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Posts Tagged ‘MRI’

MRI findings of fascia/muscle implication do not forecast clinical outcome in children with newly diagnosed juvenile dermatomyositis.

Irregular subcutaneous fat signal have vital relation with a more belligerent chronic disease course.

The medical research study was conducted by Patricia E. Ladd, Kathleen H. Emery, Shelia R. Salisbury, Tal Laor, Daniel J. Lovell and Kevin E. Bove from Department of Pediatric Radiology; Division of Biostatistics and Epidemiology; Division of Pediatric Rheumatology; Department of Pediatric Pathology (Cincinnati Children’s Hospital Medical Center, Cincinnati, OH), and Northwest Radiology, Indianapolis, IN.

The study is available in American Journal of Roentgenology. The clinical procedure of juvenile dermatomyositis (JDMS) is not capable of being foretold. Magnetic resonance imaging is utilized to decide muscle biopsy region, and to supervise disease activity. It is not known, if soft-tissue features on MRI acquired at diagnosis mutually relate with clinical outcome. The objective of this study was to decide, if primary MRI findings in the thighs and pelvis in children with juvenile dermatomyositis can foretell clinical disease route.

About 45 children with mean age of 6 years with biopsy proven, clinically diagnosed JDMS, and at the least 2 years of clinical continuation were comprised. As per Crowe clinical classification scheme, clinical outcome was classified as chronic/limited disease.

For reticulated signal changes in subcutaneous fat, and signal abnormalities of muscle and fascia, pre-treatment MRI examinations of the thighs and pelvis were assessed, and relation with clinical outcome were reviewed.

Of the result, 23 had chronic, while 22 patients had limited disease. The signal intensity varied from normal (n=3) to excessively increased in all muscle divisions (n=17). Fascial and muscle connection were not related with clinical outcome. Managing for continuance of symptoms, the altered difference of advancement to chronic disease were higher for patients with unusual subcutaneous fat signal, in comparison to other with normal fat signal.

Conclusion: MRI findings of fascia/muscle implication do not forecast clinical outcome in children with newly identified JDMS. Irregular subcutaneous fat signal seems to have vital relation with a more belligerent chronic disease route.

Apparent diffusion coefficient (ADC) values are not beneficial in determining adrenal lesions.

ADC values used to lesions with indeterminate signal intensity index may help in distinguishing a subset of malignant and benign lesions.

The medical research study was conducted by Kumaresan Sandrasegaran, Aashish A. Patel, Raja Ramaswamy, Victor P. Samuel, Benjamin G. Northcutt, Mark S. Frank and Isaac R. Francis from Department of Radiology, Indiana University School of Medicine, Indianapolis, IN; Department of Radiology, University of Michigan, Ann Arbor, MI.

The study is available in American Journal of Roentgenology, and the research objective was to evaluate the role of diffusion weighted MRI in distinguishing adrenal masses.

A retroactive examination of MRI database from August 2007-July 2009 was carried out. Independent blind comparison was done by two practiced abdominal radiologists on MRI data of about 48 patients, with lesions; they estimated the signal intensities on in-phase and opposed-phase T1-weighted imaging and apparent diffusion coefficient (ADC). Quantitative chemical shift imaging parameters and ADC measurements were evaluated individually, and in combination. When ADC was equal to/greater than 1.0 x 10–3 mm2/s, lesions with indeterminate signal intensity index (< 16.5%) were regarded benign; but when ADC was less than 1.0 x 10–3 mm2/s, it were considered malign. ROC (receiver operating characteristic) curve and logistic regression analysis were executed in a sequence of several stages.

About the results, apparent diffusion coefficient values could not be found valuable; there were 37 benign and 12 malignant lesions. On multivariate analysis (MVA), the notable forecasters of lesion status were signal intensity index from reader 2 (p = 0.05) and lesion size (p = 0.04).

On ROC curve analysis, there was no notable variance in region under the curve for apparent diffusion coefficient, signal-intensity index, adrenal-to-spleen chemical shift ratio, or the incorporated signal-intensity index and ADC evaluation.

For lesions with indeterminate signal intensity index, the apparent diffusion coefficient (ADC) values greater than 1.50 x 10–3 mm2/s were established only in benign lesions, and nine of 11 lesions with apparent diffusion coefficient less than 1.0 x 10–3 mm2/s were malignant.

Conclusion: Apparent diffusion coefficient (ADC) values are not valuable in ascertaining adrenal lesions. Though when ADC values are used to lesions with indeterminate signal intensity index, it may aid in discerning a subset of malignant and benign lesions.

Hypointense nodules with a maximal diameter not less than 15 mm frequently become hypervascular.

Due to high incidence of vascularization, patients with hypointense nodules distinguished by a maximum diameter of 15 mm or greater must be observed cautiously.

 

The medical research study was conducted by Takashi Kumada, Hidenori Toyoda, Toshifumi Tada, Yasuhiro Sone, Masashi Fujimori, Sadanobu Ogawa and Teruyoshi Ishikawa from Department of Gastroenterology; Department of Radiology; Department of Imaging Diagnosis, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.

The study is available in American Journal of Roentgenology, and the research objective was to ascertain if hypointense hepatocellular nodules perceived in the hepatobiliary phase of MRI enhanced with Gd-EOB-DTPA (Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic acid/Gadoxetate Disodium) advance to hypervascular hepatocellular carcinoma.

On 30 patients, gadoxetate disodium–enhanced magnetic resonance imaging was iterated: in the hepatobiliary phase 49 nodules decided to be hypointense, while in the arterial phase of dynamic MRI, it were nonenhancing.

The mutual relationship amongst features of hypointense nodules with inconsiderably/significantly low signal intensity in relation to ambient liver parenchyma and their advancement to hypervascular hepatocellular carcinoma was examined methodically, in case of cirrhotic livers. The patients passed through angiography-assisted Computed Tomography, in preference to MR imaging. Kaplan–Meier estimator was utilized for to determine the progression rate to classic hepatocellular carcinoma.

Six and twelve month cumulative statistics of vascularization were 27.6% and 43.5%. Cumulative statistics (6 and 12 month) of vascularized nodules with maximum diameter less than 15 mm were 16.9% and 16.9%, and maximum diameter 15 mm or greater were 43.3% and 77.3%, in the order given. The variance amongst relative frequency of occurrence was significant.

Conclusion: Hypointense nodules with a maximal diameter not less than 15 mm frequently become hypervascular. For the reason of high incidence of vascularization, patients with hypointense nodules distinguished by a maximum diameter of 15 mm or greater must be observed cautiously.

Mutually exclusive MR imaging criteria for diagnosing hepatocellular carcinoma in 1–2-cm nodules discovered at surveillance ultrasonography can enhance sensitivity, in comparison to AASLD.

 

The medical research study was conducted by Tae Kyoung Kim, MD, Kyoung Ho Lee, MD, Hyun–Jung Jang, MD, Masoom A. Haider, MD, Lindsay M. Jacks, MSc, Ravi J. Menezes, PhD, Seong Ho Park, MD, Leyla Yazdi, MD, Morris Sherman, MD and Korosh Khalili, MD from the Departments of Medical Imaging, Biostatistics, and Medicine, University of Toronto, Toronto General Hospital, ON, Canada; Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea; and Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

The study is available in online journal of Radiological Society of North America, and the research objective was to retrospectively recognize out MRI findings related with hepatocellular carcinoma (HCC) in 1–2-cm nodules discovered at close ultrasound observation, and to put forward newer MRI criteria.

Approved by institutional board and written consent from patients, 145 patients presented with newly detected 1-2 cm nodules went through gadobenate dimeglumine-enhanced MR imaging. After exclusion of unconfirmed nodules and hemangiomas, about 96 patients were continued through, with 116 nodules, inclusive of 73 benign nodules and 43 hepatocellular carcinomas. Signal intensity at every sequence were assessed by through MRI findings. Through with results of univariate and multivariate regression models, various analytical criteria were elaborated utilizing data set of MRI findings, which were then equated with practice guidelines of American Association for the Study of Liver Diseases (AASLD).

About the results, univariate analysis divulged subsequent findings related with hepatocellular carcinoma: arterial phase hyperintensity, hyperintense signal changes on T2-weighted images, portal venous/delayed hypointensity, and hepatobiliary-phase. In multivariate regression, portal/delayed phase hypointensity and arterial phase hyperintensity were related with hepatocellular carcinoma. Of the advanced criteria, with nodules befitting AASLD, or nodules with more than 3 findings were regarded as with sound judgment, demonstrating enhanced sensitivity, and equivalent specificity.

Conclusion: Mutually exclusive MRI criteria for analyzing hepatocellular carcinoma in 1-2 cm nodules recognized at close ultrasound observation can enhance sensitivity, in contrast to that with proposed AASLD practice guidelines. Further study is required to substantiate the denoting concept in this research study.

Three-dimensional late gadolinium enhancement MRI is feasible for assessment of transmurality and scar tissue mass in patients with acute or chronic myocardial infarction at considerably reduced acquisition times.

 

The medical research study was conducted by Robert Manka, MD, Robert Goetti, MD, Sebastian Kozerke, PhD, Olivio F. Donati, MD, Daniel Sürder, MD, Paul Stolzmann, MD, Philipp A. Kaufmann, MD, Thomas F. Lüscher, MD, Roberto Corti, MD from Department of Diagnostic Radiology, Department of Cardiac Imaging, and Cardiology Clinic, University Hospital Zurich; and Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.

The study is available in online journal of Radiological Society of North America, and the research objective was to evaluate late gadolinium enhancement (LGE), single–breath-hold three-dimensional inversion recovery MRI sequence for myocardial scar quantification and transmurality of myocardial infarction, in contrast to clinically recognized 2D sequence.

Established by institutional review board and written consent from patients, the study was comprised of 90 patients, with mean age of 54.4 years, presented with acute, sub-acute/chronic myocardial infarction cases. 1.5T MRI was utilized for to image them; the angular resolution was similar for 2D and 3D images. Bland-Altman plot and Pearson’s correlation coefficient were put to use for quantitative analogy of myocardial/scar mass, scar transmurality on five-point scale.

No significant deviation could be established amid collection of data of 2D and 3D, with respect to mean myocardial and scar tissue mass, and the mean deviation were assessed by. Except for acquisition time which was considerably shorter for 3D dataset, the compatibility of observations pertain to scar transmurality was good.

Conclusion: Three-dimensional late gadolinium enhancement MRI makes possible the assessment of transmurality and scar tissue mass in patients with acute or chronic myocardial infarction, at considerably reduced acquisition times, in contrast with 2D LGE magnetic resonance imaging.

Plateau curve enhancement and non-mass lesions are prevalent MRI findings of pure ductal carcinoma in situ.

The lesions with mass visibility on MRI findings have more suspicious kinetic features, than non-mass lesions.

 

The medical research study was conducted by Jeong-Ah Kim, Eun Ju Son, Ji Hyun Youk, Eun-Kyung Kim, Min Jung Kim, Jin Young Kwak and Joon Jeong from Department of Radiology and Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.

The study is available in online journal of American Roentgen Ray Society, and the research objective were to examine the kinetic and morphologic features of pure ductal carcinoma in situ, and MR images, and to equate the kinetic characteristics in relation to mammographic/sonographic findings, MRI lesion type and histopathologic factors.

About 67 patients presented with histologically demonstrated pure ductal carcinoma in situ were picked up for the study. Breast Imaging-Reporting and Data System (BIRADS) was utilized to analyze MRI findings, without pathological data. Quantitative variables of enhancement pattern were calculated for lesions, along with assessment of histological factors of hormone receptor and c-erbB-2 expression status, nuclear grade etc.

Independent assessments were made for sonographic and mammographic findings, without facts about MRI, and kinetic features were equated, in relation to MRI lesion type, mammographic/sonographic finding and histopathologic factors.

About the results, the prevalent morphological appearance was a non mass lesion with diverse enhancement, where the pure ductal carcinoma in situ lesions displayed inconsistent enhancement patterns composed of plateau, persistent and washout curves. Other than correlation of MRI lesion type with mean enhancement slope, time to peak enhancement and same of sonographic findings with time to peak enhancement, there was were no statistically significant relationship amid histopathologic factors/mammographic finding and kinetic features.

Conclusion: Plateau curve enhancement and non-mass lesions were prevalent MRI findings of pure ductal carcinoma in situ. In contrast to non-mass lesions, the lesions with mass appearance at MRI findings had more leery kinetic features.

Functional MRI is feasible for avoidance of increased number of negative biopsies.

Two and more imaging variables have no effect on positive detection rate of cancer.

 

The medical research study was conducted by Joan C. Vilanova, Carles Barceló-Vidal, Josep Comet, Maria Boada, Joaquim Barceló, Joana Ferrer and Joan Albanell from Department of MRI, Clínica Girona; Department of Medical Science, Faculty of Medicine, University of Girona; Department of Radiology, Hospital St. Caterina; Department of Computer Science and Applied Mathematics, University of Girona, and Department of Urology, Hospital Dr. J. Trueta, Girona, Spain.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to evaluate  predictive values for detection of prostate cancer by MRI, through functional MRI sequences (diffusion weighted, MR spectroscopy, dynamic contrast enhanced imaging) and MRI morphological assessment (T2 weighted images), and the free/total prostate specific antigen ratio (PSA: alone/combined).

About 70 patients were included in the contemplative study that have had 1.5 T endorectal MRI, prior biopsy, where the probability of cancer was stratified on a five point scale.

The imaging data were equated with biopsy-histology reports. Estimated accuracy levels from regions under receiver operating characteristic curves (ROC curves) through hemiprostate analysis results were analyzed by, where the probability value less than 0.05 marked statistical significance.

About the results, in comparison to stand-alone variables, the model with combination variables was more precise. Combination of imaging variables with free/total prostate specific antigen ratio (PSA), in particular morphologic imaging with T2 sequence, diffusion weighted imaging and free/total PSA ratio-MR spectroscopy-DWI showed similar precision accuracy, as that of the complete model, with negative predictive values of 91.0% and 89.5%, in the order given.

Models with combination of two imaging variables – MR spectroscopy/diffusion weighted imaging (85%) and T2 weighted imaging/diffusion weighted imaging (84.8%)  demonstrated precision similar to that of combination of all other imaging variables.

Conclusion: The combination of at the least one functional technique with free/total PSA ratio is more precise than combination of imaging variables only, in detection of cancer. The utility of two and more imaging variables have no effect on positive detection rate – and functional MRI scan is feasible for avoidance of increased number of negative biopsies.

MRI & CT cross-sectional imaging is vital for determination of stage of distant and local cancer spread.

 

The medical research study was conducted by Nishat Bharwani, Andrea G. Rockall, Anju Sahdev, Maria Gueorguiev, William Drake, Ashley B. Grossman and Rodney H. Reznek from Imaging Department, St. Bartholomew’s Hospital, and Department of Endocrinology, Barts & The London NHS Trust, London, United Kingdom.

The medical research review is available online in American Journal of Roentgenology. Adrenocortical carcinoma (ACC) is a malignant neoplastic disorder of the adrenal glands, and arises from the cortical moietie of the suprarenal glands.

Enhanced use of cross-sectional imaging for inappropriate causes and reasons has led to greater amount of adrenocortical carcinomas recognized out coincidentally at an early cancer stage. Identification of distinctive imaging, clinical/biochemical findings is essential for swift analysis and medical intervention for early relevant remedies/therapies.

Conclusion: MRI & CT cross-sectional imaging is vital for determination of stage of distant and local cancer spread. At present, complete surgical removal  is one potentially curative therapy for Adrenocortical carcinoma, as the information gathered through computed tomography and magnetic resonance imaging is vital for surgical guidance and for effective patient management and care.

For monoexponential analysis and the distribution function model – renal allografts with diffusion weighted imaging correlated well.

 

The medical research study was conducted by Dirk Blondin, Rotem Shlomo Lanzman, Janina Klasen, Axel Scherer, Falk Miese, Patric Kröpil and Hans-Jörg Wittsack from Institute of Radiology, University Hospital Duesseldorf, Germany.

The study is available online in American Journal of Roentgenology, and the research objective was to evaluate the clinical significance of monoexponential and distribution function models of diffusion weighted imaging in renal allografts, as contrast enhanced MRI due to nephrogenic fibrosing dermopathy is problematical in renal allograft.

About 23 patients were categorized into 3 different group on basis of stable renal allograft function for at the least 6 months (A); transplantation in past 30 days with good renal allograft function (B); decrease/acute deterioration in renal allograft function (C). Coronal T1 weighted, axial T2 weighted and paracoronal DWI sequences with 16 b values were carried out on 1.5T MRI scanner. ROI based analysis of apparent diffusion coefficient of the renal cortex was utilized by.

Mean ADC values were assessed over monoexponential analysis and distribution function for different patient groups – A, B and C respectively. The deviation amidst combination of A & B, and C was significant for both statistical models.

Conclusion: for monoexponential analysis and the distribution function model – renal allografts with diffusion weighted imaging correlated well with renal function, on unenhanced evaluation. For both analytical models, there was no statistically relevant difference in renal allograft function and apparent diffusion coefficient values, but the distribution function demonstrated best regression.

The deviations in scanning capacity – MRI/CT may transform clinical management aspects, of patients demonstrated with stroke symptoms.

 

The medical research was conducted by Max P. Rosen, MD, MPH and associates, of Department of Radiology, and the study results are available in the Journal of the American College of Radiology.

The research objective was to understand about some of deciding factors of prescribing for diagnostic imaging, one of big and emerging constituent of healthcare overhead costs.

Researchers examined the effects of differential capacity of the imaging progress of patients with acute non hemorrhagic stroke.

The medical research team utilized data of patients from year 2001-2005, at US medical school and two-campus Canadian medical school that were discharged with diagnoses of acute non hemorrhagic stroke.

Their medical billing data coupled with clinical information systems were analyzed for identification of imaging studies, coexisting medical conditions (comorbidities), and patient disposition for varied reasons.

About 2677 patients, from US and Canadian hospital were included for the study, with patients analogous in age and dispersion of comorbid conditions.

MRI scan rate at the US hospital (95.75 scans per 100 patients) was double than either of the Canadian medical schools (41.39 scans per 100 patients).

The length of hospital stay and death rate were considerably shorter and lower at US medical school, in comparison to the Canadian medical school.

Multivariate regression analysis showed that only patient age/site were important forecasters of MRI usage, controlling for patient gender, comorbidities, and application of anticoagulants for prevention, or to hold back blood clotting.

The scanning usage differed at medical schools with differential access to scanning technologies. Usage frequency of MRI scanning was less in hospitals with inadequate access to the imaging modality.

Conclusion: Health system factors and patients are vital when translating the mechanisms for this disparity, its significance, and the possible relationship of imaging usage with patient outcomes.