scholarly journals Detection of pancreatic fibrosis using magnetic resonance imaging: correlation with histopathology

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Carsyn Kranz ◽  
Omer Saeed ◽  
Vitalis Osuji ◽  
Evan Fogel ◽  
Nicholas Zyromski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Interobserver Agreement ◽  
Weighted Kappa ◽  
Pancreatic Fibrosis ◽  
Imaging Biomarkers ◽  
Fibrosis Score ◽  
Resonance Imaging ◽  
Post Contrast

Background and Hypothesis: Diagnosis of chronic pancreatitis (CP) is challenging and controversial. Magnetic Resonance Imaging (MRI) offers a noninvasive modality to diagnose CP, but its findings have been rarely correlated with histopathology. We aimed to assess the correlation of T1 signal intensity ratio of pancreas to spleen (T1 SIRp/s) and arterio-venous ratio (AVR) of the parenchyma on MRI and Cambridge score on MRCP with surgical histopathology in patients who underwent pancreatic resection.  Methods: We identified 160 pancreatic resections performed in adults between 2017 and 2019 by searching our institution’s surgery database. Seventy-one of them had surgical pathology specimens available and 59 of them had MRI/MRCP within 3 months prior to the surgery. Histologic grading was performed by a gastrointestinal pathologist using Ammann’s fibrosis score. Two image analysts blinded to the clinical information and fibrosis score measured T1 SIRp/s from unenhanced T1-weighted fat-saturated gradient-echo images and arterio-venous ratio (AVR) from post-contrast dynamic phase. Cambridge score was also recorded from MRCP. Statistical analysis included Pearson’s correlation coefficient of the T1 SIRp/s, AVR, and Cambridge score with the fibrosis score and weighted kappa for interobserver agreement.  Results: Correlations between T1 SIRp/s and AVR with the fibrosis score were (r= -0.30, p=0.02, 95%CI: -0.51 to -0.04 and r= -0.36, p=0.01, 95%CI: -0.58 to -0.09, respectively). In comparison, there is less correlation between the Cambridge grade and the fibrosis (r= 0.17, p=0.15, 95% CI for r= -0.07 to 0.39). Interobserver agreement was good (kappa=0.80).  Conclusion: There is moderate correlation between the T1 signal intensity and enhancement ratio of the pancreas with pancreatic fibrosis. This is higher than the correlation between the Cambridge grade and fibrosis. Multi-institutional, prospective studies are needed to verify T1 SIR and AVR as potential imaging biomarkers of pancreatic fibrosis. 

Contrast magnetic resonance imaging for measurement of cartilage glycosaminoglycan content in dogs: A pilot study

2013 ◽  
Vol 26 (02) ◽  
pp. 100-104 ◽  
Author(s):  
M. C. Stewart ◽  
L. Ciobanu ◽  
P. D. Constable ◽  
J. F. Naughton
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Coefficient Of Variation ◽  
Signal Intensity ◽  
Linear Regression Analysis ◽  
Resonance Imaging ◽  
Post Contrast ◽  
Enhanced Mri ◽  
Over Time

SummaryObjective: To assess the ability of a contrast-enhanced magnetic resonance imaging (MRI) technique to quantitatively determine glycosaminoglycan content in canine articular cartilage.Methods: Fifty-four full-thickness cartilage discs were collected from the femorotibial and scapulohumeral joints of three adult dogs immediately following euthanasia. One set of discs from each dog was analysed for glycosaminoglycan content using a colourimetric laboratory assay. The remaining position-matched set of discs from contralateral limbs underwent pre- and post-contrast gadolinium-enhanced MRI, using repeated saturation recovery pulse sequences which were used to generate calculated T1 maps of the cartilage discs. Linear regression analysis was then performed relating delayed gadolinium-enhanced MRI T1 calculated signal intensity to the cartilage glycosaminoglycan content normalized to DNA content. Repeatability of triplicate measurements was estimated by calculating the coefficient of variation.Results: Mean coefficient of variation estimates for the gadolinium-enhanced MRI T1 signal intensity values for nine sampling sites from three dogs ranged from 5.9% to 7.5%. Gadolinium-enhanced MRI T1 signal intensity was significantly correlated (p <0.05) with normalized glycosaminoglycan content in two dogs (r = 0.79, p = 0.011; r = 0.78, p = 0.048), but not in the third dog (r = 0.53, p = 0.071).Clinical significance: Gadolinium-enhanced MRI assessment of cartilage may be predictive of glycosaminoglycan content and therefore offer an in vivo assessment of changes in cartilage characteristics over time. Additional studies appear indicated to determine the reliability and clinical applicability of gadolinium-enhanced MRI in detecting changes in cartilage over time.

scholarly journals Correlative Magnetic Resonance Imaging and Histopathology in Small Ruminant Listeria Rhombencephalitis

2020 ◽  
Vol 11 ◽  
Author(s):  
Christina Precht ◽  
Peter Vermathen ◽  
Diana Henke ◽  
Anne Staudacher ◽  
Josiane Lauper ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Signal Intensity ◽  
Small Ruminants ◽  
Large Animal ◽  
Resonance Imaging ◽  
Post Contrast ◽  
Mri Features ◽  
Inflammatory Infiltrates

Background: Listeria rhombencephalitis, infection of the brainstem with Listeria monocytogenes, occurs mainly in humans and farmed ruminants and is associated with high fatality rates. Small ruminants (goats and sheep) are a large animal model due to neuropathological similarities. The purpose of this study was to define magnetic resonance imaging (MRI) features of listeria rhombencephalitis in naturally infected small ruminants and correlate them with histopathology. Secondly, the purpose of this study was to compare the results with MRI findings reported in humans.Methods: Twenty small ruminants (13 sheep and 7 goats) with listeria rhombencephalitis were prospectively enrolled and underwent in vivo MRI of the brain, including T2-weighted, fluid attenuation inversion recovery, and T1-weighted sequences pre- and post-contrast administration and postmortem histopathology. In MRI, lesions were characterized by location, extent, border definition, signal intensity, and contrast enhancement. In histopathology, the location, cell type, severity, and chronicity of inflammatory infiltrates and signs of vascular damage were recorded. In addition, histopathologic slides were matched to MRIs, and histopathologic and MRI features were compared.Results: Asymmetric T2-hyperintense lesions in the brainstem were observed in all animals and corresponded to the location and pattern of inflammatory infiltrates in histopathology. Contrast enhancement in the brainstem was observed in 10 animals and was associated with vessel wall damage and perivascular fibrin accumulation in 8 of 10 animals. MRI underestimated the extension into rostral brain parts and the involvement of trigeminal ganglia and meninges.Conclusion: Asymmetric T2-hyperintense lesions in the brainstem with or without contrast enhancement can be established as criteria for the diagnosis of listeria rhombencephalitis in small ruminants. Brainstem lesions were similar to human listeria rhombencephalitis in terms of signal intensity and location. Different from humans, contrast enhancement was a rare finding, and abscessation was not observed.

Influence of preoperative statins and aspirin administration on biological and magnetic resonance imaging properties in patients with abdominal aortic aneurysm

VASA ◽  
2020 ◽  
pp. 1-9
Author(s):  
Milos Sladojevic ◽  
Petar Zlatanovic ◽  
Zeljka Stanojevic ◽  
Igor Koncar ◽  
Sasenka Vidicevic ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Abdominal Aortic Aneurysm ◽  
Magnetic Resonance ◽  
Aortic Aneurysm ◽  
Signal Intensity ◽  
Psoas Muscle ◽  
Resonance Imaging ◽  
Maximal Diameter ◽  
Aneurysm Wall ◽  
Abdominal Aortic

Summary: Background: Main objective of this study was to evaluate the influence of statins and/or acetylsalicylic acid on biochemical characteristics of abdominal aortic aneurysm (AAA) wall and intraluminal thrombus (ILT). Patients and methods: Fifty patients with asymptomatic infrarenal AAA were analyzed using magnetic resonance imaging on T1w sequence. Relative ILT signal intensity (SI) was determined as a ratio between ILT and psoas muscle SI. Samples containing the full ILT thickness and aneurysm wall were harvested from the anterior surface at the level of the maximal diameter. The concentration of enzymes such as matrix metalloproteinase (MMP) 9, MMP2 and neutrophil elastase (NE/ELA) were analyzed in ILT and AAA wall; while collagen type III, elastin and proteoglycan 4 were analyzed in harvested AAA wall. Oxidative stress in the AAA wall was assessed by catalase and malondialdehyde activity in tissue samples. Results: Relative ILT signal intensity (1.09 ± 0.41 vs 0.89 ± 0.21, p = 0.013) were higher in non-statin than in statin group. Patients who were taking aspirin had lower relative ILT area (0.89 ± 0.19 vs 1.13. ± 0.44, p = 0.016), and lower relative ILT signal intensity (0.85 [0.73–1.07] vs 1.01 [0.84–1.19], p = 0.021) compared to non-aspirin group. There were higher concentrations of elastin in AAA wall among patients taking both of aspirin and statins (1.21 [0.77–3.02] vs 0.78 (0.49–1.05) ng/ml, p = 0.044) than in patients who did not take both of these drugs. Conclusions: Relative ILT SI was lower in patients taking statin and aspirin. Combination of antiplatelet therapy and statins was associated with higher elastin concentrations in AAA wall.

scholarly journals Perspectives on the Role of Magnetic Resonance Imaging (MRI) for Noninvasive Evaluation of Diabetic Kidney Disease

2021 ◽  
Vol 10 (11) ◽  
pp. 2461
Author(s):  
José María Mora-Gutiérrez ◽  
María A. Fernández-Seara ◽  
Rebeca Echeverria-Chasco ◽  
Nuria Garcia-Fernandez
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Imaging Biomarkers ◽  
Major Advance ◽  
Resonance Imaging ◽  
Diabetic Kidney ◽  
Magnetic Resonance Imaging Mri

Renal magnetic resonance imaging (MRI) techniques are currently in vogue, as they provide in vivo information on renal volume, function, metabolism, perfusion, oxygenation, and microstructural alterations, without the need for exogenous contrast media. New imaging biomarkers can be identified using these tools, which represent a major advance in the understanding and study of the different pathologies affecting the kidney. Diabetic kidney disease (DKD) is one of the most important diseases worldwide due to its high prevalence and impact on public health. However, its multifactorial etiology poses a challenge for both basic and clinical research. Therefore, the use of novel renal MRI techniques is an attractive step forward in the comprehension of DKD, both in its pathogenesis and in its detection and surveillance in the clinical practice. This review article outlines the most promising MRI techniques in the study of DKD, with the purpose of stimulating their clinical translation as possible tools for the diagnosis, follow-up, and monitoring of the clinical impacts of new DKD treatments.

scholarly journals POS1349 THE JOINT INVOLVEMENT IN ADULT ONSET STILL’S DISEASE IS CHARACTERISED BY A PECULIAR MAGNETIC RESONANCE IMAGING AND A SPECIFIC TRANSCRIPTOMIC PROFILE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 957.1-957
Author(s):  
P. Ruscitti ◽  
A. Barile ◽  
O. Berardicurti ◽  
S. Iafrate ◽  
P. DI Benedetto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Clinical Characteristics ◽  
Joint Involvement ◽  
Resonance Imaging ◽  
Bone Erosions ◽  
Transcriptomic Profile ◽  
Synovial Tissues ◽  
Bone Oedema

Background:Adult onset Still’s disease (AOSD) is a rare systemic autoinflammatory disease and joint involvement is one of its clinical manifestations [1]. Arthritis, either oligoarthritis or bilateral symmetrical rheumatoid arthritis-like polyarthritis, is another common clinical feature of AOSD, with a migrating pattern at the beginning and becoming stable over the time [1].Objectives:The aims of the study were to assess joint involvement in AOSD by using magnetic resonance imaging (MRI), to describe main patterns of involvement, and associated clinical characteristics, and to evaluate the global transcriptomic profile of synovial tissues in AOSD to elucidate possible pathogenic pathways involved with.Methods:AOSD patients, who underwent to magnetic resonance imaging (MRI) exam on joints, were assessed to describe patterns of joint involvement and associated clinical characteristics. Some synovial tissues were collected for RNA-sequencing purposes.Results:In this study, 31 patients with AOSD (mean age 42.3 ± 15.2 years, 54.8% male gender), who underwent to at least one MRI exam on joints, were assessed. The most common MRI finding was the presence of synovitis on 60.5%, mainly in peripheral affected joints. MRI revealed a mild to moderate proliferative synovitis, as thickening of the synovial membrane, with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-fat saturated weighted and STIR images, suggesting the presence of a hyperplastic than of a hypertrophied synovial tissue. Bone oedema and bone erosions were reported on 34.9% and 25.6% MRI exams, respectively. In all patients but one, bone erosions were synchronous with bone oedema, overlapping completely the locations. Assessing clinical characteristics in patients with MRI-erosions, a higher prevalence of splenomegaly, a more frequent chronic disease course, lower levels of erythrocyte sedimentation rate and ferritin was observed.Assessing the synovial tissues of some AOSD patients, a moderate perivascular mononuclear infiltrate in the sub-lining stroma of hip synovial tissues was observed, whereas the lining cells were relatively unremarkable. In addition, interleukin (IL)-1β, IL-6, TNF, and heavy ferritin subunit (FeH) were found on AOSD synovial tissues.An RNA-sequencing analysis assessed the global transcriptomic profile of synovial tissues on AOSD patients and matched-controls. Assessing IL-1 pathway, we found an increased expression of il1a, il1b, il1rap, il1r1, il18r1, and Il18bp on AOSD tissues when compared with controls. In IL-6 pathway, we found an increased expression of il6 and il6st/gp130 on AOSD synovial tissues whereas an increased expression of il6r was shown on the controls. Among genes involved in TNF pathway, tnf, traf1, traf2, tnfaip3 and tnfrsf1a resulted to be more expressed in AOSD synovial tissues than in controls. Finally, fth1 and ftl were more expressed in AOSD patients than controls, when we explored the iron uptake and transport pathway.Conclusion:A peculiar MRI pattern of joint involvement in AOSD was reported; the most common finding was the presence of synovitis, characterised by intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. Bone erosions and bone oedema were also observed. This MRI pattern was associated with a hyper-activation of IL-1, IL-6, and TNF pathways together with a hyper-expression of ferritin genes on AOSD synovial tissues.References:[1]Giacomelli R, Ruscitti P, Shoenfeld Y. A comprehensive review on adult onset Still’s disease. J Autoimmun. 2018;93:24-36.Disclosure of Interests:None declared

scholarly journals POS0294 PROFILE OF SPINAL TUMORS IN RHEUMATOLOGY DEPARTMENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 372.2-372
Author(s):  
B. A. Hiba ◽  
H. Sahli ◽  
S. Boussaid ◽  
S. Nouicer ◽  
S. Jemmali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Spinal Tumor ◽  
Sensory Function ◽  
Spinal Tumors ◽  
Vertebral Compression Fractures ◽  
Myxopapillary Ependymoma ◽  
Resonance Imaging ◽  
Weighted Sequences

Background:Spine tumors remain a hot topic because of their associated morbidity by affecting motor and sensory function. Contrary to metastatic spine disease (MSD), extremely prevalent, rise within or surrounding the spinal cord and/or vertebral column, primary spinal tumors are rare, 5% of all primary skeletal tumors and frequently benign (20%). The diagnostic delay of these tumors, even when benign, is associated with a poor prognosis. Establishing the correct diagnosis is heavily reliant on magnetic resonance imaging and histological confirmation.Objectives:to provide an overview of the epidemiology, radiological and histopathological of spinal tumors diagnosed in a rheumatology department.Methods:A retrospective study consisting of clinical characteristics analysis, laboratory and x-ray examinations, was performed on 40 patients who were hospitalised for a spinal tumor, in a rheumatology department, over 5-year period from 2015 to 2020.Results:A total of 40 patients with a mean age of 66 ± 13.5 years [18-93] and a sex-ratio of 1.1, were included. The most common initial complaints were inflammatory back pain (67.5%) and fatigue (52.5%), with a median duration of 5 months. Physical examination abnormalities included lumbar stiffness (32.5%), radicular signs (18.7%), hepatomegaly (12.5%), and lymphadenopathy (17.5%). Neurological deficit was found in only 3 patients (7.5%). Hypercalcemia (corrected serum calcium > 105 mg/l), and anemia (hemoglobin (Hb) < 100 g/l in female, Hb <110g/l in male) were present initially in respectively 47.5% and 46.3% patients, while biological inflammatory syndrome was present in 89.7% patients (median C-reactive protein of 44.7). Tumor markers were performed in 12 patients and they were positive in 9 of them.Plain radiographs findings were vertebral compression fractures (43.6%), osteolytic lesions (30.8%) and osteoblastic lesions (12.5%). Lumbar spine was the most affected (57.5%), followed by the dorsal spine (45%). Magnetic resonance imaging (MRI) was performed in 55%, and the most common lesion was low signal intensity on T1-weighted sequences and high signal intensity on T2-weighted sequences (68.1%).In our study, only one patient was diagnosed for a myxopapillary ependymoma, a benign primary spinal tumor characterised by a metastatic dissemination risk. For the rest (39 patients), the diagnosis of bone metastasis, multiple myeloma (57.7%), and of solid tumor cancers (40%), were established. Primary cancers were mainly prostate cancer (37.5%), lung cancer (18.7%) and kidney cancer (18.7%). By a median follow-up time of 25 months, overall survival rate was 30%.Conclusion:Extradural lesions are the most common, and are typically metastatic. Special attention should be pain to the patient’s medical history and laboratory abnormalities. In fact, an early diagnosis requires a high index of clinical suspicion.Disclosure of Interests:None declared

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