scholarly journals Power of 3D Transrectal Ultrasonography and Magnetic Resonance Imaging in Diagnosis of Cryptogenic Rectal Fistulae

2020 ◽  
Vol 27 (6) ◽  
pp. 44-59
Author(s):  
D. O. Kiselev ◽  
I. V. Zarodnyuk ◽  
Yu. L. Trubacheva ◽  
R. R. Eligulashvili ◽  
A. V. Мatinyan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Error Rate ◽  
Fistulous Tract ◽  
External Sphincter ◽  
Transrectal Ultrasonography ◽  
Resonance Imaging ◽  
Internal Fistula ◽  
Significant Difference ◽  
Intraoperative Revision

Background. The only radical curative treatment for rectal fistulae is surgery. The choice of surgery requires precise characterisation of the fistulous tract. The most common instrumental methods for rectal fistula diagnosis are transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI).Objectives. Comparative assessment of the diagnostic power of 3D TRUS and MRI techniques in revealing cryptogenic anal fistulae with respect to intraoperative examination.Methods. The study enrolled 92 patients with rectal fistulae aged 27 to 66 years. Fistulous opening was external in 47 (51.1%) and obliterated in 45 (48.9%) patients. The average patient age was 42.7 ± 15.9 years. Surgery for acute paraproctitis 14 to 32 days prior to examination was in history of 58 (63.1%) patients. All patients had preoperative subsequent 3D TRUS and MRI compared with intraoperative examination results.Results. The rate of correct fistulous tract type diagnosis verified with intraoperative revision was 96.7% (89/92) with 3D TRUS and 82.6% (76/92) with MRI (p = 0.0027). The error rate of 3D TRUS estimation of external sphincter involvement was 1.1% (1/92), sensitivity 96.6%, specificity 93.5%, overall accuracy 94.5%. The MRI error rate was 21.7% (20/92), with a statistically significant difference for sensitivity and overall accuracy (p < 0.0001). The rate of correct estimation of internal fistulous localisation in “anorectal clock” was 97.8% (90/92) with 3D TRUS and 90% (81/90) with MRI (p = 0.0342). Internal fistula was not detected with MRI in 2/92 (2.2%) cases, which explains the deviation. Intraoperative revision identified total 113 abscesses. The rate or correct abscess estimation was 97.3% (110/113) with 3D TRUS and 74.7% (71/95) with MRI. MRI failed to detect abscess in 18/113 (15.9%) cases (p < 0.0001).Conclusion. 3D transrectal ultrasonography is statistically superior over magnetic resonance imaging in estimating internal fistula localisation in “anorectal clock”, fistulous type, as well as the fistulous tract location relative to external sphincteric tissue in patients with transsphincteric anal fistulae. Estimation of pararectal and intramural abscesses was also significantly different.

scholarly journals Usefulness of Grayscale Values of Hypoechoic Lesions Matched with Target Lesions Observed on Magnetic Resonance Imaging for the Prediction of Clinically Significant Prostate Cancer

2021 ◽  
Author(s):  
Dong Gyun Kim ◽  
Jeong Woo Yoo ◽  
Kyo Chul Koo ◽  
Byung Ha Chung ◽  
Kwang Suk Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Area Under The Curve ◽  
Imaging Data ◽  
Resonance Imaging ◽  
Scoring Method ◽  
Significant Difference ◽  
Picture Archiving And Communication ◽  
Clinically Significant

Abstract INTRODUCTION: To analyze grayscale values for hypoechoic lesions matched with target lesions evaluated using prebiopsy magnetic resonance imaging (MRI). METHODS We collected data on 420 target lesions in patients who underwent MRI/transrectal ultrasound fusion biopsies. Images of hypoechoic lesions that matched the target lesions on MRI were stored in a picture archiving and communication system, and their grayscale values were estimated using the red/green/blue scoring method through an embedded function. We analyzed imaging data using grayscale values. RESULTS Of the 420 lesions, 261 (62.1%) were prostate cancer lesions. Grayscale ranges (42.6–91.8) were significant predictors of clinically significant prostate cancer (csPC) in multivariable logistic regression analyses. Area under the curve for detecting csPC using grayscale values along with conventional variables was 0.839, which was significantly higher than that for detecting csPC using only conventional variables (0.828; p = 0.036). Subgroup analysis revealed a significant difference for PI-RADS 3 lesions between grayscale values for benign and cancerous lesions (p = 0.008). Grayscale values were the only significant predictive factor (p = 0.005) for csPC. CONCLUSIONS Distribution of grayscale values according to PI-RAD 3 scores was useful, and the grayscale range (42.6–91.8) was an important factor for csPC diagnosis.

scholarly journals Agreement of Magnetic Resonance Imaging With Computed Tomography in the Assessment for Acute Skull Fractures in a Canine and Feline Cadaver Model

2021 ◽  
Vol 8 ◽  
Author(s):  
Silke Hecht ◽  
Kimberly M. Anderson ◽  
Aude Castel ◽  
John F. Griffin ◽  
Adrien-Maxence Hespel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Head Trauma ◽  
Imaging Modality ◽  
Small Animal ◽  
Skull Fractures ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Mri Sequences

Computed tomography (CT) is the imaging modality of choice to evaluate patients with acute head trauma. However, magnetic resonance imaging (MRI) may be chosen in select cases. The objectives of this study were to evaluate the agreement of MRI with CT in the assessment for presence or absence of acute skull fractures in a canine and feline cadaver model, compare seven different MRI sequences (T1-W, T2-W, T2-FLAIR, PD-W, T2*-W, “SPACE” and “VIBE”), and determine agreement of four different MRI readers with CT data. Pre- and post-trauma CT and MRI studies were performed on 10 canine and 10 feline cadaver heads. Agreement of MRI with CT as to presence or absence of a fracture was determined for 26 individual osseous structures and four anatomic regions (cranium, face, skull base, temporomandibular joint). Overall, there was 93.5% agreement in assessing a fracture as present or absent between MRI and CT, with a significant difference between the pre and post trauma studies (99.4 vs. 87.6%; p &lt; 0.0001; OR 0.042; 95% CI 0.034–0.052). There was no significant difference between dogs and cats. The agreement for the different MRI sequences with CT ranged from 92.6% (T2*-W) to 94.4% (PD-W). There was higher agreement of MRI with CT in the evaluation for fractures of the face than other anatomic regions. Agreement with CT for individual MRI readers ranged from 92.6 to 94.7%. A PD-W sequence should be added to the MR protocol when evaluating the small animal head trauma patient.

scholarly journals Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

Reumatismo ◽  
2016 ◽  
Vol 68 (2) ◽  
pp. 72 ◽  
Author(s):  
M. Lorenzin ◽  
A. Ortolan ◽  
P. Frallonardo ◽  
S. Vio ◽  
C. Lacognata ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
X Rays ◽  
Resonance Imaging ◽  
Diagnostic Significance ◽  
Significant Difference ◽  
Spine Mri ◽  
Activity Indices

Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA), patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+), patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-). The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME) in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJMRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.

Abstract 19008: Is Cold Pressor Cardiac Magnetic Resonance Imaging Testing Useful for Detection of Coronary Endothelial Dysfunction?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sherwin Dela Cruz ◽  
Janet Wei ◽  
Chrisandra Shufelt ◽  
Puja Mehta ◽  
Andre Rogatko ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Endothelial Dysfunction ◽  
Cardiac Magnetic Resonance Imaging ◽  
Myocardial Perfusion Reserve ◽  
Cold Pressor ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Coronary Endothelial Dysfunction

Background: Coronary endothelial dysfunction is typically assessed by invasive coronary reactivity testing (CRT) to measure coronary blood flow ([[Unable to Display Character: &#8710;]]CBF) and diameter responses to acetylcholine (Ach). We evaluated if cold pressor testing (CPT) during noninvasive cardiac magnetic resonance imaging (CMRI) measurement of myocardial perfusion reserve index (MPRI) reflects invasive measurements with Ach and CPT in subjects suspected of having endothelial dysfunction. Methods: CRT was performed in 137 symptomatic women using incremental infusions of Ach in the left coronary artery for 3 minutes and with CPT using ice pack on their hand and forearm for 2 minutes. Quantitative coronary angiography was performed 5 mm distal to the Doppler wire positioned in the proximal left anterior descending artery. In 132 women, [[Unable to Display Character: &#8710;]]CBF was calculated from average peak velocity and vessel cross sectional area. Invasive CPT could not be completed on 4 women. All women underwent CPT CMRI (1.5 T) to measure MPRI as a ratio of stress and rest upslopes of the whole myocardium. Five definitions of normal invasive CPT and Ach diameter response (dilation > 0, 5, 10, 15 or 20%) were compared to two abnormal definitions (≤ 0 or - 5%) of endothelial function. Normal [[Unable to Display Character: &#8710;]]CBF was defined as ≤ 50%. We used Wilcoxon Two-Sample statistical test to compare MPRI in each group. Results: CPT MPRI was significantly different in those with normal versus abnormal invasive Ach when Ach diameter response was defined as ≥ 20% or < - 5 % (p=0.04), though not with other thresholds (Table). Conclusion: Noninvasive CPT CMRI may not be useful for detection of endothelial dysfunction in symptomatic women as no significant difference in MPRI was found in those with normal and abnormal invasive CRT. However, there may be a role for CPT MPRI in detecting endothelial dysfunction at higher thresholds of normal diameter response. Additional investigation will evaluate CPT CMRI and cardiovascular outcomes.

scholarly journals Sexual Dimorphism in Laryngeal Volumetric Measurements Using Magnetic Resonance Imaging

2019 ◽  
Vol 99 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Abdul-Latif Hamdan ◽  
Elie Khalifee ◽  
Georges Ziade ◽  
Sahar Semaan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Statistical Significance ◽  
Resonance Imaging ◽  
Men And Women ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
The Right ◽  
Volumetric Measurements

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.

scholarly journals Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State

2020 ◽  
Vol 46 (4) ◽  
pp. 834-845
Author(s):  
Daiki Sasabayashi ◽  
Yoichiro Takayanagi ◽  
Tsutomu Takahashi ◽  
Naoyuki Katagiri ◽  
Atsushi Sakuma ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
At Risk ◽  
Magnetic Resonance ◽  
Globus Pallidus ◽  
Mental State ◽  
Lateral Ventricle ◽  
Psychotic Disorders ◽  
Resonance Imaging ◽  
Significant Difference ◽  
At Risk Mental State

Abstract Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.

P3839Hypertension or hypertrophic cardiomyopathy? Using cardiovascular magnetic resonance imaging to unmask the great imitator

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Keteepe-Arachi ◽  
A Malhotra ◽  
J Basu ◽  
G Parry-Williams ◽  
B Ensam ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Wall Thickness ◽  
Lifestyle Modification ◽  
Left Ventricular ◽  
Grey Zone ◽  
Resonance Imaging ◽  
Hypertensive Patients ◽  
Significant Difference

Abstract Background Structural cardiac adaptations due to hypertension (HTN) present a diagnostic challenge when differentiating from hypertrophic cardiomyopathy (HCM), using traditional imaging techniques such as echocardiography (echo). Cardiac magnetic resonance imaging (CMR) offers reproducible anatomical, functional quantification and myocardial tissue characterisation which discriminates between hypertension and HCM. Purpose To identify hypertensive individuals with undiagnosed HCM using CMR imaging. Methods 100 consecutive hypertensive patients underwent CMR at a tertiary centre dedicated blood pressure clinic (55% male, mean age 51 years). In keeping with ESC guidelines, end diastolic wall thickness (EDWT) ≥15mm identified individuals within the “grey zone” between hypertension and with a potential HCM diagnosis. 19 individuals were referred on to the dedicated inherited cardiac conditions clinic for further evaluation. Four patients expressed a definitive LV phenotype and were diagnosed with HCM. CMR parameters were compared in three groups: Hypertensive (HTN), “grey zone” Hypertensive (GZH) and HCM. Results CMR demonstrated end diastolic wall thickness (EDWT) >11 mm in 50% of hypertensives. 73% of the referred patients were Afro-Caribbean (AC) and all 4 HCM patients were AC. All referrals demonstrated EDWTs ≥14mm, 9 (47%) demonstrated late gadolinium enhancement of which 3 (16%) had HCM. Three had asymmetrical septal hypertrophy – 2 were in the HCM cohort and one underwent endomyocardial biopsy confirming HTN. Left ventricular mass index (LVMI) was significantly higher in GZH compared to HTN (p<0.0001) and in HCM compared to HTN (p=0.0004). EDWT was significantly greater in GZH compared to HTN (p<0.0001) and in HCM compared to HTN (p=0.0002). There was no significant difference in these parameters between GZH and HCM. Table 1. P-values for CMR data in hypertensive (HTN), gray zone hypertensive (GZH) and hypertrophic cardiomyopathy (HCM) cohorts CMR Parameter HCM vs. HTN GZH vs. HTN GZH vs. HCM EDVI NS p=0.025 NS EDWT p=0.0002 p<0.0001 NS LVMI p=0.0004 p<0.0001 NS Conclusion This study reports a 4% prevalence of HCM among hypertensive patients - 20 x greater than in the general population - which would be left undiagnosed using echo alone. Screening hypertensive individuals with CMR is not routine but we advocate its use in these individuals especially in Afro Caribbeans and in those in the “grey zone”, to identify undiagnosed HCM, which has significant implications for lifestyle modification and family screening. Acknowledgement/Funding Cardiac Risk in the Young

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