scholarly journals Ultrasound and magnetic resonance imaging evaluation of the femoral and sciatic nerves. A study of healthy volunteers

Author(s):  
Georgeta Mihaela Rusu ◽  
Andra Diana Curcean ◽  
Sorin Marian Dudea

Background and aims. The study describes the femoral (FN) and sciatic nerves (SN), explored using ultrasound (US) and magnetic resonance imaging (MRI). The aims of the study are: to establish US / MRI correlations and define reference values: for the anteroposterior (AP) and mediolateral (ML) diameters and cross-sectional area (CSA) of the two nerves respectively, in well-defined anatomical measuring sites; to analyze the intraobserver variation; to define the value with least variability; to determine differences between the right-left and male-female reference values. Methods. A prospective study was carried out on 24 healthy volunteers (11 men and 13 women). MRI scans were performed using a 1.5T system. To visualize both nerves (FN and SN), a single 3D T2 weighted acquisition was performed, in the coronal plane, with a wide FOV. For ultrasonographic examinations, a Hitachi EUB-8500 ultrasound machine, equipped with a 13 MHz linear transducer was used. The measurements were performed at well-defined anatomical locations. The mean reference values of the AP, ML diameters and CSA were calculated for femoral and sciatic nerves, both on MRI and US. The correlations between the values determined by the two techniques were analyzed. The intra-observer variation was calculated by measuring the nerves at the same anatomical location at two separate time points. Results. Wilcoxon matched-pairs signed rank test indicated a non-significant difference (p> 0.05) for the femoral and sciatic nerves, on both sides, except the femoral nerve ML diameter on MRI (p= 0.014). The mean MRI and US reference values for the femoral nerve were calculated between the psoas and iliac muscles: FNAPMRI 4.533 ± 0.486, FNAPUS 4.800 ± 1.237, FNMLMRI 6.172 ± 1.203, FNMLUS 7.685 ± 3.338, FNCSAMRI 24.811 ± 3.394, FNCSAUS 26.285 ± 17.608. The mean MRI and US measurements for the sciatic nerve were determined under the buttock, at the level of the ischial tuberosity: SNAPMRI 5.500 ± 1.201, SNAPUS 5.975 ± 1.312, SNMLMRI 10.375 ± 2.272, SNMLUS 13.500 ± 1.661, SNCSAMRI 50.625 ± 15.373, SNCSAUS 53.631 ± 15.847. The MRI and US differences between right and left sides, both for the femoral and sciatic nerves were insignificant. In selected cases, Wilcoxon paired test indicated differences between subjects, according to their gender, both on MRI and US. Conclusion. Reference values for the femoral and sciatic nerves at specific anatomical sites were identified. Side to side variation and gender related differences add to current knowledge on nerve size in young Caucasian population.

2019 ◽  
Vol 99 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Abdul-Latif Hamdan ◽  
Elie Khalifee ◽  
Georges Ziade ◽  
Sahar Semaan

The objective of this study is to investigate the dimensional and volumetric measurements in the thyroarytenoid (TA) muscle in men and women using magnetic resonance imaging (MRI). The hypothesis is that there is a gender-related difference in these measurements. A retrospective chart review of 76 patients who underwent MRI of the neck at the American University of Beirut Medical Center was conducted. The dimension and volume of the right and left TA muscle were measured on axial and coronal planes short tau inversion recovery images. Male and female groups were compared with respect to demographic data and MRI findings using parametric and nonparametric tests. The mean length of the thyro-arytenoid muscle in males was larger than that in females on the right (males 2.44 [0.29] cm vs females 1.70 [0.22] cm) and on the left (males 2.50 [0.28] cm vs females 1.72 [0.24] cm) reaching statistical significance ( P < .001). The mean width of the thyro-arytenoid muscle in males was larger than that in females on the right (males 0.68 [0.13] cm vs females 0.59 [0.11] cm) and on the left (males 0.68 [0.12] cm vs females 0.57 [0.12] cm) reaching statistical significance ( P < .001). The mean height of the thyro-arytenoid muscle in males was larger than that in females on the right (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) and on the left (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) reaching statistical significance ( P < .01 on the right and P < .05 on the left). The volume of the thyroarytenoid muscle in males was larger than that in females on the right (males 0.86 [0.25] mL vs females 0.48 [0.15] mL) and on the left (males 0.89 [0.27] mL vs females 0.48 [0.17] mL) reaching statistical significance ( P < .001). The results of this investigation clearly indicate a significant difference in these measurements between men and women.


2020 ◽  
Vol 41 (11) ◽  
pp. 1368-1375
Author(s):  
Yalkin Camurcu ◽  
Hanifi Ucpunar ◽  
Furkan Yapici ◽  
Resit Karakose ◽  
Seckin Ozcan ◽  
...  

Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 ( P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups ( P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.


2012 ◽  
Vol 63 (3) ◽  
pp. 170-176 ◽  
Author(s):  
Steven Co ◽  
Sonny Bhalla ◽  
Kevin Rowan ◽  
Sven Aippersbach ◽  
Simon Bicknell

Purpose The purpose of this study was to evaluate whether 3-dimensional (3D) volumetric acquisition of shoulder ultrasound (US) data for supraspinatus rotator cuff tears is as sensitive when compared with conventional 2-dimensional (2D) US and routine magnetic resonance imaging (MRI), and whether there is improved workroom time efficiency when using the 3D technique compared with the 2D technique. Methods In this prospective study, 39 shoulders underwent US and MRI examination of their rotator cuff to confirm the accuracy of both the 2D and 3D techniques. The difference in sensitivities was compared by using confidence interval analysis. The mean times required to obtain the 2D and 3D US data and to review the scans were compared by using a 1-tailed Wilcoxon test. Results Sensitivity and specificity of 2D US in detecting supraspinatus full- and partial-thickness tears was 100% and 96%, and 80% and 100%, respectively, and similar values were obtained with 3D US at 100% and 100%, and 90% and 96.6%, respectively. Analysis of the confidence limits of the sensitivities showed no significant difference. The mean time (± SD) of the overall 2D examination of the shoulder, including interpretation was 10.02 ± 3.28 minutes, whereas, for the 3D examination, it was 7.08 ± 0.35 minutes. Comparison between the 2 cohorts when using a 1-tailed Wilcoxon test showed a statistically significant difference ( P < .05). Conclusion 3D US of the shoulder is as accurate as 2D US when compared with MRI for the diagnosis of full- and partial-thickness supraspinatus rotator cuff tears, and 3D US examination significantly reduced the time between the initial scan and the radiologist interpretation, ultimately improving workplace efficiency.


2020 ◽  
Vol 13 (1) ◽  
pp. 45-50
Author(s):  
Sushma Singh ◽  
Bhoj Raj Sharma ◽  
Urusha Prajapati ◽  
Pujan Sharma ◽  
Manoj Bhatta ◽  
...  

Background and Objective: Magnetic resonance imaging (MRI) provides image acquisition of three-dimensional data and measurement in any chosen imaging plane. Objective of this study is to assess the size of ventricles of the brain of normal Nepalese people and establish the range of size of the ventricular system and compute the ventricular dimensions among different age and gender. Materials and methods: This is a cross-sectional retrospective study done at Gandaki Medical College, Pokhara. A total of 106 MRI scan data of healthy individuals were collected over a period of seven months between March to September 2019. Patients ranged between eight and eighty years of age with 58 males and 48 females. Measurements of the mean of bifrontal diameter (BFD), bihemispheric diameter (BHD), third ventricle transverse dimension (TVTD), fourth ventricle antero-posterior dimension (FVAP), fourth ventricle width (FVW), and frontal horn ratio (FHR) were done. Result: The mean of BFD, BHD, TVTD, FVAP, FVW, and FHR were found to be 3.05 ± 0.10 cm, 10.11 ± 0.40 cm, 0.43 ± 0.11 cm, 0.90 ± 0.11 cm, 1.22 ± 0.12 cm, and 0.30 ± 0.01 cm, respectively. The mean width of fourth ventricle in males and females was observed to be 1.23 ± 0.12 cm and 1.19 ± 0.11 cm respectively. There was a significant correlation of TVTD, FVAP, FHR and BFD with age with Pearson correlation coefficient 0.393 (P value <0.01), 0.259 (P value <0.01), 0.34 (P value <0.01), and 0.219 (P value <0.05) respectively. However, BHD and FVW have no correlation with age. Conclusion: Third Ventricle Traverse Dimension, FVP, FVW and FHR show almost similar or slight difference in measurement according to gender. However, BFD shows larger difference in measurement according to gender. Similarly there is no such significant difference according to age in measurement of BFD, BHD, FVAP, FVW and FHR, while TVTD measurement shows slight increased measurement according to age.  


2021 ◽  
pp. 036354652110188
Author(s):  
Gonzalo Rojas ◽  
Simone Perelli ◽  
Maximiliano Ibanez ◽  
Mario Formagnana ◽  
Inmaculada Ormazabal ◽  
...  

Background: Lateral extra-articular tenodesis (LET) is one of the most widely used procedures to restore anterolateral stability. Clinical outcomes after the addition of LET to anterior cruciate ligament (ACL) reconstruction (ACLR) have been widely investigated; however, the potential influence of LET on the ACL ligamentization process has not been examined. Purpose/Hypothesis: The purpose was to use 10-month postoperative magnetic resonance imaging (MRI) scans to determine whether the maturity of grafts after hamstring autograft ACLR was affected by concomitant LET. The hypothesis was that when modified Lemaire lateral extra-articular tenodesis (MLLET) was performed, the MRI parameters of ACL graft maturity would be modified. Study Design: Cohort study; Level of evidence, 3. Methods: The study included patients treated between December 2017 and December 2018 who had undergone anatomic 3-strand hamstring tendon autograft ACLR, with or without concomitant MLLET, and had undergone MRI 10 months postoperatively. Thus, the study included 30 patients who had isolated ACLR and 22 patients who had ACLR plus MLLET. The 2 groups were comparable based on all criteria analyzed. To evaluate graft maturity, the signal-to-noise quotient (SNQ) was measured in 3 regions of interest of the proximal, midsubstance, and distal ACL graft. Lower SNQ ratios indicate less water content and, theoretically, better maturity and healing of the graft. Results: The mean ± SD for SNQ was 4.62 ± 4.29 (range, 3.12-6.19) in the isolated ACLR group and 7.59 ± 4.68 (range, 4.38-8.04) in the ACLR plus MLLET group ( P = .012). Upon comparing the mean values of the 3 portions between the 2 groups, we found a significant difference between the 2 groups for the proximal and middle portions ( P = .007 and P = .049, respectively) but no difference in the distal portion ( P = .369). Conclusion: At the 10-month follow-up, hamstring tendon autografts for anatomic ACLR with MLLET did not show the same MRI signal intensity compared with isolated hamstring anatomic ACLR.


2018 ◽  
Vol 15 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Om Biju Panta ◽  
Yagya Raj Pathak ◽  
Dan Bahadur Karki

Background: Magnetic Resonance Imaging is the imaging modality of choice for imaging spinal infection due to its high sensitivity and specificity. This study aims to study the magnetic resonance imaging changes in patients with spondylodiscitis.Methods: The study was a retrospective study carried in a multimodality imaging centre in Kathmandu. Magnetic resonance imaging records and clinical record of 3 years duration were reviewed and patients with clinical and radiological diagnosis of spondylodiscitis were included in the study. Three radiologists interpreted Magnetic Resonance Imaging with mutual consensus in disputed issues. Data analysis was done with Statistical Package for Social Sciences21.0.Results: A total of 52 patients were included in the study. The mean age of the patients was 43.9 ± 17.6 years. Spondylodiscitis involved lumbar spine in 26(50%) case, cervical and thoracic spine in 13(25%) cases each. Multiple IV discs were involved in 24(46.2%) cases, which was most common in cervical spine and least common in thoracic spine. Only one vertebral end plate was involved in 16(30.8%) cases. Epidural collection was seen in 23(44.2%) cases and paravertebral collection was noted in 63(33.5%) cases. Statistical significant difference in region of spine involved (p=0.02) and epidural collection (p=0.04) was noted between genders.Conclusions: Lumbar spine was the most common level involved with spondylodiscitis, perivertebral enhancing soft tissue was present in all cases, and involvement of disc and the endplates were the most common pattern.


2021 ◽  
Vol 8 (41) ◽  
pp. 3513-3518
Author(s):  
Sowmya D. ◽  
Anusha S. ◽  
Hari Babu Pidaparti P. ◽  
Jaya Chandra T. ◽  
Mytri Priyadarshini K.

BACKGROUND Prostate is an associated gland of the male reproductive system. Worldwide, among the men, prostate cancer (PC) is the second most common cancer. PC is the seventh commonest cancers among the Indian male. Studies reported that diffusion weighted imaging (DWI) and dynamic contrast enhanced imaging (DCE-MRI), can offer additional value in localizing cancer. A study was conducted to evaluate and correlate the role of DWI in detection and staging of PC and correlation with histopathology. METHODS A cross-sectional observational study was conducted in the Department of Radiodiagnosis, GSL Medical College, over a period of 18 months. Males with symptoms of nocturia, urinary urgency, frequency, hesitancy and bone pain were included in the study. Trans rectal ultrasound scan (TRUS) biopsy was collected, Gleason‘s score (GS) was considered for the histopathologic analysis. The evaluation of DWI as a tool for detection of PC was based on comparing the sensitivity and specificity of the results after taking histopathology as the gold standard test chi-square test was used to find the statistical significance and P < 0.05 was considered statistically significant. RESULTS Total, 36 (82 %) were diagnosed to be malignant, maximum number (18; 50 %) were between 61 – 70 years age group. Peripheral zone is the most common (61.2 %; 22) area for the PC followed by transitional (33.3 %) and central zone (5.5 %). In this study, 16.6 % members had GS ≤6; Apparent diffusion coefficient (ADC) was ranged between 0.81 to 0.87 and mean + SD were 0.85 + 0.02. Out of the 22.2 % members whose GS was 7, the mean + SD ADC were 0.74 ± 0.02. For 22 (61 %) members, GS was >8; the mean + SD ADC was 0.63 ± 0.08; statistically there was significant difference between the parameters. Magnetic resonance imaging (MRI) revealed that 61.3 % (27) cases as highly suspicious, 25 % (11) as probably malignant and 13.6 % (6) as indeterminate; the sensitivity for MRI was 94.5 % and specificity was 85.7 %. CONCLUSIONS Patients with increased prostate specific antigen (PSA), multi-parametric magnetic resonance imaging (MPMRI) is valuable, non-invasive and a better option to detect PC. Also helps in localizing the exact location. KEYWORDS Cancer, Tumour, Biopsy, Study


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lynn Stothers ◽  
Jennifer A. Locke ◽  
Marwa Abdulaziz ◽  
Darren Lazare ◽  
Alex Kavanagh ◽  
...  

Introduction: The role of imaging in pelvic organ prolapse (POP) assessment is unclear. Open magnetic resonance imaging (MRI) systems have a configuration that allows for imaging women with POP in different positions. Herein, we use a 0.5 Tesla open MRI to obtain supine, seated, and standing images. We then compare these images to evaluate the impact of posture on detection and staging of POP. Methods: Women presenting with symptoms of POP at a tertiary care university hospital were asked to participate in this prospective cohort study. Symptom scores, POP-Q staging and three-position MRI imaging of the pelvis data were collected. The pubococcygeal line (PCL) was used to quantify within-patient changes in pelvic organ position as defined by: no displacement, <1 cm inferior to the PCL, mild (1–3 cm), moderate (3.1–6 cm), and severe (>6 cm) in the axial and sagittal T2-weighted images. Statistical analysis was completed (T-test; p<0.05 significant). Results: A total of 42 women, age range 40–78 years, participated. There was a significant difference in the mean values associated with anterior prolapse in the supine (0.7±1.8), seated (2.4±3.4), and upright (4.2±1.6) positions (p=0.015). There was a significant difference in the mean values associated with apical prolapse in the supine (0.5±1.5), seated (1.5±1.4), and upright (2.1±1.5) positions (p=0.036). Conclusions: Our findings suggest that POP is more readily detected and upstaged with standing MRI images as compared to supine and seated positions. The developed two-minute standing MRI protocol may enable clinicians to better assess the extent of POP.


2021 ◽  
pp. 197140092199898
Author(s):  
Anousheh Sayah ◽  
April D Farley ◽  
Eric C Munoz ◽  
Faheem A Sandhu ◽  
Frank Berkowitz

Objective An abnormally decreased clivoaxial angle (CXA) is used during the clinical evaluation for corrective skull base surgery. Published normal ranges of CXA using x-ray, computed tomography, or magnetic resonance imaging (MRI) vary dramatically, especially with neck flexion or extension. The aim of this study was to use high-resolution MRI to determine the normal range of CXA in various neck positions using a reproducible measurement technique. Methods The CXA was measured in 10 healthy volunteers on sagittal T2 SPACE c-spine MRI in supine and prone positions and with the neck both neck and extended. CXA is strictly defined as the angle between a line along the inferior third of the dorsal clival cortex and a line from the superior/posterior cortex of the dens to the posterior/inferior corner of the C2 body. Statistical analysis was performed in all positions and included mean CXA, range, standard deviation ( SD), inter-reader agreement, and group comparisons. Results The mean CXA overall was 156.92° ( SD=4.23°; range 134–179°). The mean value for extension CXA was 169.20° ( SD=5.81°), and the mean value for flexion CXA was 144.73° ( SD=5.71°), the difference being statistically significant ( p<0.0001) regardless of supine or prone position. Concordant correlations of reader measurements showed substantial agreement in the supine position at 0.96, with lower agreement in the prone position at 0.87. Conclusions We report normal ranges for CXA in various neck positions based on 3D T2-weighted MRI, using a reproducible measurement method. There was a significant difference in the CXA values between neck extended and neck flexed positions but not between supine and prone positions.


Author(s):  
Sang-Yoon Lee ◽  
Young-Min Noh

Background: This study was performed to identify the incidence of screw in-type lateral anchor pull-out in patients older than 60 years who underwent rotator cuff repair for large to massive rotator cuff tears.Methods: This study reviewed 25 patients older than 60 years who were diagnosed with large to massive rotator cuff tear and underwent arthroscopic rotator cuff repair in our hospital from March 2017 to February 2021. Preoperative tear size (anterior to posterior, medial to lateral) was measured via preoperative magnetic resonance imaging (MRI), and the re-tear rate was evaluated at 3 months via MRI. All 25 patients underwent MRI scanning on postoperative day 1 and at 3 months after surgery. The change of lateral row anchor position was measured in axial views on MRI images. The change of anchor position was measured postoperative day 1 and 3 months after surgery by MRI and statistically compared according to bone mineral density (BMD), sex, and number of lateral anchors. Results: Two consecutive MRIs (postoperative day 1 and 3 months) in 25 patients were compared. Anchor pull-out occurred in six patients during 3 months (6.7%), and the mean pull-out length difference was 1.56 mm (range, 0.16–2.58). There was no significant difference in the number of pull-out anchors, degree of pull-out difference, or the re-tear rate by comparing BMD (A, BMD≤-2.5; B, BMD>-2.5), sex, or number of anchors used in each surgery (C, two anchors; D, three anchors) (p>0.05). Conclusions: Pull-out of screw in-type lateral anchors was observed in very few patients (6.7%), and the mean pull-out length difference was negligibly small (1.56 mm) in our study. The screw in-type lateral anchor seems to be a decent option without concern of anchor pull-out even in elderly patients (>60 yr).


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