Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence

Abstract Background Repeated bleeding in hemophilic arthropathy (HA) may result in severe degenerative changes and joint destruction. The gradient-recalled echo (GRE) sequence MR is proved to be the best method to detect hemosiderin deposition. However, MR is not widely available in developing countries, including Indonesia. Some studies have proposed ultrasonography (US) as an alternative tool in evaluating hemophilic joint. However, there is still some disagreement on the ability of US to detect hemosiderin deposition. Objective To evaluate the association between US and GRE-sequence MR imaging in detecting hemosiderin deposition in hemophilic ankle joint. Material and methods A total of 102 sites from 17 ankle joints of 11 boys with severe hemophilia A underwent US examination using a high-frequency linear array transducer. GRE-sequence MR examination was performed in sagittal view consistent with the sites scanned by US. Both examinations were performed on the same day, but MR interpretation was performed blindly at different times. The association between US and GRE-sequences in detecting hemosiderin deposition was analyzed using McNemar’s test. Results Statistical analysis showed a significant association (p value < 0.001) between US and GRE MR in detecting hemosiderin deposition, but the association is weak (R = 0.26). Sensitivity and specificity of US for detecting hemosiderin deposition were 46.84% (95%CI: 35.51–58.40) and 95.65% (95%CI: 78.05–99.89), respectively, with positive predictive value 97.37% (95%CI: 84.29–99.61), negative predictive value 34.38% (95%CI: 29.50–39.60) and accuracy 57.84% (95%CI: 47.66–67.56). Conclusion There was a weak association between US and GRE-sequences in detecting hemosiderin deposition of hemophilic ankle joint.

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Interventional Mr imaging

Acta Radiologica ◽

10.1080/02841859709171240 ◽

1997 ◽

Vol 38 (1) ◽

pp. 43-46

Author(s):

R. P. J. Joensuu ◽

R. E. Sepponen ◽

A. E. Lamminen ◽

C.-G. M. Standertskjöld-Nordenstam

Keyword(s):

Mr Imaging ◽

Signal To Noise Ratio ◽

Coaxial Cable ◽

High Signal ◽

The Poor ◽

Imaging Sequence ◽

Reference Phantom ◽

Interventional Mr ◽

Interventional Devices ◽

Interventional Mr Imaging

Purpose: The poor localization facility of interventional instruments in MR imaging has been one of the major obstacles to the popularization of interventional MR imaging. It has been suggested that the Overhauser enhancement be used to generate markers of small size and high visibility. This article studies the feasibility of a localization marker based on this method. Material and Methods: A small Overhauser marker was constructed on the tip of a coaxial cable and comparative images were taken by a 0.23 T imager with and without electron spin irradiation. Results: During irradiation an enhanced signal intensity from the marker was observed. The signal from the marker also exceeded the signal from a 0.25 mmol MnCl2 reference phantom. Conclusion: Its small size and high signal-to-noise ratio, together with immunity to most system nonlinearities and imaging errors, makes the Overhauser marker a promising localization method for the accurate positioning of interventional devices. The method may be applied at any field strength, and markers are visible in images obtained with any practical imaging sequence.

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Cement Arthroplasty for Ankle Joint Destruction

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.m.01280 ◽

2014 ◽

Vol 96 (17) ◽

pp. 1468-1475 ◽

Cited By ~ 8

Author(s):

Ho-Seong Lee ◽

Ji-Yong Ahn ◽

Jong-Seok Lee ◽

Jun-Young Lee ◽

Jae-Jung Jeong ◽

...

Keyword(s):

Ankle Joint ◽

Joint Destruction ◽

Cement Arthroplasty

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Comment on “Blood Flow Mimicking Aneurysmal Wall Enhancement: A Diagnostic Pitfall of Vessel Wall MRI Using the Postcontrast 3D Turbo Spin-Echo MR Imaging Sequence”

American Journal of Neuroradiology ◽

10.3174/ajnr.a5777 ◽

2018 ◽

Vol 39 (11) ◽

pp. E118-E118 ◽

Cited By ~ 1

Author(s):

M. Edjlali ◽

P. Turski ◽

C. Oppenheim ◽

O. Naggara

Keyword(s):

Blood Flow ◽

Mr Imaging ◽

Vessel Wall ◽

Spin Echo ◽

Turbo Spin Echo ◽

Aneurysmal Wall ◽

Turbo Spin ◽

Diagnostic Pitfall ◽

Imaging Sequence

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Superficial siderosis: Case report and literature review

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1304219k ◽

2013 ◽

Vol 141 (3-4) ◽

pp. 219-222

Author(s):

Nikola Kresojevic ◽

Igor Petrovic ◽

Natasa DragasevicMiskovic ◽

Vladimir Kostic

Keyword(s):

Spinal Cord ◽

Hearing Loss ◽

Mr Imaging ◽

Brain Mri ◽

Therapeutic Interventions ◽

Superficial Siderosis ◽

Mri Findings ◽

Hand Tremor ◽

Hemosiderin Deposition ◽

Clinical Triad

Introduction. Superficial siderosis (SS) is caused by chronic subarachnoid bleeding and is characterized by free iron and hemosiderin deposition along the pial and subpial structures of central nervous system. SS leads to progressive and irreversible CNS damage. The most common causes of chronic subarachnoidal bleeding are tumors, head and spinal cord trauma, arteriovenous malformations and aneurysms. SS is characterized by clinical triad: sensorineural hearing loss, cerebellar ataxia and piramydal signs. Brain MR imaging is the investigation of choice for the diagnosis of SS. Typical findings include hypointensities seen on T2?weighted MR imaging around the brain, cerebellum, brain stem, spinal cord, VIII cranial nerve and atrophy of cerebellum and medulla. Case Outline. A 71-year?old female patient noticed hand tremor in the middle of the third decade of life, and later slowly progressive bilateral hearing loss. At the age of 64 she developed un? steady gate, hand clumsiness and dysarthria, to became incapable of independent walking and standing five years later. Clinical course and brain MRI findings were typical for SS, but additional investigation did not reveal the couse of subarahnoidal bleeding. Conclusion. SS represents a rare and under?recognized condition that must be considered in all patients with cerebellar syndrome of unknown cause. Early diagnosis of SS in some cases with identified cause of chronic bleeding allowes therapeutic interventions that may prevent further progression of the disease.

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The Influence of Profession on Functional Ankle Stability in Musicians

Medical Problems of Performing Artists ◽

10.21091/mppa.2010.1005 ◽

2010 ◽

Vol 25 (1) ◽

pp. 22-28 ◽

Cited By ~ 4

Author(s):

Susanne Rein ◽

Tobias Fabian ◽

Hans Zwipp ◽

Jan Heineck ◽

Stephan Weindel

Keyword(s):

Reaction Time ◽

Ankle Joint ◽

Postural Balance ◽

Balance Control ◽

Ankle Sprains ◽

Exact Test ◽

Work Related ◽

Ankle Stability ◽

Ankle Joints ◽

The Right

OBJECTIVE: The aim of this study was to examine the influence of extensive work-related use of the feet on functional ankle stability among musicians. METHODS: Thirty professional organists were compared to professional pianists and controls. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time, and positional sense tests of the ankle were measured. The postural balance control was investigated with the Biodex Stability System for the stable level 8 and unstable level 2. Statistical analysis was done with the Kruskal-Wallis test, Mann-Whitney test with Bonferroni-Holm correction, and Fisher’s exact test. RESULTS: Nine of 30 organists compared to 5 of 30 pianists and controls reported ankle sprains in their medical history. Pianists had a significant increased flexion of both ankle joints compared to organists (p≤0.01) and increased flexion of the right ankle joint compared to controls (p=0.02). The positional sense test and postural balance control showed no significant differences among groups. The peroneal reaction time of the right peroneus longus muscle was significantly increased in pianists compared to controls (p=0.008). CONCLUSIONS: Organists have shown a high incidence of ankle sprains. Despite their extensive work-related use of the ankle joints, organists have neither increased functional ankle stability nor increased ROM of their ankle joints in comparison to controls. Pianists have increased flexion of the ankle joint, perhaps due to the exclusive motion of extension and flexion while using the pedals. To minimize injuries of the ankle and improve functional ankle stability as well as balance control, proprioceptive exercises of the ankle in daily training programs are recommended.

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Efficacy assessment of radiosynoviorthesis on the progression of radiological osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis

Nuklearmedizin ◽

10.1055/a-1108-1187 ◽

2020 ◽

Vol 59 (03) ◽

pp. 269-275

Author(s):

Imre Szerb ◽

Tamás Gál ◽

Dániel Kiss ◽

Viktória Nagy ◽

László Hangody

Keyword(s):

Rheumatoid Arthritis ◽

Ankle Joint ◽

Term Effect ◽

Control Group ◽

Hip Joints ◽

Study Objective ◽

Long Term Effect ◽

Structural Progression ◽

Ankle Joints

Abstract Objective The study objective was to evaluate the long-term effect of radiosynoviorthesis (RSO) on the progression of radiological and nuclear-medical osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis. Patients and Methods The study included 89 hip joints of 81 patients, of which 48 had osteoarthritis (OA) and 33 had rheumatoid arthritis (RA). In terms of ankle joints, 64 patients were included of which 43 suffered from OA and 21 from RA. The mean follow-up time was 9.2 years for OA and 8.9 years for RA patients. Patients with RA were the active control group. Structural alterations of the hip joints were evaluated following Kellgren-Lawrence score and of ankle joint following Takakura score for both disease entities. For the evaluation of synovitis 2-phase bone scintigraphy was performed. Results RSO could prevent radiologic status deterioration among 70.6 % of hip osteoarthritic patients and 73.7 % among the hip RA patients. No structural progression was observed in 79.1 % of the treated ankle joints in patients with OA and in 85.7 % of the ankle joints in patients with RA.The scintigraphic response rate for the hip joints of OA patients was 68.6 %, 76.3 % for hip joints of RA patients, 83.1 %, ankle joints of OA patients, and 90.4 % ankle joints of RA patients.The radiographic and scintigraphic RSO response rates were not significantly higher for both joints in RA than OA patients. Conclusion RSO can be a good alternative in the treatment of synovitis and prevention of deterioration of inflammatory and radiographic features even in patients suffering from osteoarthritis and rheumatoid arthritis. RSO may have also a long-term effect to stop or delay progression of both diseases.

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Highly Resolved MR Imaging of Arbitrary Subregions in Large Objects by a Whole-Body Imager

Zeitschrift für Naturforschung A ◽

10.1515/zna-1993-0703 ◽

1993 ◽

Vol 48 (7) ◽

pp. 753-758

Author(s):

Karin Pfeffer ◽

Markus Pfeffer ◽

Wulf-Ingo Jung ◽

Otto Lutz ◽

Fritz Schick

Keyword(s):

High Resolution ◽

Mr Imaging ◽

Spin Echo ◽

Regions Of Interest ◽

Whole Body ◽

Biological Objects ◽

Imaging Sequence ◽

Phantom Measurements

Abstract Highly resolved images of defined regions of interest within extended objects were obtaind with a 1.5 T whole-bode imager and standard hardware. The high-resolution spin echo imaging sequence avoids aliasing and allows pixel resolutions down to 39 µm which are confirmed by phantom measurements. The application of the sequence to large biological objects such as, for example, an amaryllis bulb results in images which provide much detail which could not be resolved with standard sequences.

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Role of MRI in the Diagnosis of Injury to the Lisfranc Ligament Complex

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00297 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0029

Author(s):

Christopher Kreulen ◽

Eric Giza ◽

Eva Escobedo ◽

Cyrus Bateni ◽

Michael Doherty

Keyword(s):

Magnetic Resonance ◽

Mr Imaging ◽

Negative Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Lisfranc Injury ◽

Radiology Reports ◽

Lisfranc Ligament ◽

Sensitivity Specificity

Category: Sports Introduction/Purpose: Subtle Lisfranc ligamentous injuries are difficult to diagnose and magnetic resonance is becoming a useful tool. The purpose of this study is to evaluate the efficacy of magnetic resonance (MR) imaging for the diagnosis of injuries of the Lisfranc ligament complex. Methods: The radiology database was searched between Jan 1, 2010 and Mar 10, 2015 to identify patients over the age of 18 years who had MR imaging of the foot for suspected injury of the Lisfranc ligament complex. MR images were reviewed by 2 fellowship trained musculoskeletal radiologists, whom were blinded to the original radiology reports. Findings were categorized as: no injury or injury present. Injury was deemed to be present if 2 of the 3 components of C1-M2 ligament showed disruption or signal alterations on T1 and T2 weighted images. Disagreements were resolved by consensus. Correlation was made with surgical findings whenever performed. In patients not undergoing surgery, the presence or absence of injury was determined by clinical examination performed by an orthopedic surgeon and follow-up. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) of MR for diagnosis of Lisfranc ligament complex injury was determined. Results: Of 60 patients, 9 were excluded due to a lack of follow-up. Lisfranc injury was determined to be present on MR in 26 patients and 18 underwent surgery. Injury was confirmed in 16, and 2 were intact. 2 patients underwent closed reduction and were clinically determined to be injured. 6 of the injured 26 patients were sprained and not injured/torn on clinical evaluation. Of the 25 patients determined to have no injury on MR, 24 were intact clinically. 1 patient had a Lisfranc injury on follow-up. Sensitivity, specificity, PPV and NPV of MR for detection of significant Lisfranc injury were 94.7% (CI: 73.9% to 99.9%), 75% (CI: 56.6% to 88.5%), 69.2% (CI: 55% to 80.5%) and 96% (CI: 77.9% to 99.4%) respectively. Conclusion: MR has a high sensitivity and negative predictive value for diagnosis of injury to the Lisfranc ligament complex. MR of the foot should be considered in patients with clinical suspicion of injury to the Lisfranc ligament complex, and it is highly accurate in excluding such injuries.

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Intracranial Gliomas: Association between MRI Features and Tumor Grade

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v8i2.42351 ◽

2019 ◽

Vol 8 (2) ◽

pp. 93-99

Author(s):

Md Rokibul Islam ◽

KM Tarikul Islam ◽

Moshiur Rahman ◽

Mohammad Hossain ◽

Raziul Haque ◽

...

Keyword(s):

Mr Imaging ◽

Contrast Enhancement ◽

Predictive Value ◽

Tumor Grade ◽

Mass Effect ◽

Low Grade ◽

Imaging Features ◽

Peritumoral Edema ◽

Cross Sectional ◽

Mri Features

Purpose: Intracranial gliomas are not uncommon in our country. The therapeutic management and prognosis in patients with gliomas depend on the reliable distinction between high and low-grade gliomas. The purpose of the present study was to determine whether any association exists between various individual MR imaging features and histopathologically determined tumor grade of intracranial gliomas. Our target was to explore whether MRI could enable correct determination the grading of gliomas which will help early diagnosis, staging, grade assessing, determining the appropriate treatment, preoperative planning for surgical resection and post operative management plan. Materials and Methods: It was a cross sectional type of observational study. This study was conducted on 44 cases of intracranial gliomas. Only patients having histopathologically proven intracranial gliomas who underwent surgery or stereotactic biopsy were considered as a study population. Results: The present study revealed that there is significant association between the MR imaging features and histopathological grading of intracranial gliomas. Contrast enhancement in MRI showed most significant (p<0.001). Other significant MR imaging features were peritumoral edema (p=0.001), tumor border definition (p=0.001), necrosis or cystic change of tumor (p=0.001) and mass effect (p=0.003). In this study preoperative MRI diagnosis was correct in 39 patients with accuracy of 88.6%. Sensitivity, specificity, positive predictive value and negative predictive value of MRI in detecting tumor grade were 86.4%, 90.9%, 90.5% and 87% respectively. Conclusion: MRI is sensitive, specific and accurate in assessing the grade of gliomas. Contrast enhancement is the most important predictor. Peritumoral edema, tumor border definition, mass effect and necrosis/cystic changes of tumor are also important indicators of tumor grade. Bang. J Neurosurgery 2019; 8(2): 93-99

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