scholarly journals Correlation of magnetic resonance imaging and post-ablation endoscopy to detect oesophageal thermal injury in patients after atrial fibrillation ablation: MRI-EDEL-study

EP Europace ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. 1009-1016
Author(s):  
Philipp Halbfass ◽  
Lukas Lehmkuhl ◽  
Borek Foldyna ◽  
Artur Berkovitz ◽  
Kai Sonne ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Atrial Fibrillation ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Oesophageal Injury ◽  
Mri Sequences ◽  
Sensitivity Specificity ◽  
Signal Intensities

Abstract Aims  To correlate oesophageal magnetic resonance imaging (MRI) abnormalities with ablation-induced oesophageal injury detected in endoscopy. Methods and results  Ablation-naïve patients with atrial fibrillation (AF), who underwent ablation using a contact force sensing irrigated radiofrequency ablation catheter, received a cardiac MRI on the day of ablation, and post-ablation oesophageal endoscopy (OE) 1 day after ablation. Two MRI expert readers recorded presence of abnormal oesophageal tissue signal intensities, defined as increased oesophageal signal in T2-fat-saturated (T2fs), short-tau inversion-recovery (STIR), or late gadolinium enhancement (LGE) sequences. Oesophageal endoscopy was performed by experienced operators. Finally, we correlated the presence of any affection with endoscopically detected oesophageal thermal lesions (EDEL). Among 50 consecutive patients (age 67 ± 7 years, 60% male), who received post-ablation MRI and OE, complete MRI data were available in 44 of 50 (88%) patients. In OE, 7 of 50 (14%) presented with EDEL (Category 1 lesion: erosion n = 3, Category 2 lesion: ulcer n = 4). Among those with EDEL, 6 of 7 (86%) patients presented with increased signal intensities in all three MRI sequences, while only 2 of 37 (5%) showed hyperintensities in all three MRI sequences and negative endoscopy. Correspondingly, sensitivity, specificity, positive predictive value, and negative predictive value (NPV) for MRI (increased signal in T2fs, STIR, and LGE) were 86%, 95%, 75%, and 97%, respectively. Conclusion  Increased signal intensity in T2fs, STIR, and LGE represents independent markers of EDEL. In particular, the combination of all three has the highest diagnostic value. Hence, MRI may represent an accurate, non-invasive method to exclude acute oesophageal injury after AF ablation (NPV: 97%).

Diagnostic Performance of Nanoparticle-Enhanced Magnetic Resonance Imaging in the Diagnosis of Lymph Node Metastases in Patients With Endometrial and Cervical Cancer

2005 ◽  
Vol 23 (12) ◽  
pp. 2813-2821 ◽  
Author(s):  
Andrea G. Rockall ◽  
Syed A. Sohaib ◽  
Mukesh G. Harisinghani ◽  
Syed A. Babar ◽  
Naveena Singh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Resonance Imaging ◽  
Lymph Node Sampling ◽  
Node Metastases ◽  
Sensitivity Specificity

Purpose Lymph node metastases affect management and prognosis of patients with gynecologic malignancies. Preoperative nodal assessment with computed tomography or magnetic resonance imaging (MRI) is inaccurate. A new lymph node–specific contrast agent, ferumoxtran-10, composed of ultrasmall particles of iron oxide (USPIO), may enhance the detection of lymph node metastases independent of node size. Our aim was to compare the diagnostic performance of MRI with USPIO against standard size criteria. Methods Forty-four patients with endometrial (n = 15) or cervical (n = 29) cancer were included. MRI was performed before and after administration of USPIO. Two independent observers viewed the MR images before lymph node sampling. Lymph node metastases were predicted using size criteria and USPIO criteria. Lymph node sampling was performed in all patients. Results Lymph node sampling provided 768 pelvic or para-aortic nodes for pathology, of which 335 were correlated on MRI; 17 malignant nodes were found in 11 of 44 patients (25%). On a node-by-node basis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) by size criteria were 29%*, 99%, 56%, and 96%, and by USPIO criteria (reader 1/reader 2) were 93%/82%* (*P = .008/.004), 97%/97%, 61%/59%, and 100%/99%, respectively (where [*] indicates the statistical difference of P = x/x between the two results marked by the asterisk). On a patient-by-patient basis, sensitivity, specificity, PPV, and NPV by size criteria were 27%*, 94%, 60%, and 79%, and by USPIO criteria (reader 1/reader 2) were 100%/91%* (*P = .031/.06), 94%/87%, 82%/71%, and 100%/96%, respectively. The κ statistic was 0.93. Conclusion Lymph node characterization with USPIO increases the sensitivity of MRI in the prediction of lymph node metastases, with no loss of specificity. This may greatly improve preoperative treatment planning.

Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study

2017 ◽  
Vol 68 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sharon E. Clarke ◽  
Dipan Mistry ◽  
Talal AlThubaiti ◽  
M. Naeem Khan ◽  
David Morris ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Second Look ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.

Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value.

1991 ◽  
Vol 73 (1) ◽  
pp. 17-29 ◽  
Author(s):  
J P Iannotti ◽  
M B Zlatkin ◽  
J L Esterhai ◽  
H Y Kressel ◽  
M K Dalinka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Sensitivity Specificity

Radiologic and Pathological Correlation of Staging of Rectal Cancer with 3 Tesla Magnetic Resonance Imaging

2011 ◽  
Vol 62 (3) ◽  
pp. 215-222 ◽  
Author(s):  
Parangama Chatterjee ◽  
Anu Eapen ◽  
Benjamin Perakath ◽  
Ashish Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rectal Carcinoma ◽  
Predictive Value ◽  
3 Tesla ◽  
Resected Specimen ◽  
Resonance Imaging ◽  
3T Mri ◽  
Tumour Spread ◽  
Sensitivity Specificity

Purpose To assess the sensitivity and specificity of 3 Tesla magnetic resonance imaging (MRI) in the prediction of extramural spread and metastatic adenopathy in rectal carcinoma. Materials and Methods This was a prospective cohort study that included forty consecutive patients with rectal carcinoma from the Department of Colorectal Surgery. Three Tesla (3T) MRI was performed on these patients after a 4-hour fast and cleansing water enema. TI-weighted and T2-weighted images were obtained with high-resolution images T2-weighted sequences through the pelvis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 3T MRI for prediction of metastatic adenopathy and extramural spread were calculated. The TNM staging based on MRI was compared with histopathology of the resected specimen (taken as the criterion standard). Results In our study, sensitivity, specificity, PPV, and NPV of 3T MRI for prediction of metastatic adenopathy were 100%, 78.3%, 77.3%, and 100%, respectively. Sensitivity, specificity, PPV, and NPV of 3T MRI for prediction of extramural tumour spread were 100% and 20%, 89.7% and 100%, respectively (ie, prediction of stages T3 and above). Conclusion MRI allows accurate measurement of the depth of extramural tumour spread. In the assessment of metastatic adenopathy, however, MRI has a low specificity. This study shows that MRI is unlikely to miss any significant parameter in staging of rectal carcinoma. However, it has a tendency to overstage extramural spread of tumour.

scholarly journals Magnetic resonance imaging in the evaluation of meniscal tear

2010 ◽  
Vol 4 (2) ◽  
pp. 215-222
Author(s):  
Numphung Numkarunarunrote ◽  
Anoma Sanpatchayapong ◽  
Pongsak Yuktanandana ◽  
Somsak Kuptniratsaikul
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Meniscal Tear ◽  
Posterior Horn ◽  
Anterior Horn ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Sensitivity Specificity ◽  
Knee Pathology

Abstract Background: Magnetic resonance imaging (MRI) has been recognized as the imaging method for non-invasive evaluation of knee pathology, particular meniscus and ligaments. Objective: Compare the sensitivity, specificity, and accuracy of MRI in the detection of meniscal tears with arthroscopy. Material and methods: Twenty-seven patients who were diagnosed as meniscal tear on arthroscopy with preoperative MRI were included in this study between January 2003 and June 2008. MRI was performed with a 1.5 Tesla Signa Horizon Echospeed MRI for eight patients between January 2003 and June 2005 and a 1.5 Tesla Signa Excited HD MRI for nineteen patients between July 2005 and June 2008. The location of meniscal tear was evaluated by studying three areas: anterior horn, body and posterior horn. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of the anterior horn, body, posterior horn and overall meniscus were calculated. Results: The sensitivity of MRI for detecting meniscal tears at the anterior horn, body, posterior horn, and overall medial meniscus was 42.9%, 87.5%, 94.1%, and 81.3%, respectively. The specificity was 95.0%, 84.2%, 81.8%, and 88.0%, respectively. The accuracy was 81.5%, 85.2%, 89.3%, and 85.4%, respectively. The PPV was 75.0%, 70.0%, 88.9%, and 81.2%, respectively. The NPV was 82.6%, 94.1%, 90.0%, and 88.0%, respectively. The sensitivity of MRI for detecting meniscal tears at the anterior horn, body, posterior horn and overall lateral meniscus was 0%, 100%, 85.7%, and 80.0%, respectively. The specificity was 100%, 100%, 90.5% and 97.2%, respectively. The accuracy was 96.0%, 100%, 90.5%, and 97.2%, respectively. The PPV was 100%, 75% and 80%, respectively. The NPV was 96.3%, 100%, 95.0%, and 97.2%, respectively. Conclusion: MRI is a helpful technique to detect meniscal tear with different sensitivity and accuracy on the meniscal location.

scholarly journals Magnetic Resonance Imaging Evaluation of Menisci and Cruciate Ligamentous Injuries of the Knee with Arthroscopic Correlation

2017 ◽  
Vol 13 (1) ◽  
pp. 95-98
Author(s):  
Mohammed Mominul Hoque Sarker ◽  
Md Taharul Alam ◽  
Syed Zoherul Alam ◽  
Mohammad Shafiqul Alam ◽  
AKM Sharifur Rahman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Spin Echo ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Arthroscopic Examination ◽  
Sensitivity Specificity

Introduction: Now a days Magnetic Resonance Imaging (MRI) has become the primary investigation for the assessment of knee injuries. Non-invasive MRI has the ability of high resolution and accuracy to diagnose the knee injuries and it can be the alternative to diagnostic arthroscopy. Objective: To validate MRI evaluation in the assessment of cruciate ligamentous and meniscal injuries of the knee joint and compare with arthroscopic findings. Materials and Methods: This cross sectional study was conducted at Combined Military Hospital, Dhaka from 01 January 2013 to 30 June 2013 where sixty patients who had the history of twisting injuries to the knee were selected in this study. Along with injury history they were strongly suspected to have meniscal and/or cruciate ligamentous tears. Then they were examined by open MRI machine 0.4 tesla, Hitachi, made in Japan. A Quadrature (QD) extremity coil was used in this study. Spin echo T1, fast spin echo T2 and Short Tau Inversion Recovery (STIR) sequences were taken in direct coronal, sagittal and axial planes with 4mm slice thickness. Data were recorded and statistical analysis was done by SPSS version 20. Results: Total 60 patients underwent MRI and Arthroscopic examination. The final diagnosis was established by direct findings at Arthroscopic examination. The Sensitivity, Specificity and Accuracy of Magnetic Resonance Imaging in the diagnosis of cruciate ligamentous and meniscal injuries as compared to arthroscopy were Anterior Cruciate Ligament (ACL): 96.88% sensitivity, 96.43% specificity, 96.66% accuracy, 96.87% Positive predictive value (PPV) and 96.42% Negative predictive value (NPV); Medial Meniscus (MM): 96.43% sensitivity, 98.87% specificity,96.66% accuracy, 96.42% PPV and 98.88% NPV; for Lateral Meniscus (LM): 80.00% sensitivity, 97.77% specificity, 93.33% accuracy, 92.30% PPV and 93.62% NPV. Conclusion: As a non-invasive diagnostic modality Magnetic Resonance Imaging is very useful and having high sensitivity, specificity and accuracy in the detection of meniscal and cruciate ligament injuries. To prevent unwanted arthroscopies MRI should be done in every patient of suspected cruciate ligamentous and meniscal injury before doing arthroscopy. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 95-98

scholarly journals Comparative study of cardiac magnetic resonance imaging and transesophageal echocardiography in detection of left atrial and left atrial appendage thrombi

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
H Shahawy ◽  
A Al Agha ◽  
M Helmy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Left Atrial ◽  
Diagnostic Performance ◽  
Left Atrial Appendage ◽  
Invasive Technique ◽  
Resonance Imaging ◽  
Sensitivity Specificity

Abstract Funding Acknowledgements Type of funding sources: None. Background Left atrial (LA) thrombi are the most common intracardiac masses. Left atrial appendage (LAA) is the most common site for thrombus formation in patients with atrial fibrillation (AF), and in patients with valvular lesions. Transesophageal echocardiography (TEE) has been the conventional investigation for thrombus detection. However, because TEE is a semi-invasive technique; a completely non-invasive technique would be of great concern.  Purpose  The aim of this study is to evaluate the feasibility and diagnostic performance of cardiac magnetic resonance imaging (CMR), for the assessment of thrombi in the left atrium and left atrial appendage (LA/ LAA). Also whether CMR is comparable to TEE in identification and measurement of thrombus size. Methods We studied 43 patients who were diagnosed to have LA/LAA thrombus, or highly suspected thrombus by TEE. They underwent multisequence CMR for assessment of thrombus detection; within 7 days of TEE performance. Data collected from CMR study were statistically analyzed to evaluate for sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and overall accuracy of detection of LA/LAA thrombus using TEE as the gold standard. Also agreement between both imaging techniques was assessed using kappa agreement coefficient. We conducted a questionnaire where 10 questions were asked to every patient in the study. It aimed to obtain an idea about patients’ opinion of both tests. Results During the study period of 13 months, 43 patients were assessed. Twenty one patients had AF and 22 patients were in sinus rhythm. The median CHA2DS2VASc score of AF patients was 2.52 ± 1.12, and 76.7% of patients were undergoing anticoagulation therapy. In all subjects, the LAA was readily visualized with CMR. When evaluating the diagnostic performance of CMR results revealed overall sensitivity, specificity, PPV, NPV and accuracy of 97.44%, 75%, 97.44%, 75% and 95.35% respectively. Results of questionnaire was statistically significant p value yielding good overall opinion for the sake of CMR. There was an additional role for CMR regarding tissue characterization; where CMR detected 3 cases, diagnosed by TEE as thrombus, 1 case revealed Libman-Sacks Endocarditis and 2 cases revealed fibroelastoma. This made a paradigm shift in patient management. Conclusion CMR is a noninvasive, feasible and comparable modality for thrombus detection in the LA and LAA and could be a reasonable, more comfortable alternative to TEE.

scholarly journals Differential value of brain magnetic resonance imaging in multiple system atrophy cerebellar phenotype and spinocerebellar ataxias

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Minkyeong Kim ◽  
Jong Hyeon Ahn ◽  
Yoonsu Cho ◽  
Ji Sun Kim ◽  
Jinyoung Youn ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Multiple System Atrophy ◽  
Disease Duration ◽  
Early Stage ◽  
Brain Magnetic Resonance Imaging ◽  
Diagnostic Value ◽  
Spinocerebellar Ataxias ◽  
Resonance Imaging ◽  
Sensitivity Specificity

AbstractClinically differentiating multiple system atrophy cerebellar (MSA-C) phenotype and spinocerebellar ataxias (SCAs) is challenging especially in the early stage. We assessed diagnostic value of brain magnetic resonance imaging (MRI) in differentiating MSA-C and SCAs based at different disease stages (<3, 3–7, and >7 years of disease duration). Overall, 186 patients with probable MSA-C and 117 with genetically confirmed SCAs were included. Hot cross bun (HCB) signs and middle cerebellar peduncle (MCP) hyperintensities were exclusively prevalent in MSA-C compared to SCAs at <3 years (HCB, 44.6% versus 0.9%; MCP hyperintensities, 38.3% versus 0.9%, respectively). Sensitivity, specificity, and positive predictive value (PPV) for HCB signs to differentiate MSA-C from SCAs were 45%, 99%, and 99% and those for MCP hyperintensities were 68%, 99%, and 99%, respectively; considering both HCB signs and MCP hyperintensities, specificity and PPV were 100%. However, the differential value of MRI signs decreased over time. MCP widths were smaller and showed more significant decrease in MSA-C than in SCAs. In conclusion, pontine and MCP changes were exclusively prominent in early stage MSA-C rather than in SCAs. Therefore, we should consider disease duration when interpreting pontine and MCP changes in brain MRIs, which will help better differentiate MSA-C and SCAs.

scholarly journals Diagnostic Value of Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Positron Emission Tomography (PET) in the Detection of Lymph Node Metastases in Gynaecologic Cancers

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Node Metastases ◽  
Magnetic Resonance Imaging Mri

Background: A factor that affects the staging of gynaecological cancers is the status of adenopathy’s and imaging tests are a fundamental part of staging. Primary Objective: To assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in the detection of pathological lymphadenopathies in gynaecological cancers of magnetic resonance imaging (MRI), computerized axial tomography (CAT) and positrons emission tomography (PET). Study Hypothesis: Imaging tests are not as valid as lymphadenectomy for the diagnosis of pathological lymphadenopathies. Trial Design: Retrospective study performed in the gynaecological oncology unit of a tertiary hospital. Major Inclusion/Exclusion Criteria: Patients diagnosed with genital cancer (endometrium, ovary or cervix) in the period between January 1, 2014 and December 31, 2018, who meet the following inclusion criteria: (i) have requested a diagnostic test of image (RNM, CT or PET-CT) prior to undergoing surgery; (ii) have undergone surgery for the treatment of cancer and (iii) have undergone lymphadenectomy, pelvic and / or para-aortic, during surgery. Primary Endpoint: Correlation between the imaging tests and the anatomopathological result of the lymph node biopsies. Sample Size: 219 patients who underwent pelvic, para-aortic lymphadenectomy or both due to cancer of the endometrium, ovary or cervix, and at least one imaging test prior to surgery. Results: In our study, PET presents the highest sensitivity (42%) of the diagnostic tests evaluated, the TAC the highest specificity (95%) and the highest PPV (77%) and the MRI the highest NPV (76%). Conclusions: The diagnostic value of imaging tests in the detection of lymph node metastases in gynaecological cancers is limited.

Role of Magnetic Resonance Imaging in Predicting Residual Breast Cancer After Vacuum-Assisted Breast Biopsy

2020 ◽  
pp. 000313482095243
Author(s):  
Sun Zheng ◽  
Liu Qi ◽  
Zhang Guang-Qiang ◽  
Shi Ming-Ming ◽  
Xu Chun-Hong
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Breast Biopsy ◽  
Breast Mri ◽  
High Sensitivity ◽  
Resonance Imaging ◽  
Residual Cancer ◽  
Sensitivity Specificity

Purpose This study aims to evaluate the effectiveness of breast magnetic resonance imaging (MRI) in detecting residual breast cancer in patients after vacuum-assisted breast biopsy (VABB). Methods Between 2012 and 2019, 26 patients with breast cancer who underwent VABB were enrolled. Breast MRI was conducted after VABB. Imaging findings were then compared with the histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Results Residual cancer was confirmed histologically in 8 of the 26 patients after VABB. The overall sensitivity, specificity, PPV, NPV, and accuracy of MRI for diagnosing residual cancer were 79.9%, 73.0%, 87.1%, 61.3%, and 77.8%, respectively. The sensitivity and NPV improved to 100%, when the number of biopsy specimens was larger than five. Conclusion Breast MRI showed high sensitivity and NPV in detecting residual breast tumor after VABB.

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