chrzanowska ◽  
...  
Keyword(s):  
Diagnostic Value ◽  
P Value ◽  
Gadolinium Contrast ◽  
Contrast Administration ◽  
Post Contrast ◽  
Mri Examination ◽  
Mri Protocol ◽  
Rathke's Cleft ◽  
Sensitivity Specificity ◽  
Waiting Children

The aim of this study was to assess the diagnostic value of non-contrast pituitary MRI in children with growth or puberty disorders (GPDs) and to determine the criteria indicating the necessity to perform post-contrast examination. A retrospective study included re-analysis of 567 contrast-enhanced pituitary MRIs of children treated in a tertiary reference center. Two sets of sequences were created from each MRI examination: Set 1, including common sequences without contrast administration, and Set 2, which included common pre- and post-contrast sequences (conventional MRI examination). The differences in the visibility of pituitary lesions between pairs of sets were statistically analyzed. The overall frequency of Rathke’s cleft cysts was 11.6%, ectopic posterior pituitary 3.5%, and microadenomas 0.9%. Lesions visible without contrast administration accounted for 85% of cases. Lesions not visible before and diagnosed only after contrast injection accounted for only 0.18% of all patients. Statistical analysis showed the advantage of the antero-posterior (AP) pituitary dimension over the other criteria in determining the appropriateness of using contrast in pituitary MRIs. The AP dimension was the most significant factor in logistic regression analysis: OR = 2.23, 95%CI, 1.35–3.71, p-value = 0.002, and in ROC analysis: AUC: 72.9% with a cut-off value of 7.5 mm, with sensitivity/specificity rates of 69.2%/73.5%. In most cases, the use of gadolinium-based contrast agent (GBCA) in pituitary MRI in children with GPD is unnecessary. The advantages of GBCA omission include shortening the time of MRI examination and of general anesthesia; saving time for other examinations, thus increasing the availability of MRI for waiting children; and acceleration in their further clinical management.

scholarly journals Contrast-free MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders: A Practical Approach.

2021 ◽  
Author(s):  
Marta Michali-Stolarska ◽  
Andrzej Tukiendorf ◽  
Jagoda Jacków-Nowicka ◽  
Anna Zacharzewska-Gondek ◽  
Joanna Chrzanowska ◽  
...  
Keyword(s):  
P Value ◽  
Contrast Administration ◽  
Post Contrast ◽  
Mri Examination ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Rathke's Cleft Cysts ◽  
Rathke's Cleft ◽  
Sensitivity Specificity ◽  
Administration Methods

Abstract Objectives Most of the pituitary MRI examinations in children with growth or puberty disorders (GPD) might not require gadolinium-based contrast agent (GBCA) administration. Methods Retrospective re-analysis of contrast-enhanced 567 pituitary MRIs of children with GPD. Two sets of sequences were created from each MRI examination: Set1 - common sequences without contrast administration and Set2 - common pre- and post-contrast sequences. The differences in the visibility of pituitary lesions between sets were statistically analyzed. Results The overall frequency of Rathke's cleft cysts was 11.6%, ectopic posterior pituitary 3.5% and microadenomas 0.9%. Lesions visible without contrast administration accounted for 85% of cases, while lesions diagnosed only after contrast injection accounted for 0.18% of all patients. Statistical analysis showed the advantage of antero-posterior (AP) pituitary dimension over other criteria in determining the appropriateness of using contrast in pituitary MRIs. The AP dimension was the most significant factor in logistic regression analysis: OR=2.23, 95%CI, 1.35-3.71, p-value=0.002 and in ROC analysis: AUC:72.9% with cut-off value 7.5 mm, with sensitivity/specificity rates: 69.2%/73.5%. Conclusions In most cases, the use of GBCA in pituitary MRI in children with GPD is unnecessary. The additional advantages of GBCA omission include: shortening the time of MRI examination and of general anesthesia.

scholarly journals POS0257 TOWARDS A SIMPLIFIED FLUID-SENSITIVE MRI-PROTOCOL IN SMALL JOINTS OF THE HAND IN EARLY ARTHRITIS PATIENTS: RELIABILITY BETWEEN MDIXON AND REGULAR FSE FAT SATURATION MRI-SEQUENCES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 351.1-351
Author(s):  
E. Niemantsverdriet ◽  
M. Verstappen ◽  
F. Wouters ◽  
M. Reijnierse ◽  
H. Bloem ◽  
...  
Keyword(s):  
Early Recognition ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Joint Inflammation ◽  
Early Arthritis ◽  
Scan Time ◽  
Mri Protocol ◽  
Mri Sequences ◽  
T1 And T2 ◽  
Inflammation Score

Background:MRI facilitates early recognition of rheumatoid arthritis (RA) by depicting inflammation. Contrast-enhanced T1-weighted and T2-weighted fat-suppressed sequences have been sensitive and thus recommended, but are hampered by invasiveness, costs and long scan time. Therefore we introduced a modified Dixon-sequence (mDixon) which is more patient-friendly, reduces cost, and scan times by 83%. However, it is not known if this mDixon-sequence is reliable in relation to regular MRI-sequences with and without contrast (T1- and T2-weighted, respectively).Objectives:We determined the reliability between regular MRI-sequences with and without contrast (T1- and T2-weighted, respectively) and mDixon-MRI in early arthritis patients.Methods:29 early arthritis patients underwent regular fat-suppressed-MRI (T1- and T2-weighted) and mDixon-sequences, of metacarpophalangeal-2-5 and wrist-joints. Two readers scored erosions, osteitis, synovitis and tenosynovitis. Intraclass correlation coefficients (ICCs) between readers, and comparing the two sequences, were studied. Spearman correlations were determined.Results:Performance between the two readers with the regular-MRI sequences, was good to excellent (ICCs all ≥0.88). The between reader ICC was also good to excellent for the mDixon-MRI (ICCs all ≥0.76). Next, ICCs between the two sequences was investigated to determine the reliability of mDixon. ICCs were good to excellent for total RAMRIS score 0.87 (95%CI 0.74-0.94), for erosions 0.88 (95%CI 0.69-0.95), and total inflammation score 0.84 (95%CI 0.69-0.82). The individual MRI-inflammation scores, had ICCs for osteitis 0.97 (95%CI 0.93-0.98), for tenosynovitis 0.78 (95%CI 0.58-0.89), and for synovitis 0.57 (95%CI 0.26-0.77). In addition, scores were highly correlated for total RAMRIS, erosions, and total MRI-inflammation score (ρ=0.82, ρ=0.81, ρ=0.80, respectively).Conclusion:Regular-MRI sequences and mDixon-MRI perform equally well, this suggests that mDixon-sequence is reliable to detect joint inflammation. Thus, this is the first step towards an simplified and abridged MRI-protocol in small hand-joints in early arthritis patients. The ultimate goal will be implementation of this mDixon-MRI sequence. Validation in larger studies is warranted.Disclosure of Interests:None declared

Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

Stem cell visualization in the rat brain by an improved MRI protocol

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S512-S512
Author(s):  
Uwe Himmelreich ◽  
Pedro Ramos-Cabrer ◽  
Ralph Weber ◽  
Susanne Wegener ◽  
Mathias Hoehn
Keyword(s):  
Stem Cell ◽  
Rat Brain ◽  
Mri Protocol

Improved Optic Nerve Visualization and Surgical Planning through a Novel MRI Protocol

2019 ◽  
Author(s):  
Kyle Wu ◽  
Wenya Bi ◽  
Michael Moooney ◽  
Jeffrey Guennette ◽  
Raymond Huang ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Surgical Planning ◽  
Mri Protocol

Pearls and Pitfalls of Contrast-Enhanced Mammography

2019 ◽  
Vol 1 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Jordana Phillips ◽  
Valerie J Fein-Zachary ◽  
Priscilla J Slanetz
Keyword(s):  
Imaging Modality ◽  
Breast Mri ◽  
Successful Implementation ◽  
Newly Diagnosed ◽  
Disease Extent ◽  
Diagnostic Problem Solving ◽  
Contrast Enhanced ◽  
Comparable Performance ◽  
Mri Protocol ◽  
Monitoring Response

Abstract Contrast-enhanced mammography (CEM) is a promising new imaging modality that uses a dual-energy acquisition to provide both morphologic and vascular assessment of breast lesions. Although no official BI-RADS lexicon exists, interpretation entails using the mammographic BI-RADS lexicon in combination with that for breast MRI. CEM has comparable performance to breast MRI, with sensitivity of 93–100% and specificity of 80–94%. Currently FDA approved for diagnostic imaging, this technology can be helpful in determining disease extent in patients with newly diagnosed breast malignancy, monitoring response to neoadjuvant therapy, identifying mammographically occult malignancies, and diagnostic problem-solving. Studies are ongoing about its role in screening, especially in women with dense breasts or at elevated risk. There are some challenges to successful implementation into practice, but overall, patients tolerate the study well, and exam times are less than the full breast MRI protocol.

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