scholarly journals Interobserver Agreement in Magnetic Resonance of the Sacroiliac Joints in Patients with Spondyloarthritis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Juan C. Rueda ◽  
Sofia Arias-Correal ◽  
Andres Y. Vasquez ◽  
Enrique Calvo ◽  
Paola Peña ◽  
...  

Background. Clinical, laboratory, and radiologic parameters are used for diagnosis and classification of spondyloarthritis (SpA). Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is being increasingly used to detect early sacroiliitis. We decided to evaluate the interobserver agreement in MRI findings of SI joints of SpA patients between a local radiologist, a rheumatologist, and an expert radiologist in musculoskeletal diseases. Methods. 66 MRI images of the SI joints of patients with established diagnosis of SpA were evaluated. Agreement was expressed in Cohen’s kappa. Results. Interobserver agreement between a local radiologist and an expert radiologist was fair (κ=0.37). Only acute findings showed a moderate agreement (κ=0.45), while chronic findings revealed 76.5% of disagreement (κ=0.31). A fair agreement was observed in acute findings (κ=0.38) as well as chronic findings (κ=0.38) between a local radiologist and a rheumatologist. There was a substantial agreement between an expert radiologist and a rheumatologist (κ=0.73). In acute findings, a 100% agreement was achieved. Also chronic and acute plus chronic findings showed high levels of agreement (κ=0.73 and 0.62, resp.). Conclusions. Our study shows that rheumatologists may have similar MRI interpretations of SI joints in SpA patients as an expert radiologist.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1835.1-1836
Author(s):  
A. C. Genç ◽  
F. Turkoglu Genc ◽  
A. B. Kara ◽  
Z. Ozturk ◽  
D. Karatas ◽  
...  

Background:Axial spondyloarthritis has characteristic clinical features such as enthesitis, sacroiliitis and spondylitis, and extra-articular manifestations(1). Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is used to detect early sacroiliitis(2). Health institutions in our country carry out some of the radiology reporting services by outsourcing for reasons such as high cost and insufficient number of radiologists(3).Objectives:We decided to evaluate the interobserver agreement in active MRI findings of SI between radiologist of outsourcing radiology services and local/expert radiologist in musculoskeletal diseases.Methods:Between the years of 2015 and 2019, 8100 sacroiliac MRIs were taken at our center. The MRI of 1150 patients who were reported as active or chronic sacroiliitis from these sacroiliac MRIs or whose MRI was considered by the primary physician in favor of sacroiliitis was included in the study. Concordance between Evaluation and Service Procurement was examined using Kappa (k) coefficients. Mc Nemar test was used to compare the evaluation result between two observers. A p-value <0.05 was considered significant. Analyses were performed using commercial software (IBM SPSS Statistics, Version 23.0. Armonk, NY: IBM Corp.)Results:Of the 1150 patients examined in the study, 526 (45.7%) were male and 624 (54.3%) were female. The general average age is 37.20 ± 11.65 and the average age of men and women is 34.98 ± 11.19 and 39.07 ± 11.71 respectively. A statistically significant difference was found between the expert radiologists and outsourcing radiologist reports. In other words, a high level of compatibility was not found among the evaluators (p <0.001). When the consistency between expert radiologist and outsourced radiologist reports was examined, it was observed that there was a medium level of concordance (k = 0.589).Conclusion:The diagnosis of a spondyloarthropathy may be delayed for some reasons. In addition to the insidious course of the disease, being contented with an outsourced radiologist report may delay diagnosis. If the patient’s clinic and MRI report are not consistent, the patient should not be removed from follow-up.References:[1]Braun J. ‘Axial spondyloarthritis including ankylosing spondylitis’ Rheumatology (Oxford). 2018 1;57(suppl_6):vi1-vi3[2]Jans L, Egund N, Eshed I, Sudoł-Szopińska I, Jurik AG. Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity. Semin Musculoskelet Radiol. 2018;22: 180–188.[3]Quélin B, Duhamel F. Bringing Together Strategic Outsourcing and Corporate Strategy: European Management Journal. 2003. pp. 647–661. doi:10.1016/s0263-2373(03)00113-0OUTSOURCING RADIOLOGIST REPORTSTOTALpNOT ACTIVE SACROILIITISACTIVE SACROILIITISEXPERT RADIOLOGIST REPORTSNOT ACTIVE SACROILIITIS508178686<0.0010.589ACTIVE SACROILIITIS59405464TOTAL5675831150Disclosure of Interests:None declared


Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.


2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.


Author(s):  
Sebnem Karasu ◽  
Atilla Hikmet Cilengir ◽  
Irfan Ocal ◽  
Serpil Aydogmus

Background: Vaginal adenosis is a rare clinicopathological entity which refers to the presence of glandular endometrial tissue in the vaginal wall. Case report: A gravida 46-year-old woman was presented to the gynecology department with symptoms of chronic pelvic pain. Maternal Diethylstilbestrol (DES) usage has been proven effective in the development of vaginal adenosis. It can also be idiopathic. Its sonographic or magnetic resonance imaging (MRI) findings have not been described in English literature previously. Conclusion: Here, we report the clinical, transperineal ultrasonographic (US) and MRI findings of a pathologically proven case of vaginal adenosis.


2018 ◽  
Vol 70 (5) ◽  
pp. 1383-1387 ◽  
Author(s):  
T.M. Granato ◽  
L.P. Mesquita ◽  
R.C. Costa ◽  
J.P. Andrade Neto ◽  
P.C. Maiorka

ABSTRACT The aim of this report was to describe the magnetic resonance imaging (MRI) and pathological features of a canine mixed glioma. A 12-year-old boxer male dog was presented for necropsy along with data from an MRI evaluation conducted ante-mortem. The images were examined and showed a poorly demarcated prosencephalic lesion, hyperintense on T2W images, hypointense on T1W images and heterogeneously hyperintense on T2W FLAIR images. There was mild nonuniform contrast enhancement, apparent midline shift, moderate perilesional edema and marked distortion of the adjacent lateral ventricle. The brain was evaluated macroscopically, microscopically and immunohistochemically. Grossly, there was a poorly demarcated soft mass, with areas of hemorrhage, within the left parietal and temporal lobes. Histologically, there was a densely cellular mass composed of two geographically distinct populations of neoplastic cells. The first population was composed of small and round cells organized in a honeycomb pattern. The second population constituted of intermingled streams and bundles of neoplastic cells that were strongly immunolabeled for glial fibrillary acidic protein (GFAP). The diagnosis of a mixed glioma was based on MRI findings, and mainly on histological and immunohistochemical findings.


2017 ◽  
Vol 11 (1-2) ◽  
pp. 8 ◽  
Author(s):  
Fikret Balyemez ◽  
Ahmet Aslan ◽  
Ibrahim Inan ◽  
Ercan Ayaz ◽  
Vildan Karagöz ◽  
...  

Introduction: We aimed to introduce the diagnostic value of diffusion-weighted (DWI) magnetic resonance imaging (MRI) for distinguishing benign and malignant renal cystic masses.Methods: Abdominal DWI-MRIs of patients with Bosniak categories 2F, 3, and 4 cystic renal masses were evaluated retrospectively. Cystic masses were assigned as benign or malignant according to histopathological or followup MRI findings and compared with apparent diffusion coefficient (ADC) values.Results: There were 30 patients (18 males and 12 females, mean age was 59.23 ± 12.08 years [range 38‒83 years]) with cystic renal masses (eight Bosniak category 2F, 12 Bosniak category 3, 10 Bosniak category 4). Among them, 14 cysts were diagnosed as benign and 16 as malignant by followup imaging or histopathological findings. For the malignant lesions, the mean ADC values were lower than for benign lesions (p=0.001). An ADC value of ≤2.28 x10-6 mm2/s or less had a sensitivity of 75% and a specificity of 92.86% for detecting malignancy.Conclusions: ADC can improve the diagnostic performance of MRI in the evaluation of complex renal cysts when used together with conventional MRI sequences.


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