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Xia S, Gowda P, Silva FD, Guirguis M, Ravi V, Xi Y, Chhabra A. Comparison between ZOOMit DWI and conventional DWI in the assessment of foot and ankle infection: a prospective study. Eur Radiol 2024; 34:3483-3492. [PMID: 37848770 DOI: 10.1007/s00330-023-10315-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The study aimed to compare ZOOMit diffusion-weighted imaging (DWI) MRI with conventional DWI MRI for visualizing small bones in the foot, soft tissue abscesses, and osteomyelitis. MATERIALS AND METHODS The cohort consisted of a consecutive series of patients with potential foot and ankle infections referred for MR imaging. Patients were imaged using both conventional and ZOOMit DWI in the same setting. Blinded reads were then conducted in separate settings and independent of known clinical diagnosis by two expert radiologists. The results from the reads were compared statistically using paired t-tests and with biopsy specimen analysis, both anatomopathological and microbiological. RESULTS There was improvement in fat suppression using ZOOMit sequence compared to conventional DWI (p = .001) with no significant difference in motion artifacts (p = .278). ZOOMit had a higher rate of concordance with pathology findings for osteomyelitis (72%, 31/43 cases) compared with conventional DWI (60%, 26/43 cases). ZOOMit also identified 46 additional small bones of the foot and ankle (405/596, 68.0%) than conventional DWI (359/596, 60.2%). Conventional DWI however exhibited a more negative contrast-to-noise ratio (CNR) than ZOOMit (p = 0.001). CONCLUSION ZOOMit DWI improves distal extremity proton diffusion assessment and helps visualize more bones in the foot, with less image distortion and improved fat saturation at the expense of reduced CNR. This makes it a viable option for assessing lower extremity infections. CLINICAL RELEVANCE STATEMENT This study highlights the novel utilization of ZOOMit diffusion-weighted imaging (DWI) for the assessment of lower extremity lesions compared to conventional DWI. KEY POINTS • Distal extremity diffusion-weighted imaging (DWI) is often limited. • ZOOMit DWI displayed improved fat suppression with less motion artifacts and better visualization of the lower extremity bones than conventional DWI. • ZOOMit shows decreased contrast-to-noise ratio than conventional DWI.
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Affiliation(s)
| | | | | | | | | | - Yin Xi
- UT Southwestern, Dallas, TX, USA
| | - Avneesh Chhabra
- UT Southwestern, Dallas, TX, USA.
- Radiology & Orthopedic Surgery, UT Southwestern, Dallas, TX, 75390-9178, USA.
- Johns Hopkins University, Baltimore, MD, USA.
- University of Dallas, Richardson, TX, USA.
- Walton Centre for Neuroscience, Liverpool, UK.
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2
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Ghasemi A, Ahlawat S, Fayad LM. Magnetic Resonance Imaging Biomarkers of Bone and Soft Tissue Tumors. Semin Musculoskelet Radiol 2024; 28:39-48. [PMID: 38330969 DOI: 10.1055/s-0043-1776433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Magnetic resonance imaging (MRI) is essential in the management of musculoskeletal (MSK) tumors. This review delves into the diverse MRI modalities, focusing on anatomical, functional, and metabolic sequences that provide essential biomarkers for tumor detection, characterization, disease extent determination, and assessment of treatment response. MRI's multimodal capabilities offer a range of biomarkers that enhance MSK tumor evaluation, aiding in better patient management.
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Affiliation(s)
- Ali Ghasemi
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Laura Marie Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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3
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Martín-Noguerol T, Díaz-Angulo C, Vilanova C, Barceló A, Barceló J, Luna A, Vilanova JC. How to do and evaluate DWI and DCE-MRI sequences for diabetic foot assessment. Skeletal Radiol 2023:10.1007/s00256-023-04518-x. [PMID: 38001301 DOI: 10.1007/s00256-023-04518-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
MRI evaluation of the diabetic foot is still a challenge not only from an interpretative but also from a technical point of view. The incorporation of advanced sequences such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI into standard protocols for diabetic foot assessment could aid radiologists in differentiating between neuropathic osteoarthropathy (Charcot's foot) and osteomyelitis. This distinction is crucial as both conditions can coexist in diabetic patients, and they require markedly different clinical management and have distinct prognoses. Over the past decade, several studies have explored the effectiveness of DWI and dynamic contrast-enhanced MRI (DCE-MRI) in distinguishing between septic and reactive bone marrow, as well as soft tissue involvement in diabetic patients, yielding promising results. DWI, without the need for exogenous contrast, can provide insights into the cellularity of bone marrow and soft tissues. DCE-MRI allows for a more precise evaluation of soft tissue and bone marrow perfusion compared to conventional post-gadolinium imaging. The data obtained from these sequences will complement the traditional MRI approach in assessing the diabetic foot. The objective of this review is to familiarize readers with the fundamental concepts of DWI and DCE-MRI, including technical adjustments and practical tips for image interpretation in diabetic foot cases.
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Affiliation(s)
| | | | - Cristina Vilanova
- Department of Orthopaedic Surgery, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - Ariadna Barceló
- Department of Radiology, Complejo Asistencial Universitario de Palencia (CAUPA), Palencia, Spain
| | - Joaquim Barceló
- Department of Radiology, Clinical Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
| | - Antonio Luna
- MRI unit, Radiology Department, HT medica, Carmelo Torres 2, 23007, Jaén, Spain
| | - Joan C Vilanova
- Department of Radiology, Clinical Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
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4
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Kim Y, Lee SK, Kim JY, Kim JH. Pitfalls of Diffusion-Weighted Imaging: Clinical Utility of T2 Shine-through and T2 Black-out for Musculoskeletal Diseases. Diagnostics (Basel) 2023; 13:diagnostics13091647. [PMID: 37175036 PMCID: PMC10177815 DOI: 10.3390/diagnostics13091647] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/30/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Diffusion-weighted imaging (DWI) with an apparent diffusion coefficient (ADC) value is a relatively new magnetic resonance imaging (MRI) sequence that provides functional information on the lesion by measuring the microscopic movement of water molecules. While numerous studies have evaluated the promising role of DWI in musculoskeletal radiology, most have focused on tumorous diseases related to cellularity. This review article aims to summarize DWI-acquisition techniques, considering pitfalls such as T2 shine-through and T2 black-out, and their usefulness in interpreting musculoskeletal diseases with imaging. DWI is based on the Brownian motion of water molecules within the tissue, achieved by applying diffusion-sensitizing gradients. Regardless of the cellularity of the lesion, several pitfalls must be considered when interpreting DWI with ADC values in musculoskeletal radiology. This review discusses the application of DWI in musculoskeletal diseases, including tumor and tumor mimickers, as well as non-tumorous diseases, with a focus on lesions demonstrating T2 shine-through and T2 black-out effects. Understanding these pitfalls of DWI can provide clinically useful information, increase diagnostic accuracy, and improve patient management when added to conventional MRI in musculoskeletal diseases.
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Affiliation(s)
- Yuri Kim
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seul Ki Lee
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jee-Young Kim
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jun-Ho Kim
- Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
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Kolmer F, Bierry G, Willaume T. Exercise-related leg muscle signal changes: assessment using diffusion-weighted MRI. Eur Radiol Exp 2023; 7:10. [PMID: 36882563 PMCID: PMC9992489 DOI: 10.1186/s41747-023-00323-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/23/2023] [Indexed: 03/09/2023] Open
Abstract
We aimed to detect physiologic changes of leg muscle signal on magnetic resonance (MR) diffusion-weighted imaging (DWI) in asymptomatic subjects after repetitive plantar flexion exercises. In this monocentric prospective study, DWI of both legs were performed at rest and after exercise periods (5 min, Ex5: and 10 min, Ex10) in 20 active healthy subjects (mean age 31 years). The exercise consisted in repetitive plantar flexion of the right foot using elastic band, the patient being sited directly on the MR table. Both visual semiquantitative evaluations and quantitative (apparent diffusion coefficient, ADC; fractional anisotropy, FA) were performed in 5 leg compartments. Visually, signal changes involved mainly the fibular and gastrocnemius muscles and were considered intense after Ex5 in 3 subjects, moderate only after Ex5 in 10, and moderate only after Ex10 in 4. No changes were visible in 3 subjects. Quantitative evaluation confirmed significant signal changes in the fibular (ADC: + 17.4%, p < 0.001; FA: -8.3%, p = 0.030) and gastrocnemius (ADC: + 13.7%, p < 0.001; FA: -11.4%, p < 0.001) muscles between rest and post-exercise MR. Plantar flexion exercises induce changes on DWI, especially in fibular and gastrocnemius muscles, which can be visually and quantitatively detectable in asymptomatic active subjects.Trial registrationEudraCT 2008-A00694-51.
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Affiliation(s)
- Floriane Kolmer
- MSK Imaging, University Hospital of Strasbourg, 1 Avenue Molière, 67098, Strasbourg, France
| | - Guillaume Bierry
- MSK Imaging, University Hospital of Strasbourg, 1 Avenue Molière, 67098, Strasbourg, France.
| | - Thibault Willaume
- MSK Imaging, University Hospital of Strasbourg, 1 Avenue Molière, 67098, Strasbourg, France
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6
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Review of primary superficial soft tissue mesenchymal tumors of malignant or intermediate biological potential. Skeletal Radiol 2023; 52:435-445. [PMID: 35867123 DOI: 10.1007/s00256-022-04127-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 02/02/2023]
Abstract
The majority of the sarcomas are deep in location, larger than 5 cm in size, and heterogenous in imaging appearance. However, when sarcomas occur superficially, these typical features may be absent, failing to alert the radiologist to a malignancy and mimicking one of the more numerous benign superficial tumors that make up the bulk of soft tissue mass evaluations. This manuscript will discuss the current role of imaging in recognizing features concerning for superficial soft tissue sarcomas. Provided is an overview of the demographic, clinical, and imaging features of the most commonly encountered superficial soft tissue sarcomas, including undifferentiated pleomorphic, leiomyosarcoma, synovial sarcoma, liposarcoma, myxofibrosarcoma, dermatofibrosarcoma protuberans, epithelioid sarcoma, and angiosarcoma. A less common but primary superficial tumor, angiomatoid fibrous histiocytoma, is also reviewed as the diagnosis may be confounding both clinically and on imaging studies.
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Dagestad MH, Vetti N, Kristoffersen PM, Zwart JA, Storheim K, Bakland G, Brox JI, Grøvle L, Marchand GH, Andersen E, Assmus J, Espeland A. Apparent diffusion coefficient values in Modic changes – interobserver reproducibility and relation to Modic type. BMC Musculoskelet Disord 2022; 23:695. [PMID: 35869480 PMCID: PMC9306145 DOI: 10.1186/s12891-022-05610-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/29/2022] [Indexed: 11/21/2022] Open
Abstract
Background Modic Changes (MCs) in the vertebral bone marrow were related to back pain in some studies but have uncertain clinical relevance. Diffusion weighted MRI with apparent diffusion coefficient (ADC)-measurements can add information on bone marrow lesions. However, few have studied ADC measurements in MCs. Further studies require reproducible and valid measurements. We expect valid ADC values to be higher in MC type 1 (oedema type) vs type 3 (sclerotic type) vs type 2 (fatty type). Accordingly, the purpose of this study was to evaluate ADC values in MCs for interobserver reproducibility and relation to MC type. Methods We used ADC maps (b 50, 400, 800 s/mm2) from 1.5 T lumbar spine MRI of 90 chronic low back pain patients with MCs in the AIM (Antibiotics In Modic changes)-study. Two radiologists independently measured ADC in fixed-sized regions of interests. Variables were MC-ADC (ADC in MC), MC-ADC% (0% = vertebral body, 100% = cerebrospinal fluid) and MC-ADC-ratio (MC-ADC divided by vertebral body ADC). We calculated mean difference between observers ± limits of agreement (LoA) at separate endplates. The relation between ADC variables and MC type was assessed using linear mixed-effects models and by calculating the area under the receiver operating characteristic curve (AUC). Results The 90 patients (mean age 44 years; 54 women) had 224 MCs Th12-S1 comprising type 1 (n = 111), type 2 (n = 91) and type 3 MC groups (n = 22). All ADC variables had higher predicted mean for type 1 vs 3 vs 2 (p < 0.001 to 0.02): MC-ADC (10− 6 mm2/s) 1201/796/576, MC-ADC% 36/21/14, and MC-ADC-ratio 5.9/4.2/3.1. MC-ADC and MC-ADC% had moderate to high ability to discriminate between the MC type groups (AUC 0.73–0.91). MC-ADC-ratio had low to moderate ability (AUC 0.67–0.85). At L4-S1, widest/narrowest LoA were for MC-ADC 20 ± 407/12 ± 254, MC-ADC% 1.6 ± 18.8/1.4 ± 10.4, and MC-ADC-ratio 0.3 ± 4.3/0.2 ± 3.9. Difference between observers > 50% of their mean value was less frequent for MC-ADC (9% of MCs) vs MC-ADC% and MC-ADC-ratio (17–20%). Conclusions The MC-ADC variable (highest mean ADC in the MC) had best interobserver reproducibility, discriminated between MC type groups, and may be used in further research. ADC values differed between MC types as expected from previously reported MC histology. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05610-4.
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8
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Kruk KA, Dietrich TJ, Wildermuth S, Leschka S, Toepfer A, Waelti S, Kim CHO, Güsewell S, Fischer T. Diffusion-Weighted Imaging Distinguishes Between Osteomyelitis, Bone Marrow Edema, and Healthy Bone on Forefoot Magnetic Resonance Imaging. J Magn Reson Imaging 2022; 56:1571-1579. [PMID: 35106870 DOI: 10.1002/jmri.28091] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diagnosis of osteomyelitis by imaging can be challenging. The feasibility of diffusion-weighted imaging (DWI) as ancillary sequence was evaluated in this study. PURPOSE To evaluate DWI for differentiation between osteomyelitis, bone marrow edema, and healthy bone on forefoot magnetic resonance imaging (MRI). STUDY TYPE Prospective. SUBJECTS A total of 60 consecutive patients undergoing forefoot MRI divided into three study groups (20 subjects each): osteomyelitis, bone marrow edema, and healthy bone. FIELD STRENGTH/SEQUENCE A 1.5T and 3T MRI scanners; readout-segmented multishot echo planar DWI. ASSESSMENT Two independent radiologists measured apparent diffusion coefficient (ADC) values within abnormal or healthy bone. STATISTICAL TESTS ADC values were compared between groups (pairwise t-test with Bonferroni-Holm correction for multiple testing). Intraclass correlation coefficient (ICC) was calculated to assess inter-reader agreement. Threshold ADC values were determined as the cutoffs that maximized the sum of sensitivity and specificity. Receiver operating characteristic (ROC) analysis was performed with statistical threshold of P < 0.05. RESULTS Inter-reader agreement was 0.92 in the healthy bone group and 0.78 in both the edema and osteomyelitis groups. Average ADC values were significantly different between groups: 1432 ± 222 × 10-6 mm2 /sec (osteomyelitis), 1071 ± 196 × 10-6 mm2 /sec (bone marrow edema), and 277 ± 89 × 10-6 mm2 /sec (healthy bone). A threshold ADC value of 534 × 10-6 mm2 /sec distinguishes between healthy and abnormal bone with specificity and sensitivity of 100% each. For distinction between osteomyelitis and bone marrow edema, two cutoff values were determined: a 95%-specificity cutoff indicating osteomyelitis (>1320 × 10-6 mm2 /sec) and a 95%-sensitivity cutoff indicating bone marrow edema (<1155 × 10-6 mm2 /sec). Diagnostic accuracy of 95% was achieved for 73% (29/40) of the subjects. DATA CONCLUSION DWI with ADC maps distinguishes between healthy and abnormal bone on forefoot MRI. Calculated cutoff values allow confirmation or exclusion of osteomyelitis in a high proportion of subjects. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Konrad A Kruk
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Tobias J Dietrich
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Simon Wildermuth
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Sebastian Leschka
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Andreas Toepfer
- Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Stephan Waelti
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Chan-Hi Olaf Kim
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland
| | - Sabine Güsewell
- Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Tim Fischer
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
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Aparisi Gómez MP, Ayuso Benavent C, Simoni P, Musa Aguiar P, Bazzocchi A, Aparisi F. Imaging of Bone Marrow: From Science to Practice. Semin Musculoskelet Radiol 2022; 26:396-411. [PMID: 36103883 DOI: 10.1055/s-0042-1745803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The study of the bone marrow may pose important challenges, due to its changing features over the life span, metabolic stress, and in cases of disease or treatment. Bone marrow adipocytes serve as storage tissue, but they also have endocrine and paracrine functions, contributing to local and systemic metabolism.Among different techniques, magnetic resonance (MR) has the benefit of imaging bone marrow directly. The use of advanced MR techniques for bone marrow study has rapidly found clinical applications. Beyond the clinical uses, it has opened up pathways to assess and quantify bone marrow components, establishing the groundwork for further study of its implications in physiologic and pathologic conditions.We summarize the features of the bone marrow as an organ, address the different modalities available for its study, with a special focus on MR advanced techniques and their addition to analysis in recent years, and review some of the challenges in interpreting the appearance of bone marrow.
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Affiliation(s)
- Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, IMSKE, Valencia, Spain
| | | | - Paolo Simoni
- Department of Radiology, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Paula Musa Aguiar
- Serdil, Clinica de Radiologia e Diagnóstico por Imagem, Porto Alegre - RS, Brazil
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Francisco Aparisi
- Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
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Role of diffusion-weighted MRI in evaluation of pediatric musculoskeletal soft tissue masses. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00643-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
Background
In pediatric patients, soft tissue masses encompass a wide heterogeneous group of benign and malignant lesions. MRI is a powerful diagnostic tool in the workup of soft tissue tumors in children, and it helps in characterization of lesion and evaluation of the extent of the lesion. However, conventional MRI techniques are not specific in differentiating benign from malignant lesions. So to improve characterization of tumors, DWI was added to MRI techniques as it increases sensitivity and specificity by detecting the micro-diffusion changes of water into intra- and extracellular spaces. The aim of this work was to highlight the diagnostic value of DWI in detection and characterization of different musculoskeletal soft tissue masses in pediatrics.
Results
There was a statistically significant difference regarding the mean ADC value of benign and malignant masses (P value = 0.001*). The mean ADC value for all benign masses (n = 41) was 1.495 ± 0.55 SD × 10–3 mm2/s, while the mean ADC value for all malignant masses (n = 21) was 0.449 ± 0.27 SD × 10–3 mm2/s. The cutoff ADC value between benign and malignant masses was 0.88 × 10–3 mm2/s. This cutoff ADC value has sensitivity of 100.0%, specificity of 92.3%, PPV of 66.7%, NPV of 100.0% and diagnostic accuracy of 93.3%.
Conclusion
In pediatric patients, DWI is an innovative valuable noninvasive imaging technique for characterization of musculoskeletal soft tissue masses and discrimination between benign and malignant masses.
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Machine Learning in the Differentiation of Soft Tissue Neoplasms: Comparison of Fat-Suppressed T2WI and Apparent Diffusion Coefficient (ADC) Features-Based Models. J Digit Imaging 2021; 34:1146-1155. [PMID: 34545474 PMCID: PMC8554992 DOI: 10.1007/s10278-021-00513-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 12/26/2022] Open
Abstract
Machine learning has been widely used in the characterization of tumors recently. This article aims to explore the feasibility of the whole tumor fat-suppressed (FS) T2WI and ADC features-based least absolute shrinkage and selection operator (LASSO)-logistic predictive models in the differentiation of soft tissue neoplasms (STN). The clinical and MR findings of 160 cases with 161 histologically proven STN were reviewed, retrospectively, 75 with diffusion-weighted imaging (DWI with b values of 50, 400, and 800 s/mm2). They were divided into benign and malignant groups and further divided into training (70%) and validation (30%) cohorts. The MR FS T2WI and ADC features-based LASSO-logistic models were built and compared. The AUC of the FS T2WI features-based LASSO-logistic regression model for benign and malignant prediction was 0.65 and 0.75 for the training and validation cohorts. The model's sensitivity, specificity, and accuracy of the validation cohort were 55%, 96%, and 76.6%. While the AUC of the ADC features-based model was 0.932 and 0.955 for the training and validation cohorts. The model's sensitivity, specificity, and accuracy were 83.3%, 100%, and 91.7%. The performances of these models were also validated by decision curve analysis (DCA). The AUC of the whole tumor ADC features-based LASSO-logistic regression predictive model was larger than that of FS T2WI features (p = 0.017). The whole tumor fat-suppressed T2WI and ADC features-based LASSO-logistic predictive models both can serve as useful tools in the differentiation of STN. ADC features-based LASSO-logistic regression predictive model did better than that of FS T2WI features.
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12
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Chaturvedi A. Pediatric skeletal diffusion-weighted magnetic resonance imaging: part 1 - technical considerations and optimization strategies. Pediatr Radiol 2021; 51:1562-1574. [PMID: 33792751 DOI: 10.1007/s00247-021-04975-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/12/2020] [Accepted: 01/15/2021] [Indexed: 12/28/2022]
Abstract
Diffusion-weighted MRI, or DWI, is a fast, quantitative technique that is easily integrated into a morphological MR acquisition. The ability of DWI to aid in detecting multifocal skeletal pathology and in characterizing tissue cellularity to a level beyond that possible with other techniques makes it a niche component of multiparametric MR imaging of the skeleton. Besides its role in disease detection and establishing cellularity and character of osseous lesions, DWI continues to be examined as a surrogate biomarker for therapeutic response of several childhood bone tumors. There is increasing interest in harnessing DWI as a potential substitute to alternative modes of imaging evaluation that involve radiation or administration of intravenous contrast agent or radiopharmaceuticals, for example in early detection and diagnosis of capital femoral epiphyseal ischemia in cases of Legg-Calvé-Perthes disease, or diagnosis and staging of lymphoma. The expected evolution of skeletal diffusivity characteristics with maturation and the unique disease processes that affect the pediatric skeleton necessitate a pediatric-specific discussion. In this article, the author examines the developmentally appropriate normal appearances, technique, artifacts and pitfalls of pediatric skeletal DWI.
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Affiliation(s)
- Apeksha Chaturvedi
- Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.
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13
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York V, Sultan N, Thapa M, Chaturvedi A. Musculoskeletal MRI in Infants: Technical Considerations, Pitfalls and Optimization Strategies. Semin Roentgenol 2021; 56:277-287. [PMID: 34281680 DOI: 10.1053/j.ro.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vincent York
- Department of Radiology, Rochester General Hospital, Rochester, NY.
| | - Nadia Sultan
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY
| | - Mahesh Thapa
- Department of Radiology, University of Washington, Seattle, WA
| | - Apeksha Chaturvedi
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY
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Sambri A, Fiore M, Giannini C, Pipola V, Zucchini R, Aparisi Gomez MP, Musa Aguiar P, Gasbarrini A, De Paolis M. Primary Tumors of the Sacrum: Imaging Findings. Curr Med Imaging 2021; 18:170-186. [PMID: 33982654 DOI: 10.2174/1573405617666210512011923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 11/22/2022]
Abstract
The diagnosis of sacral neoplasms is often delayed because they tend to remain clinically silent for a long time. Imaging is useful at all stages of managing sacral bone tumors: from the detection of the neoplasm to the long-term follow-up. Radiographs are recommended as the modality of choice to begin the imaging workup of a patient with known or suspected sacral pathology. More sensitive examinations such as computerized tomography (CT), magnetic resonance (MRI), or scintigraphy are often necessary. The morphological features of the lesions on CT and MRI help to orientate the diagnosis. Although some imaging characteristics are helpful to limit the differential diagnosis, an imaging-guided biopsy is often ultimately required to establish a specific diagnosis. Imaging is of paramount importance even in the long-term follow-up in order to assess any residual tumor when surgical resection is incomplete, to assess the efficacy of adjuvant chemotherapy and radiotherapy, and to detect recurrence.
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Affiliation(s)
- Andrea Sambri
- University of Bologna, Bologna, Italy.,IRCCS Azienda Ospedaliero Universitaria Policlinico di Sant’Orsola, Bologna, Italy
| | | | | | | | | | - Maria Pilar Aparisi Gomez
- Department of Radiology, Auckland City Hospital; 2 Park Road, Grafton, 1023 Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre; Calle Valle de la Ballestera, 59, 46015 Valencia, Spain
| | - Paula Musa Aguiar
- Serdil, Clinica de Radiologia e Diagnóstico por Imagem; R. São Luís, 96 - Santana, Porto Alegre - RS, 90620-170. Brazil
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Musa Aguiar P, Zarantonello P, Aparisi Gómez MP. Differentiation Between Osteoporotic And Neoplastic Vertebral Fractures: State Of The Art And Future Perspectives. Curr Med Imaging 2021; 18:187-207. [PMID: 33845727 DOI: 10.2174/1573405617666210412142758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/22/2022]
Abstract
Vertebral fractures are a common condition, occurring in the context of osteoporosis and malignancy. These entities affect a group of patients in the same age range; clinical features may be indistinct and symptoms non-existing, and thus present challenges to diagnosis. In this article, we review the use and accuracy of different imaging modalities available to characterize vertebral fracture etiology, from well-established classical techniques, to the role of new and advanced imaging techniques, and the prospective use of artificial intelligence. We also address the role of imaging on treatment. In the context of osteoporosis, the importance of opportunistic diagnosis is highlighted. In the near future, the use of automated computer-aided diagnostic algorithms applied to different imaging techniques may be really useful to aid on diagnosis.
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Affiliation(s)
- Paula Musa Aguiar
- Serdil, Clinica de Radiologia e Diagnóstico por Imagem; R. São Luís, 96 - Santana, Porto Alegre - RS, 90620-170. Brazil
| | - Paola Zarantonello
- Department of paediatric orthopedics and traumatology, IRCCS Istituto Ortopedico Rizzoli; Via G. C. Pupilli 1, 40136 Bologna. Italy
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16
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Paixao C, Lustig JP, Causeret S, Chaigneau L, Danner A, Aubry S. Tumors and pseudotumors of the soft tissues: Imaging semiology and strategy. J Clin Imaging Sci 2021; 11:13. [PMID: 33767905 PMCID: PMC7981940 DOI: 10.25259/jcis_135_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 02/17/2021] [Indexed: 11/26/2022] Open
Abstract
The aims of this educational review are to learn the semiological basis of soft-tissue lesions and, with the help of diagnostic algorithms, to apply the current recommendations for the management of soft-tissue tumors. Pseudotumors must first be identified and excluded. Among primary tumors, the search for macroscopic fat content on MRI is decisive; since it restricts the diagnostic range to adipocytic tumors. Key imaging features of non-adipocytic tumors are highlighted. When a deep soft-tissue mass is found, therapeutic abstention or simple monitoring is only appropriate when there is diagnostic certainty: This is only the case for typical pseudotumors, typical benign tumors, and fat tumors without atypical criteria. In all other cases, histological evidence is required. If there is any suspicion of soft-tissue sarcoma or any undetermined lesion, the patient should be referred to a sarcoma referral center before biopsy.
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Affiliation(s)
- Charlinne Paixao
- Department Radiology, Musculoskeletal Imaging Unit, CHU Besancon, Besancon, France
| | - Jean-Philippe Lustig
- Department Radiology, Musculoskeletal Imaging Unit, CHU Besancon, Besancon, France
| | - Sylvain Causeret
- Department of Surgery, CHU Dijon, Centre Georges-François Leclerc, Dijon, France
| | - Loic Chaigneau
- Department of Oncology, CHU Besancon, CHU de Besancon, Besancon, France
| | - Alexis Danner
- Department Radiology, Musculoskeletal Imaging Unit, CHU Besancon, Besancon, France
| | - Sebastien Aubry
- Department Radiology, Musculoskeletal Imaging Unit, CHU Besancon, Besancon, France
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17
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Liu X, Su Y, Jiang M, Fang S, Huang Y, Li Y, Zhong S, Wang Y, Zhang S, Wu Y, Sun J, Fan X, Zhou H. Application of Magnetic Resonance Imaging in the Evaluation of Disease Activity in Graves' Ophthalmopathy. Endocr Pract 2020; 27:198-205. [PMID: 33658136 DOI: 10.1016/j.eprac.2020.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/01/2020] [Accepted: 09/17/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate magnetic resonance imaging parameters, T2 signal intensity ratios (SIRs), and normalized apparent diffusion coefficients (n-ADC) of the extraocular muscles (EOMs) in the identification of different stages of Graves' ophthalmopathy (GO) and to find out the correlation of T2-SIRs and n-ADC values with disease changes after anti-inflammatory treatment. METHODS Altogether, 43 patients (86 orbits) were enrolled and classified into "active" or "inactive" stages by clinical activity score (CAS). Twenty-three (53.5%) patients received anti-inflammatory treatment and underwent a follow-up evaluation. Fifteen age- and gender-matched control participants (30 orbits) were included. T2-SIRs and n-ADC values of EOMs were calculated among GO and healthy controls and were correlated with CAS. Changes in these parameters were also evaluated before and after anti-inflammatory treatment. RESULTS Mean T2-SIRs and n-ADC values were both significantly higher in GO patients than in controls and higher in active GO than in inactive GO. In the inactive stage, n-ADC values of inferior rectus muscles were still higher than those in healthy controls. Both T2-SIRs and n-ADC values decreased after intravenous steroid pulse therapy. The cutoff value of pretreatment n-ADC was 1.780 to detect stages with specificity of 93.7% and sensitivity of 48.3% (P = .035). CONCLUSION T2-SIRs and n-ADC values are valuable magnetic resonance imaging indicators of the inflammatory activity in GO by detecting involvement of EOMs. They are also ideal tools to monitor the efficacy of anti-inflammatory treatment in patients with active stage GO. n-ADC values, when combined with CAS, can be promising predictive factors in the detection of stages of diseases.
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Affiliation(s)
- Xingtong Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Yun Su
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011
| | - Sijie Fang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Yazhuo Huang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Yinwei Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Sisi Zhong
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Yang Wang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Shuo Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Yu Wu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011
| | - Jing Sun
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011.
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011.
| | - Huifang Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011.
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Zeitoun R, Khafagy SM, Mahmoud IH, El-Wahab NMA. Radiological evaluation of deep soft tissue fibromatosis, the characteristic MR criteria on conventional and corresponding diffusion-weighted images. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-019-0097-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To analyze the characteristic features of deep fibromatosis on conventional and diffusion-weighted MR images.
Result
The lesions were growing along the musculoaponeurotic fascia, mostly invaded the muscles, and showed ill-defined margins, low T2 signal bands and areas, and facial tail sign. Diffusion images showed mostly high or high mixed with low signal; only 2 lesions showed a persistent low signal. The average mean and minimum ADC values were 1.41 ± 0.26 × 10−3 mm2/s and 0.79 ± 0.43 × 10−3 mm2/s respectively. Post-contrast and DWI detected synchronous lesions and extensions missed on T1 and T2 images.
Conclusion
The most frequent MR features of deep fibromatosis are low T2 signal bands and areas, fascial tail sign, ill or partially defined margins, and predominant restricted diffusion pattern in addition to areas of “T2-blackout effect.” Post-contrast and DWI are more valuable in local staging of the tumor.
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Moustafa AFI, Eldaly MM, Zeitoun R, Shokry A. Is MRI diffusion-weighted imaging a reliable tool for the diagnosis and posttherapeutic follow-up of extremity soft tissue neoplasms? Indian J Radiol Imaging 2019; 29:378-385. [PMID: 31949339 PMCID: PMC6958890 DOI: 10.4103/ijri.ijri_146_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/19/2019] [Accepted: 11/30/2019] [Indexed: 11/04/2022] Open
Abstract
Abstract
Purpose: The aim of this study was to evaluate the benefit of using quantitative diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in the initial diagnosis and post-therapeutic follow-up of extremity soft tissue masses. Patients and Methods: This study included 90 patients with extremity soft tissue masses. The DWI was obtained with 3 b values, including 0, 400, and 800 s/mm2. Calculation of the ADC value of the lesion was done by placing the region of interest (ROI) to include the largest area of the lesion. ADC values were compared with the histopathology. Eighteen patients had posttherapeutic magnetic resonance imaging (MRI). Results: Benign masses, fibromatosis, and malignant soft tissue masses had mean ADC values of 1.18 ± 1.0191 × 10−3 mm2/s; 1.31 ± 0.245 × 10−3 mm2/sec; and 1.3 ± 0.7 × 10−3 mm2/s, respectively. Myxomatous malignant masses had an ADC value of 2.6 ± 0.55 × 10−3 mm2/s, while nonmyxomatous malignant masses had an ADC value of 1.1 ± 0.8 × 10−3 mm2/s. ADC cutoff value between benign and non-benign (including malignant and locally aggressive masses) was 0.6 × 10−3 mm2/sec with 98.3% sensitivity and 50% specificity (P = 0.5123). The statistical difference between malignant soft tissue masses (mean ADC 1.309 ± 0.723 × 10−3 mm2/s) and fibromatosis masses (mean ADC value 1.31 ± 0.245 × 10−3 mm2/s) using a comparative T-test proved to be of poor significance level (P value ~ 0.9757). Nine patients with soft tissue sarcomas (STSs) had pre and post-therapeutic MRI examinations showing a mean increase of the recorded ADC values by about 0.28 × 10−3 mm2/s in the post-therapy study as compared with the recorded initial pretreatment values. Analysis of the post-therapy follow-up studies of fibromatosis showed that lesions with favorable response to chemotherapy or radiotherapy (8/12) exhibited significantly lower ADC values than those showing progressive disease course. Conclusion: DWI with ADC mapping of extremity soft tissue tumors are so complicated that they alone may not be of much value in differentiating between benign and malignant tumors; however, it can be used as a tool for monitoring response to treatment.
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Affiliation(s)
| | - Mai Maher Eldaly
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University
| | - Rania Zeitoun
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Cairo University, Egypt
| | - Ahmed Shokry
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University
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20
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Nocerino EA, Aliprandi A, Tavana R, Mazzoni S, Di Leo G, Genovese EA. Evaluation of muscle tears in professional athletes using diffusion-weighted imaging and apparent diffusion coefficient: preliminary results. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:238-244. [PMID: 31580309 PMCID: PMC7233753 DOI: 10.23750/abm.v90i3.7157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 07/20/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE Many studies have evaluated the role of DWI in musculoskeletal diseases but less is known on muscle tears. Especially for professional athletes, muscle injuries are responsible for large time lost. The aim of this study was to investigate on potential relationship between the muscle tear degree and the diffusion characteristics. METHODS In this retrospective study, patients signed a comprehensive consent form according to Good Clinical Practice guidelines before proceeding with all examinations. It satisfied all the requirements of the Declaration of Helsinki and the Italian national law for the protection of personal data. We have analyzed 38 professional athletes (36 males; mean age±standard deviation 27±8 years) with a muscle tear. They were 26 football and 12 athletics players, with clinically suspected injuries of the lower limbs muscles. All of patients underwent a 1.5-T MRI with standard protocol (STIR, TSE T2, SE T1, PD T2, PD fat sat T2) plus the DWI sequences with 0, 400 and 800 B-values (s/mm2). Per each B value, an experienced radiologist measured the signal intensity (SI, in arbitrary units [au]) using a region of interest (ROI) placed within the tear on DWI images. SI drop off at the third B value was calculated referred to the first B value. Similarly, ADC was measured using the ADC map in a small ROI within the tear. Bivariate associations were evaluated using the Student t test. Logistic regression was performed using the tear degree as dependent variable. Data were given as mean±standard deviation. RESULTS According the Muller-Wohlfarth classification, the 38 muscle tears were classified in type 3a in 22/38 cases and 3b in 16/38 cases. At bivariate analysis, 3a-tears had a SI at the third B value (24±9 au) lower (P=0.003) than that of 3b-tears (34±9 au). Similarly, 3a-tears had a SI drop off (73±10%) lower (P=0.008) than that of 3b-tears (82±9%). ADC was not significantly associated to tear degree (P=0.093). At regression analysis, SI at the third B value was the only independent predictor of the tear degree (P=0.032), while the SI drop off was borderline significant (P=0.070). CONCLUSION This preliminary data showed a positive correlation between the degree of muscle tears and the SI at the third B-value. Compared to 3a- tears, 3b-tears tend to show higher SI and a higher SI drop off.
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Tomas X, Milisenda JC, Garcia-Diez AI, Prieto-Gonzalez S, Faruch M, Pomes J, Grau-Junyent JM. Whole-body MRI and pathological findings in adult patients with myopathies. Skeletal Radiol 2019; 48:653-676. [PMID: 30377729 DOI: 10.1007/s00256-018-3107-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/12/2018] [Accepted: 10/22/2018] [Indexed: 02/08/2023]
Abstract
Magnetic resonance imaging (MRI) is considered the most sensitive and specific imaging technique for the detection of muscle diseases related to myopathies. Since 2008, the use of whole-body MRI (WBMRI) to evaluate myopathies has improved due to technical advances such as rolling table platform and parallel imaging, which enable rapid assessment of the entire musculoskeletal system with high-quality images. WBMRI protocols should include T1-weighted and short-tau inversion recovery (STIR), which provide the basic pulse sequences for studying myopathies, in order to detect fatty infiltration/muscle atrophy and muscle edema, respectively. High signal intensity in T1-weighted images shows chronic disease with fatty infiltration, whereas high signal intensity in STIR indicates an acute stage with muscle edema. Additional sequences such as diffusion-weighted imaging (DWI) can be readily incorporated into routine WBMRI study protocols. Contrast-enhanced sequences have not been done. This article reviews WBMRI as an imaging method to evaluate different myopathies (idiopathic inflammatory, dystrophic, non-dystrophic, metabolic, and channelopathies). WBMRI provides a comprehensive estimate of the total burden with a single study, seeking specific distribution patterns, including clinically silent involvement of muscle areas. Furthermore, WBMRI may help to select the "target muscle area" for biopsy during patient follow-up. It may be also be used to detect related and non-related pathological conditions, such as tumors.
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Affiliation(s)
- Xavier Tomas
- Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain.
| | - Jose Cesar Milisenda
- Department of Internal Medicine, Hospital Clinic, Universitat de Barcelona (UB) and CIBERER, Villarroel 170, 08036, Barcelona, Spain
| | - Ana Isabel Garcia-Diez
- Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Sergio Prieto-Gonzalez
- Department of Autoimmune Diseases, Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Marie Faruch
- Department of Radiology, Hopital Purpan, Centre Hospitalier Universitaire (CHU), Place du Docteur Baylac TSA 40031, 31059, Toulouse cedex 9, France
| | - Jaime Pomes
- Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Josep Maria Grau-Junyent
- Department of Internal Medicine, Hospital Clinic, Universitat de Barcelona (UB) and CIBERER, Villarroel 170, 08036, Barcelona, Spain
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22
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Faruch M, Garcia AI, Del Amo M, Pomes J, Isern J, González SP, Grau JM, Milisenda JC, Tomas X. Diffusion‐weighted magnetic resonance imaging is useful for assessing inflammatory myopathies. Muscle Nerve 2019; 59:555-560. [DOI: 10.1002/mus.26438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Marie Faruch
- Radiology Department, CHU Toulouse PurpanPlace du docteur Baylac 31059, Toulouse France
| | - Ana Isabel Garcia
- Muscle Research Unit, Radiology Department. Hospital Clínic de BarcelonaUniversidad de Barcelona Villarroel, 170, 08036, Barcelona Spain
| | - Montse Del Amo
- Muscle Research Unit, Radiology Department. Hospital Clínic de BarcelonaUniversidad de Barcelona Villarroel, 170, 08036, Barcelona Spain
| | - Jaume Pomes
- Muscle Research Unit, Radiology Department. Hospital Clínic de BarcelonaUniversidad de Barcelona Villarroel, 170, 08036, Barcelona Spain
| | - Jaime Isern
- Muscle Research Unit, Radiology Department. Hospital Clínic de BarcelonaUniversidad de Barcelona Villarroel, 170, 08036, Barcelona Spain
| | - Sergio Prieto González
- Muscle Research Unit, Internal Medicine Service, Hospital Clínic de BarcelonaUniversidad de Barcelona and CIBERER Villarroel, 170, 08036, Barcelona Spain
| | - Josep María Grau
- Muscle Research Unit, Internal Medicine Service, Hospital Clínic de BarcelonaUniversidad de Barcelona and CIBERER Villarroel, 170, 08036, Barcelona Spain
| | - José César Milisenda
- Muscle Research Unit, Internal Medicine Service, Hospital Clínic de BarcelonaUniversidad de Barcelona and CIBERER Villarroel, 170, 08036, Barcelona Spain
| | - Xavier Tomas
- Muscle Research Unit, Radiology Department. Hospital Clínic de BarcelonaUniversidad de Barcelona Villarroel, 170, 08036, Barcelona Spain
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Fukuda T, Wengler K, de Carvalho R, Boonsri P, Schweitzer ME. MRI biomarkers in osseous tumors. J Magn Reson Imaging 2019; 50:702-718. [PMID: 30701624 DOI: 10.1002/jmri.26672] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 12/12/2022] Open
Abstract
Although radiography continues to play a critical role in osseous tumor assessment, there have been remarkable advances in cross-sectional imaging. MRI has taken a lead in this assessment due to high tissue contrast and spatial resolution, which are well suited for bone lesion assessment. More recently, although somewhat lagging other organ systems, quantitative parameters have shown promising potential as biomarkers for osseous tumors. Among these sequences are chemical shift imaging (CSI), apparent diffusion coefficient (ADC), and intravoxel incoherent motion (IVIM) from diffusion-weighted imaging (DWI), quantitative dynamic contrast enhanced (DCE)-MRI, and magnetic resonance spectroscopy (MRS). In this article, we review the background and recent roles of these quantitative MRI biomarkers for osseous tumors. Level of Evidence: 3 Technical Efficacy Stage: 3 J. MAGN. RESON. IMAGING 2019. J. Magn. Reson. Imaging 2019;50:702-718.
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Affiliation(s)
- Takeshi Fukuda
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Kenneth Wengler
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Ruben de Carvalho
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Pattira Boonsri
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Mark E Schweitzer
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
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Lee K, Park HY, Kim KW, Lee AJ, Yoon MA, Chae EJ, Lee JH, Chung HW. Advances in whole body MRI for musculoskeletal imaging: Diffusion-weighted imaging. J Clin Orthop Trauma 2019; 10:680-686. [PMID: 31316239 PMCID: PMC6611843 DOI: 10.1016/j.jcot.2019.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/07/2023] Open
Abstract
Recent advances in imaging technology have enabled the acquisition of anatomical and functional imaging from head to toe in a reasonably short scan time. Accordingly, whole body magnetic resonance imaging (WB-MRI) and diffusion-weighted imaging (WB-DWI) have gained recent attention for the management of musculoskeletal problems such as bone tumors and rheumatologic diseases. WB-MRI is especially useful in diagnosing systemic or widespread disease requiring whole body evaluation, such as bone metastases, multiple myeloma, lymphoma, neurofibromatosis, and spondyloarthropathies. Among WB-MRI sequences, the WB-DWI technique greatly increases the value of WB-MRI in the evaluation of disease extent and characterization as well as treatment monitoring. In support of the utilization of WB-MRI and WB-DWI in orthopedic clinics for various musculoskeletal diseases, we provide an overview of the technical aspects of WB-MRI and WB-DWI and their clinical applications in musculoskeletal tumors and rheumatic diseases.
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Affiliation(s)
- Koeun Lee
- Asan Image Metrics, Clinical Trial Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Young Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Asan Image Metrics, Clinical Trial Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea,Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea,Corresponding author. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Amy Junghyun Lee
- Asan Image Metrics, Clinical Trial Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Min A. Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun Jin Chae
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hye Won Chung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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[Postoperative and posttherapeutic changes after primary bone tumors : What's important for radiologists?]. Radiologe 2017; 57:938-957. [PMID: 28986639 DOI: 10.1007/s00117-017-0304-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Posttreatment imaging of primary bone tumours represents a diagnostic challenge for radiologists. Depending on the primary bone tumour common radiological procedures, such as radiography, computed tomography (CT), and magnetic resonance imaging (MRI), are employed. Radiography and CT are particularly useful in benign bone tumours and in matrix-forming bone tumours. MRI comes into consideration with malignant tumour recurrence and tumoral soft tissue infiltration. Bone scintigraphy is of superior importance if a primarily multifocal manifestation of bone tumour or metastasizing tumour disease is suspected. Molecular imaging (FDG-PET and hybrid imaging, using CT) are gaining increasing importance in light of monitoring neoadjuvant chemotherapy and detecting recurrent tumour appearance. The current literature shows sensitivity and specificity values for recurrent detection of up to 92% and 93%. Diagnostic accuracy is as high as 95%, thus, exceeding accuracy values for CT (67%) and MRI (86%) by far. Likewise, this is also applicable for the assessment of the neoadjuvant chemotherapy. Moreover, PET-based modalities are able to establish prognostic statements using SUV-threshold values at baseline (especially for Ewing sarcomas). Advanced imaging techniques have made a great diagnostic step forward and have proven to be relevant and reproducible with respect to both relapse detection and treatment assessment. Furthermore, it is not clear whether a higher detection rate of early tumour recurrence will inevitably lead to better outcome and survival.
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Barat M, Dohan A, Dautry R, Barral M, Boudiaf M, Hoeffel C, Soyer P. Mass-forming lesions of the duodenum: A pictorial review. Diagn Interv Imaging 2017; 98:663-675. [PMID: 28185840 DOI: 10.1016/j.diii.2017.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 02/07/2023]
Abstract
Recent advances in imaging have resulted in marked changes in the investigation of the duodenum, which still remains primarily evaluated with videoendoscopy. However, improvements in computed tomography (CT) and magnetic resonance (MR) imaging have made detection and characterization of duodenal mass-forming abnormalities easier. The goal of this pictorial review was to illustrate the most common conditions of the duodenum that present as mass-forming lesions with a specific emphasis on CT and MR imaging. MR imaging used in conjunction with duodenal distension appears as a second line imaging modality for the characterization of duodenal mass-forming lesions. CT remains the first line imaging modality for the detection and characterization of a wide range of duodenal mass-forming lesions.
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Affiliation(s)
- M Barat
- Department of Radiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - A Dohan
- Department of Radiology, McGill University Health Centre, Montreal General and Royal Victoria Hospitals, Montreal, Canada.
| | - R Dautry
- Department of Radiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - M Barral
- Department of Radiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - M Boudiaf
- Pôle santé du plateau, 3/5, avenue de Villacoublay, 92360 Meudon-La-Forêt, France.
| | - C Hoeffel
- Department of Radiology, hôpital Robert-Debré, 11, boulevard Pasteur, 51092 Reims, France.
| | - P Soyer
- Medicine department, Université Paris-Diderot, Sorbonne Paris Cité, 10, avenue de Verdun, 75010 Paris, France.
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Keser N, Atici A, Celikoglu E, Akpinar P, Ramazanoglu AF, Aktas İ. Effect of bone mineral density on lumbar discs in young adults: A case-control study. Medicine (Baltimore) 2017; 96:e7906. [PMID: 28858108 PMCID: PMC5585502 DOI: 10.1097/md.0000000000007906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Bone mineral density (BMD) might be a risk factor for lumbar disc herniation (LDH) in young adults, but there is not enough data concerning this effect. Several studies have been performed on elderly and osteoporotic patients. Thus, we aimed to investigate the effect of BMD on the etiopathogenesis of LDH in young adults.One hundred patients (mean age: 38.45 ± 8.92 years; 50 men and 50 women) were enrolled this case-control study and classified into 2 groups, as follows. The case group (G-I) included 50 patients with symptomatic LDH who were hospitalized in the Physical Medicine and Rehabilitation Clinic, and the control group (G-II) included 50 patients with lower back pain but no finding of LDH detected using magnetic resonance imaging. Patients in the G-II were recruited among those admitted to the outpatient clinic at the time of the study, and whose age and sex were matched to those of the study group. Women in menopause were excluded from the study. BMD analysis by dual energy x-ray absorptiometry was performed in both groups.The mean values of the femur neck and lumbar spine BMD were 1.02 ± 0.13 and 1.19 ± 0.14 g/cm, respectively. There was no statistically significant relationship between BMD and LDH in this population.This result may mean that in a normal range, BMD does not exert a compressive load on the lumbar discs in young adults and therefore may not lead to LDH by this mechanism and the load.
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Affiliation(s)
| | - Arzu Atici
- Physical Medicine and Rehabilitation Department, TR University of Health Sciences, Istanbul Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | | | - Pinar Akpinar
- Physical Medicine and Rehabilitation Department, TR University of Health Sciences, Istanbul Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | | | - İlknur Aktas
- Physical Medicine and Rehabilitation Department, TR University of Health Sciences, Istanbul Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
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Gondim Teixeira PA, Bravetti M, Hossu G, Lecocq S, Petit D, Loeuille D, Blum A. Protocol optimization of sacroiliac joint MR Imaging at 3 Tesla: Impact of coil design and motion resistant sequences on image quality. Diagn Interv Imaging 2017; 98:865-871. [PMID: 28739431 DOI: 10.1016/j.diii.2017.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the impact of coil design and motion-resistant sequences on the quality of sacroiliac magnetic resonance imaging (MRI) examination in patients with spondyloarthropathy. PATIENTS AND METHODS One hundred and twenty-one patients with suspected sacroiliitis and referred for MRI of the sacroiliac joints were retrospectively evaluated with MRI at 3-Tesla. There were 78 women and 43 men with a mean age of 36.7±11.5 (SD) years (range: 15.8-78.4 years). Conventional and motion-resistant fat-saturated fast-spin echo T2-weighted sequences were performed with two different coils. Image quality was subjectively evaluated by two independent readers (R1 and R2) using a four-point scale. Confidence in the identification of bone marrow edema pattern (BMEP) was also evaluated subjectively using a three-point scale. RESULTS Phased array body coil yielded improved image quality compared to surface coil (14.1 to 30.4% for R1 and 14.6 to 25.7% for R2; P<0.0001). The impact of the sequence type on quality was also statistically significant (P=0.0046). BMEP was identified in 40 patients and best inter-reader agreement was obtained using the combination of phased-array body coil with motion-resistant T2-weighted sequence (kappa 0.990). The smallest number of indeterminate BMEP zones was seen on MRI set acquired with the phased-array body coil and motion-resistant T2-weighted sequence. CONCLUSION Phased array body coil and motion-resistant T2-weighted sequences perform better than surface coil and conventional T2-weighted sequences for the evaluation of sacroiliac joints, increasing confidence in the identification of BMEP.
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Affiliation(s)
- P A Gondim Teixeira
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - M Bravetti
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - G Hossu
- Université de Lorraine, IADI, U947, 54505 Vandœuvre-Lès-Nancy, France.
| | - S Lecocq
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - D Petit
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - D Loeuille
- Department of Rhumatology, CHRU de Nancy, Brabois adultes, rue du Morvan, 54500 Vandœuvre-Lès-Nancy, France.
| | - A Blum
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
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Cruypeninck Y, Dubourg B, Michelin P, Godin B, Savoye-Collet C, Gérardin E, Dacher JN. Pacemakers and MRI: A protocol in line with international guidelines and approved by the SFICV (French Society of Cardiovascular Imaging). Diagn Interv Imaging 2017; 98:203-215. [DOI: 10.1016/j.diii.2016.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/12/2016] [Accepted: 06/13/2016] [Indexed: 10/20/2022]
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Diagnostic performance of diffusion-weighted MR imaging in differentiation of diabetic osteoarthropathy and osteomyelitis in diabetic foot. Eur J Radiol 2017; 89:221-225. [PMID: 28267543 DOI: 10.1016/j.ejrad.2017.02.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/09/2017] [Accepted: 02/12/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE To study the diagnostic performance of diffusion weighted MR imaging in differentiation of diabetic osteoarthropathy and osteomyelitis in diabetic foot. PATIENTS AND METHODS This prospective study was carried out on 41 patients with diabetic foot, 22 males and 19 females with mean age of 51 years. They underwent diffusion-weighted MR imaging of the foot. The apparent diffusion coefficient (ADC) values of the bony lesions were calculated by two reviewers and correlated with the surgical findings or biopsy. The kappa statistic (k) was used to estimate the proportion of inter-observer agreement of two reviewers. RESULTS The mean ADC of acute diabetic osteoarthropathy was 1.27±0.19×10-3mm2/s for reviewer 1 and 1.26±0.21×10-3mm2/s for reviewer 2. The mean ADC value in diabetic osteomyelitis was 0.86±0.11×10-3mm2/s for reviewer 1 and 0.85±0.12×10-3mm2/s for reviewer 2. There was excellent inter-observer agreement of ADC value of bony lesions in diabetic foot by both reviewers (K=0.93). There was statistically significant difference in the ADC values of both groups (P=0.001). The cut-off point of ADC value of both reviewers used in differentiating acute diabetic osteoarthropathy and osteomyelitis were 0.98×10-3mm2/s and 1.04×10-3mm2/s with an accuracy of 94% and 93% and area under the curve of 0.94 and 0.93 respectively. CONCLUSION We conclude that the ADC value is a non-invasive imaging parameter that can help in differentiation of diabetic osteoarthropathy from osteomyelitis with excellent inter-observer agreement.
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Gondim Teixeira PA, Savi de Tové KM, Abou Arab W, Raymond A, Louis M, Polet Lefebvre K, Blum A. Subchondral linear hyperintensity of the femoral head: MR imaging findings and associations with femoro-acetabular joint pathology. Diagn Interv Imaging 2016; 98:245-252. [PMID: 27401501 DOI: 10.1016/j.diii.2016.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/09/2016] [Accepted: 06/14/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE The goal of this study was to evaluate the associations between linear hyperintensity in the subchondral bone of the femoral head on T2-weighted MR imaging and structural bone lesions. MATERIAL AND METHODS The MR imaging examinations of 63 patients (66 hips) that showed a bone marrow edema pattern (BMEP) of the hip were retrospectively evaluated (study group). The study group comprised 43 men and 20 women, with a mean age of 55.3 years±16.9 (SD) (range: 19-84 years). A control group of 61 patients (77 hips) without BMEP of the hip on MR imaging was created. The control group comprised 30 men and 31 women, with a mean age of 53.1 years±15.6 (SD) (range: 25-83 years). The presence of linear abnormalities of the subchondral bone on T2-weighted fat-saturated sequences (TR/TE=4220-4340/42-45ms) was evaluated and MR imaging findings were correlated with structural femoro-acetabular pathology (advanced chondropathy, osteonecrosis, subchondral insufficiency fractures and macroscopic fractures) and with pain duration. RESULTS A linear hyperintensity in the subchondral bone on T2-weighted MR imaging was found in 43/66 hips with areas of BMEP (65.1%) and in 3/77 hips without BMEP (3.8%). Subchondral linear hyperintensity was seen in 15/16 (93.7%) hips with a subchondral insufficiency fracture. Among the 16 hips with an ARCO stage III osteonecrosis, 13 (76.9%) presented BMEP associated with a subchondral linear hyperintensity. BMEP was present in 6/8 hips with ARCO stage IV osteonecrosis; however, only two hips (25%) exhibited subchondral linear hyperintensities. Finally, 77.7% of patients with subchondral linear hyperintensities presented with acute or subacute hip pain (P<0.0001). CONCLUSION Femoral head subchondral linear hyperintensity on T2-weighted MR imaging is common and is associated with acute subchondral bone damage.
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Affiliation(s)
- P A Gondim Teixeira
- Guilloz Department of Imaging, Hôpital Central, CHU de Nancy, 29, avenue Maréchal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - K-M Savi de Tové
- University of Medicine, Université de Parakou, P.O. Box 02, Parakou, Benin
| | - W Abou Arab
- Guilloz Department of Imaging, Hôpital Central, CHU de Nancy, 29, avenue Maréchal-Lattre-de-Tassigny, 54035 Nancy, France
| | - A Raymond
- Guilloz Department of Imaging, Hôpital Central, CHU de Nancy, 29, avenue Maréchal-Lattre-de-Tassigny, 54035 Nancy, France
| | - M Louis
- Guilloz Department of Imaging, Hôpital Central, CHU de Nancy, 29, avenue Maréchal-Lattre-de-Tassigny, 54035 Nancy, France
| | - K Polet Lefebvre
- Service d'imagerie médicale de femme et périnatale, Maternité Universitaire Régionale, 54035 Nancy, France
| | - A Blum
- Guilloz Department of Imaging, Hôpital Central, CHU de Nancy, 29, avenue Maréchal-Lattre-de-Tassigny, 54035 Nancy, France
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Pialat JB, Di Marco L, Feydy A, Peyron C, Porta B, Himpens PH, Ltaief-Boudrigua A, Aubry S. Sacroiliac joints imaging in axial spondyloarthritis. Diagn Interv Imaging 2016; 97:697-708. [DOI: 10.1016/j.diii.2016.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/23/2016] [Indexed: 02/08/2023]
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Sutter O, Soyer P, Shotar E, Dautry R, Guerrache Y, Placé V, Opréa R, Ricbourg A, Le Dref O, Boudiaf M, Sirol M, Dohan A. Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization. Eur Radiol 2016; 26:3558-70. [DOI: 10.1007/s00330-016-4210-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 11/29/2022]
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Lesieur E, Menager N, Delagausie P, Verschuur A, Bretelle F, Coze C, Scavarda D, Guidicelli B, Gorincour G. Fetal paravertebral congenital fibrosarcoma: MR imaging findings. Diagn Interv Imaging 2015; 97:483-5. [PMID: 26711551 DOI: 10.1016/j.diii.2015.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- E Lesieur
- Hôpital La Conception, Department of Gynecology and Obstetrics, 147, boulevard Baille, 13385 Marseille cedex 5, France; Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - N Menager
- Department of Gynecology and Obstetrics, 305, rue Raoul-Follereau, 84902 Avignon, France
| | - P Delagausie
- Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Children's Hospital La Timone, Department of Pediatric Surgery, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - A Verschuur
- Children's Hospital La Timone, Department of Pediatric Oncology, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - F Bretelle
- Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Hôpital Nord, Department of Gynecology and Obstetrics, chemin des Bourrely, 13015 Marseille, France
| | - C Coze
- Children's Hospital La Timone, Department of Pediatric Oncology, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - D Scavarda
- Chidren's Hospital La Timone, Department of Neurosurgery, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - B Guidicelli
- Hôpital La Conception, Department of Gynecology and Obstetrics, 147, boulevard Baille, 13385 Marseille cedex 5, France; Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - G Gorincour
- Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Children's Hospital La Timone, Department of Pediatric Imaging, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Li XF, Yang Y, Lin CB, Xie FR, Liang WG. Assessment of the diagnostic value of diffusion tensor imaging in patients with spinal cord compression: a meta-analysis. ACTA ACUST UNITED AC 2015; 49:e4769. [PMID: 26628393 PMCID: PMC4681415 DOI: 10.1590/1414-431x20154769] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/23/2015] [Indexed: 12/26/2022]
Abstract
We investigated the diagnostic value of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging (DTI) in patients with spinal cord compression (SCC) using a meta-analysis framework. Multiple scientific literature databases were exhaustively searched to identify articles relevant to this study. Mean values and standardized mean differences (SMDs) were calculated for the ADC and FA in normal and diseased tissues. The STATA version 12.0 software was used for statistical analysis. Of the 41 articles initially retrieved through database searches, 11 case-control studies were eligible for the meta-analysis and contained a combined total of 645 human subjects (394 patients with SCC and 251 healthy controls). All 11 studies reported data on FA, and 9 contained data related to the ADC. The combined SMDs of the ADC and FA showed that the ADC was significantly higher and the FA was lower in patients with SCC than in healthy controls. Subgroup analysis based on the b value showed higher ADCs in patients with SCC than in healthy controls at b values of both ≤500 and >500 s/mm2. In summary, the main findings of this meta-analysis revealed an increased ADC and decreased FA in patients with SCC, indicating that DTI is an important diagnostic imaging tool to assess patients suspected to have SCC.
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Affiliation(s)
- X F Li
- Department of Spine Surgery, Guangxi Orthopaedics and Traumatology Hospital, Nanning, China
| | - Y Yang
- Department of Spine Surgery, Guangxi Orthopaedics and Traumatology Hospital, Nanning, China
| | - C B Lin
- Department of Spine Surgery, Guangxi Orthopaedics and Traumatology Hospital, Nanning, China
| | - F R Xie
- Department of Spine Surgery, Guangxi Orthopaedics and Traumatology Hospital, Nanning, China
| | - W G Liang
- Department of Spine Surgery, Guangxi Orthopaedics and Traumatology Hospital, Nanning, China
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