enhancement pattern
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Author(s):  
Almila Coskun Bilge ◽  
Pinar Ilhan Demir ◽  
Hale Aydin ◽  
Isil Esen Bostanci

Objective: Our single-centre retrospective study aimed to evaluate the relationship between magnetic resonance (MR)-directed ultrasound (MDUS) detectability and magnetic resonance imaging (MRI) findings of non-mass enhancement (NME) lesions, regarding the morphologic and enhancement features, the distance from the skin and nipple, and the presence of concomitant landmarks. Methods: A total of 350 MRI-detected NME lesions that were determined between January 2015 and May 2019 and subsequently underwent MDUS were analyzed. The MRI findings, biopsy results, and follow-up outcomes of lesions were recorded. The correlation between the MRI findings of the lesions and MDUS detectability was analyzed. Results: One hundred fourteen (32.6%) of the 350 lesions had a counterpart in the MDUS. Respectively, 66 (37.9%), 38 (43.2%) and 59 (38.3%) of the lesions detected in MDUS were larger than 20 mm in size, with a distance of less than 20 mm to the nipple and 15 mm to the skin. The lesion size and lesion distance to the nipple and skin were significantly associated with a US correlate (p < 0.05). The MDUS detection rate was significantly higher in NME lesions with MR findings including diffuse distribution (p < 0.001), clustered-ring enhancement pattern (p < 0.001), washout kinetic curve (p = 0.006), and MR-BIRADS category 5 (p < 0.001). Multivariate logistic regression showed that only the clustered-ring enhancement pattern was significantly associated with an MDUS correlation (p < 0.001). Conclusion: Statistically significant correlations were found between the size, distance to the nipple and skin, distribution pattern, enhancement pattern and kinetic curve of the NME lesions on MRI and ultrasound detectability. Advances in knowledge: We found that clustered-ring enhancement patterns were significantly more frequent in MR-directed US detectable lesions.


2021 ◽  
pp. 101696
Author(s):  
Elena Panettieri ◽  
Harufumi Maki ◽  
Bradford J. Kim ◽  
HyunSeon Christine Kang ◽  
Veronica Cox ◽  
...  

2021 ◽  
Vol 11 ◽  
pp. 63
Author(s):  
Gesine Peters ◽  
Anne Margaret Lynch ◽  
Johannes Peters

Contrast-enhanced mammography (CEM) is a new technology in breast imaging and cancer detection. It has been shown to have a comparable performance to breast MRI. Currently, there is no independent BI-RADS lexicon available for CEM. This pictorial essay will demonstrate the use of breast MRI descriptors according to the BI-RADS breast MRI lexicon, to describe enhancement patterns for recombined CEM images. The authors recommend using enhancement pattern descriptors already in use for breast MRI when reporting CEM studies, to promote uniformity of interpretation and reporting.


2021 ◽  
pp. 246-247
Author(s):  
Eoin P. Flanagan

A 36-year-old woman with a history of hypothyroidism, gout, fibromyalgia, depression, substance use disorder, and nephrolithiasis had development of neck pain. Three months later, she noted numbness in the left leg, which slowly worsened over the course of several months, spreading to involve the right leg and eventually forming a sensory level across the trunk at T8. At that time she also noted numbness in both hands. She had stiffness and weakness in both legs and had trouble emptying her bladder. Neurologic examination showed mild weakness restricted to the bilateral iliopsoas and hyperreflexia in the upper and lower extremities. Hoffmann and Babinski signs were positive bilaterally. There was moderate spasticity in both lower extremities and mild distal vibratory sensation loss, with a sensory level across the trunk at T8. Her gait examination indicated a spastic gait, and she had a mildly positive Romberg sign. On re-evaluation of her previous magnetic resonance image, a transverse band or pancakelike enhancement pattern was noted at the center of a moderate to severely stenotic region of the cervical spine sparing gray matter on axial sequences. The magnetic resonance imaging findings were highly suggestive of cervical spondylotic myelopathy. A neurosurgical referral was made, and the patient underwent anterior cervical discectomy with decompression and fusion from C4-C7. At her follow-up visit 4 months after surgery, the patient reported improvement in her strength and walking. Her neurologic examination showed normal lower extremity strength, resolution of spasticity, and negative Babinski sign bilaterally but persistent sensory deficits. Magnetic resonance imaging of the cervical spine at that time showed a decrease in the degree of T2 hyperintensity and enhancement, consistent with interval response to surgery. The presence of a progressive myelopathy over many months in this case patient argued against a diagnosis of transverse myelitis. Furthermore, the cerebrospinal fluid was noninflammatory, which also favored cervical spondylosis over idiopathic transverse myelitis. However, the gadolinium enhancement pattern was the key diagnostic feature that strongly suggested cervical spondylotic myelopathy as the diagnosis and ultimately led to neurosurgical referral for decompression.


Suizo ◽  
2021 ◽  
Vol 36 (5) ◽  
pp. 331-338
Author(s):  
Asuka FUKUO ◽  
Hiromitsu MAEHIRA ◽  
Hiroya IIDA ◽  
Haruki MORI ◽  
Daiki YASUKAWA ◽  
...  

2021 ◽  
Vol 11 ◽  
Author(s):  
Shi Yun Sun ◽  
Yingying Ding ◽  
Zhuolin Li ◽  
Lisha Nie ◽  
Chengde Liao ◽  
...  

ObjectivesTo evaluate the value of synthetic magnetic resonance imaging (syMRI), diffusion-weighted imaging (DWI), DCE-MRI, and clinical features in breast imaging–reporting and data system (BI-RADS) 4 lesions, and develop an efficient method to help patients avoid unnecessary biopsy.MethodsA total of 75 patients with breast diseases classified as BI-RADS 4 (45 with malignant lesions and 30 with benign lesions) were prospectively enrolled in this study. T1-weighted imaging (T1WI), T2WI, DWI, and syMRI were performed at 3.0 T. Relaxation time (T1 and T2), apparent diffusion coefficient (ADC), conventional MRI features, and clinical features were assessed. “T” represents the relaxation time value of the region of interest pre-contrast scanning, and “T+” represents the value post-contrast scanning. The rate of change in the T value between pre- and post-contrast scanning was represented by ΔT%.ResultsΔT1%, T2, ADC, age, body mass index (BMI), menopause, irregular margins, and heterogeneous internal enhancement pattern were significantly associated with a breast cancer diagnosis in the multivariable logistic regression analysis. Based on the above parameters, four models were established: model 1 (BI-RADS model, including all conventional MRI features recommended by BI-RADS lexicon), model 2 (relaxation time model, including ΔT1% and T2), model 3 [multi-parameter (mp)MRI model, including ΔT1%, T2, ADC, margin, and internal enhancement pattern], and model 4 (combined image and clinical model, including ΔT1%, T2, ADC, margin, internal enhancement pattern, age, BMI, and menopausal state). Among these, model 4 has the best diagnostic performance, followed by models 3, 2, and 1.ConclusionsThe mpMRI model with DCE-MRI, DWI, and syMRI is a robust tool for evaluating the malignancies in BI-RADS 4 lesions. The clinical features could further improve the diagnostic performance of the model.


2021 ◽  
pp. bjophthalmol-2021-319537
Author(s):  
Valentina Daphne Petroulia ◽  
Dominik Brügger ◽  
Robert Hoepner ◽  
Rino Vicini ◽  
Anna Winklehner ◽  
...  

Background/AimsThe aim of this study was to identify specific MRI characteristics of anterior ischaemic optic neuropathy (AION) and optic neuritis (ON) that would aid in the differentiation between these two diagnoses.MethodsWe retrospectively analysed a consecutive case series including all patients with an MRI study of brain and orbit and the clinical diagnosis of either ON or AION. We examined the scans for restricted diffusion of the optic nerve, optic sheath diameter, enhancement and location of enhancement of the optic nerve and distribution of the white matter lesions.ResultsFifty patients met the inclusion criteria. We found an accuracy of 0.98 for the discrimination between AION and ON based solely on parameters extracted from MRI data. Dominance analysis to determine the most influential parameters showed that the enhancement pattern of the optic nerve and distribution of the white matter lesions had the biggest impact on the classification and led to a discrimination accuracy of 0.9 when used alone.ConclusionIn patients with an inconclusive clinical diagnosis, optic nerve enhancement pattern and distribution of white matter lesions can aid in the diagnosis and differentiation between AION and ON. Diffusion-weighted imaging did not add significant information to the diagnosis or help to differentiate between the two conditions.


2021 ◽  
Author(s):  
Peng Zhang ◽  
Juan Yan ◽  
Zhongqi Liu ◽  
Xiangsheng Li ◽  
Qianxiang Zhou

Abstract Background Human epidermal growth factor receptor-2 (HER2) correlates with cancer heterogeneity, and the identification of HER2 expression is invasive immunohistochemistry in the clinic. To determine whether noninvasive predictors of HER2 expression are implied in the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Methods 189/47 breast cancer patients collected from The Cancer Imaging Archive (TCIA) were used as a cross-validation/test group. A convex analysis of mixtures (CAM) was conducted to decompose heterogeneous tissues inside and outside the tumor. Their DCE-MRI images were decomposed into relatively homogeneous subregions with different contrast enhancement patterns. The predictor of HER2 expression was composed of radiomic features acquired from intratumoural or peritumoural subregions. The area under the curve (AUC) of receiver operating characteristic (ROC) was used to assess the predictive power.Results The predictor formed in the undecomposed tumor was used as a baseline for comparison (AUC=0.691±0.072/0.625±0.056 in cross-validation/test group). The intratumoural subregion with a contrast enhancement pattern corresponding to the plateau of signal intensity formed a more robust predictor (AUC=0.816±0.059/0.785±0.067, P=0.0128/0.0389). Peritumoral parenchyma of <20 mm from the tumor margin was also researched (AUC=0.589±0.083/0.524±0.064). The peritumoural subregion with a contrast enhancement pattern corresponding to steady enhancement also formed a helpful predictor compared to the undecomposed parenchyma (AUC=0.702±0.068/0.681±0.042, P=0.0128/0.0389). The best predictor was formed when two predictors from subregions were fused together (AUC=0.851±0.057/0.812±0.045, P=0.0011/0.0397).Conclusions A subregion rather than a heterogeneous tumor itself provided a more accurate predictor of HER2 expression. Radiomic predictors from intratumoural and peritumoural subregions were complementary to each other.


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